Family Matters: DAVID NGUYEN VS. SHERMAN LEWIS WRIGHT ET AL

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                                EJ-185

 

 

IR PARTY WITHOUT Al and AG’, 5 TELEPHONE.NO.:
ROBERT SANCHEZ, LEAD CHILD SUPPORT ATTORNEY 2\2 1% (866) 901-3212
[SAN MATEO COUNTY CHILD SUPPORT SERVICES :
555 COUNTY CTR FL2 :
REDWOOD CITY CA 94069-1665 200000000784183. .

‘Appearance Pursuant to Welt. & Inst. Code §§ 11475.1 arid 11478.2
NAME OF COURT: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO K I EZ EK

‘STREET ADDRESS: 400 MCALLISTER ST

MAILING ADDRESS: 400 MCALLISTER ST Stn Francisco Count
ty Superior
CITY AND 2P CODE: SAN FRANCISCO 94102-4512 Court
BRANCH NAME: UNIFIED FAMILY COURT - FAMILY LAW DEC 0 5 2019

 

PLAINTIFF DAVID QUANG NGUYEN . CLERK QF THE COURT
SHERMAN LEWIS WRIGHT, FORD MOTOR COMPANY, CHARIOT Transit! =

DEFENDANT Nc,, AND DOES 1 TO 30 Deputy Clork

 

CASE NUMBER:

. NOTICE OF-LIEN . . CGC-19-576056
(Attachment-Enforcement of Judgment)

 

 

 

 

 

ALL PARTIES IN THIS ACTION ARE NOTIFIED THAT .
1. A lien is created by this notice under -
a. [_] Article 3 (commencing with section 491:410) of Chapter 11 of Title 6.5 of Part 2 of the Code of Civil Procedure. -
b. [XX] Article § (commencing with section 708.410) of Chapter 6 of Title 9 of Part 2 of the Cade of Civil Procedure.
2. The lien is based on a . .
a. [(_] rightto attach order and an order permitting the creation of a lien (copies attached).
b. [<] money judgment. - ,

3. The right to attach order or the money judgment is entered in the following action:
a. Title of court (specify): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO
b. Name of case (specify): DAVID NGUYEN vs. STEPHANIE TSAt
c. Number of case (specify): FAMO108047. . : :
d. [5X] Date of entry of judgment (specify): 1/10/2011; 6/23/2013; 8/25/2016, and 10/10/2019
e. [__] Dates of renewal of judgment (specify): .
4, The name and address of the judgment creditor or person who obtained the right to attach order are (specify):

SAN MATEO COUNTY CHILD SUPPORT SERVICES PO BOX 8084
REDWOOD CITY CA 94063-0984

. The name and last known address of the judgment debtor or person whose property is subject to the right to attach order are (specify):
DAVID QUANG NGUYEN .
(address is on file with DCSS pursuant to Family Code §17212)
6. The amount required to satisfy the judgment creditor's money judgment or to secure the amount to be secured by the attachment
at the time this notice of lien is filed is $80,968.72 .

”. The lien created by this notice attaches to any cause of action of the person named in item 5 that is the subject of this action or proceeding and to that
person's righfs to money or property under any judgment subsequently procured in this action or proceeding.

- 8. No.compromise, dismissal, settlement, or satisfaction of this action or proceeding or any of the rights of the person named initem .
5 to money or property under any judgment procured in this action or proceeding may be entered into by or on behalf of that person,
and that person may not enforce any rights to money or property under any judgment procured in this action or proceeding by a
writ or otherwise, unless one. of the following requirements is satisfied: .
a. the prior approval by order of the court in this action or proceeding has been obtained;
b. the written consent of the person named in‘item 4 has been obtained or that person has released the lien; or
c. the money judgment of the person’named in item 4 has been satisfied. ~

a

~N

 

NOTICE The person named in item 5 may claim an exemption for all.or any portion of the money or property.
within 30 days after receiving notice of the creation of the lien. The exemption is waived if it is not claimed‘in
time. : : :

 

 

 

 

 

 

Date: 11/27/2019 ’
ERIC N. TANNENWALD, Child Support Attorney
TIYPE OR PRINT NAME) 6
Farm Approved by the NOTICE OF LIEN P
Judicial mie *
Ar-460, E105 New January 1 1985) (Attachment-Enforcement of Judgment) CCP 491.410, 708.410.

£185 (05/96)Simple Report All Debt Ty;-
DAVID QUANG NGUYEN is required to pay STEPHANIE TSAN $1067.00 in CURRENT SUPPORT
Total Child Support Arrears Per Child :
‘Child Name Prior Period NCP Add-Ons NCP Support NCP Total OP Add-ons OP Support Op Total
KHLOE Not Applicable 0.00 0.00 0.00. 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00Court Case Number: 0108047
Petitioner Name: DAVID NGUYEN
Respondent Name: STEPHANIE TSAN
Other Parent Name:

 

Guideline Calculation Results Detail

 

 

 

NCP Other Parent
Tax Setting Details
Federal Tax Settings
Include Self-Employment Taxes 4 NO NO
Include FICA YES YES
Include Medicare YES YES
Include Advanced Earned income Credit NO NO
Number of Children for Child Care Credits 0 1
Number of Children for Earned Income Credits 0 1
Number of Children for Child Tax Credits oO 1
Parent is Blind NO NO
Parent is 65 or Older NO NO.
New Spouse is Blind NO NO
New Spouse is 65 or older NO No
Married Filing Separately, Lived with Spouse Part of the year NO Ne}
State Tax Settings . ‘
Include California State Income Taxes Yes Yes
California State Disability Insurance YES YES
Dependency Credit for Dependent Parent(s) NO NO
Joint Custody Head of Household Credit NO NO.
California Renter's Credit Yes YES
Number of Children for Child Tax Credits ° “4
Include Other State Income Taxes NO NO
Other State Tax Rate
Other State Tax Amcunt
Deduction type when NCP and Other Parent are Married Filing Separately :
Monthly Income Information NCP Other Parent
|Wages/Salary 4680.00 4160.00
"NCP: Based on earned income: $4680.00 MONTHLY
Other Parent: Based on eared income: $24.00 HOURLY WAGE, 40 hours / week
Self-Employment Income 0.00 0.00
Unemployment Compensation 0.00 0.00
Disability (Taxable) 0.00 0.00
imputed Income NONE NONE
Other Taxable Income 0.00 0.00
Interest Received 0.00 0.00
Nonqualified Dividends 0.00 0.00
Qualified Dividends 0.00 0.00
Other Income 0.00 0.00
Short-Term Capital Gains 0.00 0.00
Long-Term Capital Gains 0.00 0.00
Rental Income 0.00 0.00
Social Security Income (Taxable) 0.00 0.00
Line 4e from IRS Form 4952 0.00 0.00
Unrecaptured Section 1250 Gains 0.00 0.00
Royalties 0.00 0.00
Other Taxable lncome Adjustments 0.00 0.00
(Other Non-Taxable Income 0.00 0.00
Social Security Income (Non-Taxable) 0.00 0.00
Other Non-Taxable Income , 0,00 0.00
Tax Exempt Interest 0.00 0,00
Disability 0.00 0.00
Worker's Compensation 0.00 0.00
Public Assistance and Child Support Received 0,00 0.00
Public Assistance 0.00 0.00
Child Support Received 0.00 0.00
INew-Spouse Income 0.00 * 0,00
Wages/Salary 0.00 “0.00
Self-Employment income 0.00 0,00
Social Security Income (Taxable) 0.00 0.00
Social Security Income (Non-Taxable) 0.00 0.00
Other Taxable Income 0.00 0.00
Spousal Support Paid Other Marriage 0.00 0.00
Retirement Contribution if Adjustments to Income 0.00 0.00
Reauired Union Dues . 0.00 0.00
Necessary Job-Related Expenses 0.00 0.00Guideline Calculation Results Detail

* Court Case Numb
Petitioner Nam
Respondent Nam

Other Parent Name:

 
 
 
 
 

 

 

 

NCP Other Parent
Monthly Deduction Information
Child Support Paid (Other Relationships) 0.00 0,00
Spousal Support Paid (This Relationship) 9.00 0.00
Property Tax 0,00 0.00
Mortgage Interest 0.00 0.00
Other Itemized Deductions . 0.00 0,00
Other Medical Expenses 0.00 0.00
Deductable Interest Expenses 0.00 0.00
Contribution Deduction 0.00 0.00
Miscellaneous Itemized 0.00 0.00
Required Union Dues 0.00 0.00
Health Insurance Premium 0.00 168.00
Health Insurance (Pre-Tax) 0.00 168.00
Health Insurance (Post-Tax) 0.00 0,00
Wage Deduction (Pre-Tax) 0.00 0.00
Wage Deduction (Post-Tax) 0.00 0.00
Retirement Contributions 0,00 208.00
Mandatory Retirement (Tax-Deferred) t 0.00 0.00
Mandatory Retirement (Non-Tax-Deferred) 0.00 0.00
Voluntary Retirement (Tax-Deferred) 0.00 208,00
Other Guideline Deductions 0.00 0.00
‘Spousal/Other Partner Support Paid Other Relationship 0.00 0.00
Necessary Job-Relaled Expenses 0.00 0.00
State Adjustments
State Adjustments to Income . 0.00 0,00
State Adjustments to Itemized Deductions 0.00 0.00
Monthly Hardship Deduction
Hardship Deduction Amount 0.00 0.00
Hardship Deduction Children 0.0 0.0
Hardship Deduction Expenses
Extraordinary Health Expenses 0.00 0.00
Uninsured Catastrophic Losses 0,00 0.00
Other Tax Deductions 0.00 0.00
Adjustments to Income 0.00 0,00
Other Discretionary Deductions ‘ 0.00 0.00
‘Alternative Minimum Tax Information 0.00 0.00
Certain Interest on Home Mortgage 0.00 0.00
Tnvestment Interest 0.00 0.00
Post-1986 Depreciation 0.00 0.00
Adjusted Gain or Loss 0.00 0.00
incentive Stock Options 0.00 0.00
Passive Activities 0.00 0.00
Estates and Trusts, Schedule K-1 0.00 0.00
‘Tax Exempt interest From Private Activity Bond 0.00 0.00
Other Preferences 0.00 0.00
Allernative Minimum Tax Operating Loss Deduction 0.00 0.00FL-692

 

 

   

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN MATEO FOR COURT USE ONLY
STREET ADDRESS: 400 COUNTY CTR ‘
MAILING ADDRESS: 400 COUNTY CTR: (ENDORSED)
CITY AND ZIP CODE: REDWOOD CITY 94063-1662,
BRANCH NAME: SOUTHERN BRANCH 200000000784183 SAN MATEO COUNTY
PETITIONER/PLAINTIFF: DAVID NGUYEN MAY 2 8 2013
RESPONDENT/DEFENDANT: STEPHANIE TSAN , : Clerk of the Superior Ci
OTHER PARENT: = BIL BBY
|CASE NUMBER:
CX] MINUTES AND PRI ORPER = [_] JUDGMENT 108047
[] RECOMMENDED ORDER ‘

 

 

 

 

This form may be used for preparation of court minutes and/or as an alternative to form FL-615, FL-625, FL-630, FL-665, or FL-687.
If this form is prepared as both court minutes and an alternative to one of these forms, then the parties do not need to prepare any
additional form of order.

4. This matter vag. as follows: [__] Uncontested [[_] By stipulation [3%] Contested
a. Date: Time: A: 7m, Department:
b. Judicial of [aS oo) x-M Crexhin ” Oo Tadd bro Tempore [3X] Commissioner
Court reporter (name): R« SAN MIGUEL ‘

Court clerk (name): © , MPS O N Bailiff (name): . ENT
c. [_] Interpreter(s) G -THOMPS D OUpre
for (name): (specify language):

(1) Petitioner present (—) Attorney present (name):

[3%] Respondent present [—] Attomey present (name):

(J Other parent present [__] Attorney present (name):

. Attorney for local child support agency (name): IN/DAD MADR OAL

. The parent ordered to pay support for purposes. is order is the cy petitioner [[—] respondent [_] other parent.
{J Other (specify): .

rsemoao

2. [] This is a recommended order/judgment based on the objection of (specify name):
3. a. [_] This matter is taken off calendar.
b. [2] This entire matter is denied [[_] with [[7] without prejudice.
c. [[_] This matter is continued at the request of the [“] local child support agency [1 petitioner [[~] respondent
{] other parent to:
Date: Time:. Department:
(Specify issues):
(1 Petitioner [[—] Respondent [[—] Other parent _ is ordered to appear at that date and time.
d. ((-] The court takes the following matters under submission (specify):

4. (_] Order of examination
The [__] petitioner [7] respondent [(—] other (specify): ‘was sworn and examined.
(D Examination was held outside of court. .
5. Referrals
a. [_] The parties are referred to family court services or mediation.
b. [] Petitioner [-_] Respondent [__] Other parent is referred to the family law facilitator.
c, [-_] Other (Specify):

THE COURT FINDS .
6.) Respondent [—] Petitioner [[~] Other parent [[_] was [_] wasnot served regarding this matter.
7.) Respondent [-_] Petitioner [[7] Other parent [——] admits [7] denies parentage.

8. [_] The parents of the children named below in item 14a are (specify names):

 

 

 

Page 1 of 4
‘Adopted Mandatory U 7
net eee Corres cress; MINUTES AND ORDER OR JUDGMENT a ee our oa gov
‘Judicial Council of Califomia (Governmental) il] ill lL aM ti mM Hi l|
71-692 Rev. July 1, 2011} .
DD2389911813FL-692

 

 

|. PETITIONER/PLAINTIFF: DAVID NGUYEN CASE NUMBER:
RESPONDENT/DEFENDANT: STEPHANIE TSAN 0108047
OTHER PARENT:

 

 

 

9. [2] Respondent [_] Petitioner [] Otherparent has read, understands, and has signed the Advisement and
Waiver of Rights for Stipulation (Governmental) (form FL-694). He or she gives up those rights and freely agrees that a judgment
may be entered in accordance with these findings.

10. a, Guideline support amount: $ ]{Q- 00
b. This order [X] is [_] isnot based on the guideline.
c. [[] The attached Guideline Findings Attachment (Governmental) (form FL-693) is incorporated into these findings.
d. (30) A printout, which shows the calculation of child support payable, is attached and must become the court's findings.

e. [__] The child support agreed to by the parentsis [—_] below [above __ the statewide child support guideline.
The amount of support that would have been ordered under the guideline formula is $ per month. The parties
have been fully informed of their rights concerning. child support. Neither party is acting out of duress or coercion.

Neither party is receiving public assistance, and no application for public assistance is pending. The needs of the children
will be adequately met by this agreed-upon amount of child support. The order is in the best interest of the children. If the
order is below the guideline, no change of circumstance will be required for the court to modify this order. If the order is
above the guideline, a change of circumstance will be required for the court to modify this order.

f. [] The low-income adjustment applies.
[] The low-income adjustment does not apply because (specify reasons):

41.) Arrearages from (specify date): through (specify date):
are $ [1] including interest [__] interest not computed and not waived.
THE COURT ORDERS :

42. All orders previously made in this action must remain in full force and effect except as specifically modified below.
43. [=] Genetic testing must be coordinated by the local child support agency.
a.{] Respondent [C1] Petitioner [—] Mother of the children

() Other (specify):
and the minor children must each submit to genetic testing as directed by the local child support agency.

b. (] The parent ordered to pay support must reimburse the local child support agency for genetic testing costs of $
14, a. [XX] The parent ordered to pay support is the parent of the children listed below and must pay current child support for them.

[1 The court finds that there is sufficient evidence that the parent ordered to pay support is the parent of the children
listed below and therefore there is sufficient evidence to enter a support order.

Name of child Date of birth Monthly basic support amount
KHLOE KALIA TSAN NGUYEN 12/01/2009 ¢ 600.00

[£1] Additional children are listed on an attached page. .
b. m4] The parent ordered to pay support must pa additional support monthlv for actual child-care costs,
EX] (specify amount): $ (84-00 Pro yata Shore pew FC S4otl |
Payments must be made to the Ga State Disbursement Unit ( other party [[_] child-care provider.
. [] The parent ordered to pay support must pay reasonable uninsured health-care costs for the children:
(1 (specify amount): $ [1 one-half [7] (specify percent): percent of said costs.
Payments must be made to the [“—] State Disbursement Unit  [__] other party [1 health-care provider.
d. [=] The parent ordered to pay support must pay additional support monthly for the following (specify):
[J (specify amount): $ [1 one-half [J (specify percent):
Payments must be made to the [_] State Disbursement Unit [ other party.
e. [_] Other (specify):

2

 

NOTICE: Any party required to pay child support must pay interest on overdue amounts at the legal rate, which is
currently 10 percent per year.

FL802 Rev, Jay 1, 2071) MINUTES AND ORDER OR JUDGMENT _ Page 2 0f4
(Governmental)FL-692

 

 

 

 

 

[[ PETITIONERIPLAINTIFF: DAVID NGUYEN (CASE NUMBER:
RESPONDENTIDEFENDANT: STEPHANIE TSAN 0108047
OTHER PARENT:
14. f [X] Foratotalof $ 740.00 payable on the fist day of each month

beginning (date): fom | ,2Z0)3
g. [__] The low-income adjustment applies.

[1] The low-income adjustment does not apply because (specify reasons):. .-

h. Any support ordered will continue until further order of court, unless terminated by operation of law.

i. As provided in Family Code section 4007.5, the obligation of the person ordered to pay support will be temporarily
suspended for any period after the first 90 consecutive days in which the person ordered to pay support is incarcerated or
\ involuntarily institutionalized, unless that person has ‘the ability to pay support during that time or has committed certain
crimes. Immediately after the person ordered to’pay support is released: from incarceration or involuntary institutionalization,
the support order will restart in the same amount as it was before it was temporarily suspended.

15.[] The parent ordered to pay support [—_] The parent receiving support must'(1) provide and maintain health insurance
coverage for the children if available at no or reasonable cost and keep the local child support agency informed of the
availability of the coverage (the cost is presumed to be reasonable if it does not exceed 5% of gross income to add a child);
(2) if health insurance is not available, provide coverage when it becomes available; (3) within 20 days of the local child
support agency's request, complete and return a health insurance form; (4) provide to the local child support agency all
information and forms necessary to obtain health-care services for the children; (5) present any claim to secure payment or
reimbursement to the other parent or caretaker who incurs costs for health-care services for the children; and (6) assign any
rights to reimbursement to the other parent or caretaker who incurs costs for health-care services for the children. The parent
ordered to provide health insurance must seek continuation of coverage for the child after the child attains the age when the
child is no longer considered eligible for coverage as a dependent under the insurance contract, if the child is incapable of
self-sustaining employment because of a physically or mentally disabling injury, illness, or condition and is chiefly dependent
upon the parent providing health insurance for support and maintenance.

16.[_] The parent ordered to pay support may claim the children for tax purposes as long as all child support payments are
current as of the last day of the year for which the exemptions are claimed.

47.) Petitioner [__] Respondent [(_] Otherparent mustpayto [] petitioner [“7] respondent

[[) other parent
as [[_] spousal support [__] familysupport $ per month, beginning (date):
[—) payable on the day of each month.
48.[_] The parent ordered to pay support must pay child support for the following past periods and in the following amounts:
Name of child Period of support Amount
KHLOE KALIA TSAN NGUYEN
a. [(_] Other (specify):
b. [] Fora total of $ : payable $ . on the day of each month

beginning (date):
c. (1 Interest accrues on the entire principal balance owing and not on each installment as it becomes due.

49.[[_] The parent ordered to pay support owes support arrears as follows, as of (date):

a. [_] Child support: $ [{] Spousal support: $ J Family support: $ [) Other: $

b. [(_] Interest is not computed and is not waived.

c. [_] Payable: $ . on the day of each month
beginning (date): ,”

d, [1 Interest accrues on the entire principal balance owing and not on each installment as it becomes due.

20. No provision of this judgment can operate to limit any right to collect all sums owing in this matter as otherwise provided by law.

21. All payments, unless specified in items 14b, c, and d above, must be made to the State Disbursement Unit at the address listed
below (specify address): CALIFORNIA STATE DISBURSEMENT UNIT .
PO BOX 989067
WEST SACRAMENTO CA 95798-9067

F692 [Rev. July 1, 2014] MINUTES AND ORDER OR JUDGMENT Pape sor4
(Governmental) .FL-692

 

PETITIONER/PLAINTIFF: DAVID NGUYEN ‘CASE NUMBER:
RESPONDENT/DEFENDANT: STEPHANIE TSAN 0108047
OTHER PARENT:

 

 

 

 

22. An earnings assignment order Is issued. .

23. in the event that there is a contract between a party receiving support and a private child support collector, the party ordered to pay
support must pay the fee charged by the private child support collector. This fee must not exceed 33 4/3 percent of the total
amount if past due support nor may it exceed 50 percent of any fee charged by the private child support collector, The money
judgment created by this provision is in favor of the private child support collector and the party receiving support, jointly.

24. If" The parent ordered to pay support" box is checked in item 15, a health insurance coverage assignment must issue.

25.([_] Job search. (Specify name(s): must seek employment for
at least (specify number): jobs per week and report those job applications and results to the court and the local child
support agency at the continuance date. These job applications are to be made in person, not by phone, fax, or e-mail.

26.([_] For purposes of the licensing issue only, the parent ordered to pay support is found to be in compliance with the support
order in this action. The local child support agency must issue a release of license(s).

27.[-] Notwithstanding any noncompliance issues with the support order in this action, the court finds that the needs of the party
ordered to pay support warrant a conditional release. The local child support agency must issue a release of license(s). Such
release is effective only as long as the parent ordered to pay support complies with all payment terms of this order.

28. co A warrant of attachment/bench warrant issues for (specify name):
a. ((] Bailis set in the amount of $
- b. [] Senice is stayed until (date):

29. [=] The court retains jurisdiction to make orders retroactive to (date):
the issues of (specify: child ave. costs

  

30. XX] The court reserves jurisdiction over [_] allissues

31, The parents must notify the local child support agency in writing within 10 days of any change in residence or employment.

32. The Notice of Rights and Responsibilities (Health-Care Costs and Reimbursement Procedures) and Information Sheet on
, Changing a Child Support Order (form FL-192) are attached and incorporated.

33. [[_] The following person (the “other parent") is added as a party to this action (name):
34. (X] The court further orders (specify):

|. Peftionar shall nofih DCSS wt fre (8) clays of any change
in incoml w drvployrrvnt :
2: Once Petar be cares ermploged fill Pr, he shall pay

Bul of hil care COs. nie E

coutcla. chiA core “id ts dried as there

3 -Peitiney's request + oa of ee hil he iS have
yisrtat

 

Approved as conforming to court order. ~

|-Date—.

(SIGHATURE

 

 

 

 

NATURE, ¢ JUDICIAL OFFICER

 

 

 

 

 

 

[0%] Number of pages attached: 3 [J Signature follows last attachment. °

‘

FL-692 [Rev. July 1, 2091] MINUTES AND ORDER OR JUDGMENT Page dots
(Governmental) .STATE OF CALIFORNIA - HEALTH AND HUMAN SERVIC AvENCY

DEPAR: mers’ OF CHILD SUPPORT SERVICES

Court Case Number; 0108047
Petitioner Name: DAVID NGUYEN
Respondent Name: STEPHANIE TSAN
‘Other Parent Name:

Guideline Calculation Results Summary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Monthly Support Totals NCP Other Parent
Monthly Child Support Amount 790.00 0.00
Basic Child Support Amount 606.00 0.00
Child Support Add-Ons Amount 184.00 | 0.00
. Child Care 0.00 600.00
Visits/Travel Expenses 0.00 0.00
School Expenses 0.00 0.00
Uninsured Health Expenses 0.00 0.00
Total Arrears Support Amount 0.00 0,00
‘Temporary Spousal Support Amount(N/A) 0.00 0.00
Monthly Tax/income Information (Tax Year: 2043 ) NCP’ Other Parent
Monthly Net Disposable income 2478.00 4238.00
Monthly Taxable Gross Income 3141.00 $291.00
Monthly Non-taxable Gross Income 0.00 0.00
Federal Adjusted Gross Income 3141.00 4731.00
Federal Taxable Income 2329.00 3373.00
Net Income of Parties With Support 1688.00 5028.00
Federal Tax Filing Status ‘SINGLE HEAD OF HOUSEHOLD
Number of Tax Exemptions (Federal) 1 2
State Tax Filing Status ‘SAME AS FEDERAL SAME AS FEDERAL
Number of Tax Exemptions (State) 1 2
Federal Tax Liabilities 313.00 321.00
State Tax Liabilities 78.00 31.00
FICA 240.00 405.00
Self-Employment Tax 0.00 0.00
DI 31.00 53,00
TANF/CalWORKS NO NO
Other Monthly Deduction Totals NCP Other Parent
Child Support Paid (Other Relationships) 0.00 0.00
Required Union Dues 0.00 0.00
Mandatory Retirement 0.00 0,00
Other Guideline Deductions 0.00 0.00
Health Insurance Premium 0.00 243.00
Hardship Deduction Amount 0.00 0.00
Hardship Deduction Children 0.0 0.0
Extraordinary Health Expenses 0.00 0.00
Uninsured Catastrophic Losses 0.00 0.00
Monthly Support Amounts Per Child
Child Name Date of Birth % Time with NCP NCP Add-Ons NCP Support NCP Total OP Add-Ons OP Support OP Total
KHLOE 2009-12-01 1.0 % 184,00 606.00 790.00 0.00 0.00 0.00
%
%
%
%
%
%
%
%
% :
Average % Time with NCP: 1.0 % 184.00 606.00 790.00 0.00 0.00 0.00
Guideline Findings:
DAVID QUANG NGUYEN is required to pay STEPHANIE TSAN $790.00 in CURRENT SUPPORT
Total Child Support Arrears Per Child
Child Name Prior Period NGP Add-Ons NCP Support NCP Total_OP Add-ons OP Support Op Total
KHLOE Not Applicable 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00Court Case Number: 0108047

- Petitioner Name: DAVID NGUYEN
Respondent Name: STEPHANIE TSAN

 

 

 

 

 

Other Parent Name:
Guideline Calculation Results Detail
NCP Other Parent
Tax Setting Details
Federal Tax Settings
Include Self-Employment Taxes NO No
Include FICA YES YES
Include Medicare YES YES
Include Advanced Eamed Income Credit YES YES
Number of Children for Child Care Credits 0 1
Number of Children for Earned Income Credits 0 1
Number of Children for Chitd Tax Credits 0 1
Parent is Blind NO NO
Parent is 65 or Older NO NO
New Spouse is Blind NO NO.
New Spouse is 65 or older NO NO
Married Filing Separately, Lived with Spouse Part of the year NO NO
State Tax Settings
Include California State Income Taxes YES YES
California State Disability Insurance YES YES
Dependency Credit for Dependent Parent(s) NO NO
Joint Custody Head of Household Credit NO NO
California Renter's Credit YES YES
Number of Children for Child Tax Credits 0 1
Include Other State Income Taxes No NO
Other State Tax Rate
Other State Tax Amount
Deduction type when NCP and Other Parent are Married Filing Separately
Monthly Income Information NCP Other Parent
Wages/Salary 3441.00 5291.00
NCP: Based on earned income: $25.00 HOURLY WAGE, 29 hours / week
Other Parent: Based on earned income: $2442.00 BI-WEEKLY
Self-Employment Income 0.00
Unemployment Compensation 0.00
Disability (Taxable) 0.00
Imputed Income NONE
Other Taxable Income 0.00
interest Received 0.00
Nonqualified Dividends 0.00
Qualified Dividends ' 0.00
Other Income 0.00
Short-Term Capital Gains 0.00
Long-Term Capital Gains 0.00 °
Rental Income 0,00
Social Security Income (Taxable) 0.00
Line 4e from IRS Form 4952 0.00
Unrecaptured Section 1250 Gains 0.00
Royalties 0.00
Other Taxable Income Adjustments 0.00
Other Non-Taxable Income 0.00
Social Security income (Non-Taxable) 0.00
Other Non-Taxable income 0.00
Tax Exempt Interest 0.00
Disability 0.00
Worker's Compensation 0.00
Public Assistance and Child Support Received 0.00 0.00
Public Assistance 0.00 0.00
Child Support Received 0.00 0.00
New-Spouse Income 0.00 0.00
Wages/Salary 0.00 0.00
Self-Employment Income 0.00 0.00
Social Security Income (Taxable) 0.00 0.00
Social Security Income (Non-Taxable) 0.00 0.00
Other Taxable Income 0.00 0.00
Spousal Support Paid Other Marriage : 0.00 0.00
Retirement Contribution if Adjustments to Income 0.00 0.00
Required Union Dues 0,00 0.00
Necessary Job-Related Expenses 0.00 0.00Court Case Number: 0108047
Petitioner Name: DAVID NGUYEN

 

 

 

 

Respondent Name: STEPHANIE TSAN
Other Parent Name:
Guideline Calculation Results Detail
NCP Other Parent
Monthly Deduction Information
Child Support Paid (Other Relationships) 0.00 0.00
Spousal Support Paid (This Relationship) 0.00 0.00
Property Tax 0.00 0.00
Mortgage Interest 0.00 0.00
Other Itemized Deductions 0.00 0.00
Other Medical Expenses 0.00 0.00
Deductable Interest Expenses 0.00 0.00
Contribution Deduction 0.00 0.00
Miscellaneous Itemized 0.00 0.00
[Required Union Dues 0.00 0.00
Health Insurance Premium 0.00 243.00
Health Insurance (Pre-Tax) . 0.00 0.00
Health Insurance (Post-Tax) 0,00 0.00
Wage Deduction (Pre-Tax) 0.00 243,00
Wage Deduction (Post-Tax) 0.00 0.00
Retirement Contributions . . 0.00 317.00
Mandatory Retirement (Tax-Deferred) 0.00 0.00
Mandatory Retirement (Non-Tax-Deferred) 0.00 0.00
Voluntary Retirement (Tax-Deferred) 0.00 317.00
(Other Guideline Deductions 0.00 0.00
‘Spousal/Other Partner Support Paid Other Relationship 0.00 0.00
Necessary Job-Related Expenses 0.00 0.00
State Adjustments
State Adjustments to income 0.00 0,00
State Adjustments to Itemized Deductions 0.00 0.00
Monthly Hardship Deduction
Hardship Deduction Amount 0.00 0,00
Hardship Deduction Children 0.0 0,0
Hardship Deduction Expenses
Extraordinary Health Expenses 0.00 0,00
Uninsured Catastrophic Losses 0.00 0.00
Other Tax Deductions . 0.00 417,00
Adjustments to Income 0.00 417.00
Other Discretionary Deductions . 0.00 0.00
Alternative Minimum Tax Information 0.00 0.00
Certain Interest on Home Mortgage 0.00 0.00
Investment Interest 0.00 0.00
Post-1986 Depreciation 0.00 0.00
Adjusted Gain or Loss 0.00 0.00
Incentive Stock Options 0.00 0,00
Passive Activities 0.00 0.00
Estates and Trusts, Schedule K-1 0.00 0.00
‘Tax Exempt Interest From Private Activity Bond 0,00 0,00
Other Preferences 0.00 - 0.00

Alternative Minimum Tax Operating Loss Deduction 0.00 0.00FL-692

 

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN MATEO FOR COURT USE ONLY
STREET ADDRESS: 400 COUNTY CTR
MAILING ADDRESS: 400 COUNTY CTR F I L E D
CITY AND ZIP CODE: REDWOOD CITY 84063-1662 SAN MATEO COUNTY
(BRANCH NAME: SOUTHERN BRANCH 200000000784183
AUG 2 5 2016

PETITIONERVPLAINTIFF: DAVID NGUYEN

RESPONDENTI/DEFENDANT: STEPHANIE TSAN - Clerk of the tor Cours
OTHER PARENT: ey

. CASE NUMBER:
DX] MINUTES AND [3] ORDER =] JUDGMENT FAMO108047

{-] RECOMMENDED ORDER
This form may be used for preparation of court minutes and/or as an alternative to form FL-615, FL-625, FL-630, FL-665, or FL-687.

If this form is prepared as both court minutes.and an alternative to one of these forms, then the parties do not need to prepare any
additional form of order.

4. This matter proceeded as follows: [X] Uncontested [7] By stipulation [—] Contested

 

 

 

 

 

a. Date: 08/25/2016 Time: 2:00 PM Department: 33
b. Judicial officer (name): CRISTINA MAZZEI (CJ Judge pro Tempore [XX] Commissioner
Court reporter (name): J. HAUPT
Court clerk (name): . z Bailiff (name): J SCHEPRTU
c. [_] Interpreter(s) Mia fPREZ
for (name): (specify language):

[ Petitioner present + ["_] Attorney present (name):
(] Respondent present [_] Attorney present (name):

(J Other parent present [—_] Attorney present (name):
Attorney for local child support agency (name): ROBERT SANCHEZ

.. The parent ordered to pay support for purposes of this order is the [[X] petitioner [—] respondent [) other parent.

. RC] Other (specify): Netter perty yas prefer

yar>ee

2. (J This is a recommended order/judgment based on the objection of (specify name):

3. a. [7] This matter is taken off calendar.
b. [] This entire matter is denied [—] with [7] without prejudice.
c. [7] This matter is continued at the request of the (-] local child support agency {) petitioner [—] respondent ~
(J other parent to:
Date: Time: Department:
(Specify issues):

(I Petitioner [—] Respondent [[—] Other parent is ordered to appear at that date and time.
d. ((_] The court takes the following matters under submission (specify):

4. (7) Order of examination
The [C7] petitioner ["_] respondent [J other (specify): “was sworn and examined.
(] Examination was held outside of court.
5. Referrals
a. [) The parties are referred to family court services or mediation.
b. [J Petitioner [] Respondent [—_] Other parent is referred to the family law facilitator.

c. [_] Other (specify):

THE COURT FINDS
6.) Respondent [_] Petitioner (_} Other parent [_] was [_] was not served regarding this matter.
7.) Respondent [—] Petitioner [—] Other parent [—) admits [—] denies parentage.

8. [_] The parents of the children named below in item 14a are (specify names):
Page 10f4

Adoptod for Altemative Mandatory Uso MINUTES AND ORDER OR JUDGMENT Family Code, §§ 17400, 17408

Form.
Instead of Form FL-615, FL-625, FL-630, FL-665, or FL-687 WWW.0OUTTS.C8.gOV
\Judieal Counel af Calfomia (Governmental) Daa ae
L692 [Rev. July 1, 2011]
DD2621261587FL-692

 

 

| PETITIONER/PLAINTIFF: DAVID NGUYEN |CASE NUMBER:
RESPONDENT/DEFENDANT: STEPHANIE TSAN FAM0108047
OTHER PARENT:

 

 

 

9. [J] Respondent [[_] Petitioner [] Other parent — has read, understands, and has signed the Advisement and
Waiver of Rights for Stipulation (Governmental) (form FL-694). He or she gives up those rights and freely agrees that a judgment
may be entered in accordance with these findings.

10. a. Guideline support amount: $$ %4~P, 0? t 3tl.0

b. This order [7M] is [(_] isnot based on the guideline.

c. [J The attached Guideline Findings Attachment (Governmental) (form FL-693) is incorporated into these findings.

d. (QJ Aprintout, which shows the calculation of child support payable, is attached and must become the court's findings.

e. (_] The child support agreed to by the parentsis [__] below [above __ the statewide child support guideline.
The amount of support that would have been ordered under the guideline formula is$ per month. The parties
have been fully informed of their rights concerning child support. Neither party is acting out of duress or coercion.

Neither party is receiving public assistance, and no application for public assistance is pending. The needs of the children
will be adequately met by this agreed-upon amount of child support. The order is in the best interest of the children. If the
order is below the guideline, no change of circumstance will be required for the court to modify this order. If the order is
above the guideline, a change of circumstance will be required for the court to modify this order.

f. (04 The low-income adjustment applies.
[J The low-income adjustment does not apply because (specify reasons):

11.2] Arrearages from (specify date): through (specify date):
are $ (C1 including interest | [_] interest not computed and not waived.
THE COURT ORDERS

412. All orders previously made in this action must remain in full force and effect except as specifically modified below.
13.2] Genetic testing must be coordinated by the local child support agency.
a.[<] Respondent [[_] Petitioner [[_] Mother of the children

[21 Other (specify): : :
and the minor children must each submit to genetic testing as directed by the local child support agency.

b. [=] The parent ordered to pay support must reimburse the local child support agency for genetic testing costs of $
14. a. [2] The parent ordered to pay support is the parent of the children listed below and must pay current child support for them.

[The court finds that there is sufficient evidence that the parent ordered to pay, support is the parent of the children
listed below and therefore there is sufficient evidence to enter a support order.

Name of child Date of birth Monthly basic support amount.
KHLOE KALIA TSAN NGUYEN 12/01/2009 $ 3 uF e”

[1 Additional children are listed on an attached page.
b. i] The parent ordered to pay support must pay additional support monthly for actual child-care costs:
LX] (specify amount): $ 21 (07 [5 one-half [=] (specify percent): percent of said costs.
Payments must be made tothe [2] State Disbursement Unit (7 other party [J child-care provider.
c. [) The parent ordered to pay support must pay reasonable uninsured health-care costs for the children:
[) (specify amount): $ [[] one-half [=] (specify percent): percent of said costs.
Payments must be made tothe [—_] State Disbursement Unit {J other party [—_] health-care provider.
d. [7] The parent ordered to pay support must pay additional support monthly for the following (specify):
1 (specify amount): $ {J one-half [7] (specify percent): .
Payments must be made to the ["_] State Disbursement Unit (2) other party.
e. [] Other (specify):

 

NOTICE: Any party required to pay child support must pay Interest on overdue amounts at the legal rate, which is
currently 10 percent per year.

F602 [Rev. July 7, 2017] MINUTES AND ORDER OR JUDGMENT Page zot4
(Governmental)FL-692

 

 

  

 

 

 

|. PETITIONER/PLAINTIFF: DAVID NGUYEN ‘CASE NUMBER:
RESPONDENT/DEFENDANT: STEPHANIE TSAN : FAM0108047
OTHER PARENT: :
14, f DE] Foratotalof $ TOY. wv payable onthe Ly-p4 day of each month ,
beginning (date): Zot L .
g. (7) The low-income ach it dpplies. ;

(1) The tow-income adjustment does not apply because (specify reasons):

h. Any support ordered will continue until further order of court, unless terminated by operation of law.

As provided in Family Code section 4007.5, the obligation of the person ordered to pay support will be temporarily
suspended for any period after the first 90 consecutive days in which the person ordered to pay support is incarcerated or
involuntarily institutionalized, unless that person has the ability to pay support during that time or has committed certain
crimes. Immediately after the person ordered to pay support is released from incarceration or involuntary institutionalization,
the support order will restart in the same amount as it was before it was temporarily suspended.

15. [J The parent ordered to pay support [_] The parent receiving Support must (1) provide and maintain health insurance

coverage for the children if available at no or reasonable cost and keep the local child support agency informed of the
availability of the coverage (the cost is presumed to be reasonable if it does not exceed 5% of gross income to add a child);
(2) if health insurance is not available, provide coverage when it becomes available; (3) within 20 days of the local child
support agency's request, complete and return a health insurance form; (4) provide to the local child support agency all
information and forms necessary to obtain health-care services for the children; (5) present any claim to secure payment or
reimbursement to the other parent or caretaker who incurs costs for health-care services for the children, and (6) assign any
rights to reimbursement to the other parent or caretaker who incurs costs for health-care services for the children, The parent
ordered to provide health insurance must seek continuation of coverage for the child after the child attains the age when the
child is no longer considered eligible for coverage as a dependent under the insurance contract, if the child is incapable of
self-sustaining employment because of a physically or mentally disabling injury, illness, or condition and is chiefly dependent
upon the parent providing health insurance for support and maintenance. .

46, [] The parent ordered to pay support may claim the children for tax purposes as long as all child support payments are.

current as of the last day of the year for which the exemptions are claimed.

17.) Petitioner [£2] Respondent (C—] Other parent mustpayto ((—] petitioner [J respondent

([) other parent
as [C_] spousalsupport [__] family support $ per month, beginning (date):
[1 payable on the day of each month.

18.[[—] The parent ordered to pay support must pay child support for the following past periods and in the following amounts:
Name of child Period of support, Amount

KHLOE KALIA TSAN NGUYEN

a. [) Other (specify):

b. [_] Fora total of $ payable $ on the day of each month
beginning (date):

c. ‘J Interest accrues on the entire principal balance owing and not on each installment as it becomes due.

19. [7] The parent ordered to pay support owes support arrears as follows, as of (date):

a. [[) Child support: $ {] Spousal support: $ [1] Family support: $ () Other: $

b. [(] Interest is not computed and is not waived.

c [J Payable: $ ‘on the day of each month
beginning (date):

d, [1 Interest accrues on the entire principal balance owing and not on each installment as it becomes due.

20. No provision of this judgment can operate to limit any right to collect all sums owing in this matter as otherwise provided by law.

21. All payments, unless specified in items 14b, c, and d above, must be made to the State Disbursement Unit at the address listed
below (specify address): CALIFORNIA STATE DISBURSEMENT UNIT

PO BOX 989067
WEST SACRAMENTO CA 95798-9067

 

FL-692 [Rev. July 1, 2011) MINUTES AND ORDER OR JUDGMENT Page Sof 4

(Governmental)FL-692

 

PETITIONER/PLAINTIFF: DAVID NGUYEN CASE NUMBER:
RESPONDENT/DEFENDANT: STEPHANIE TSAN FAM0108047
OTHER PARENT:

 

 

 

 

22. An earnings assignment order is Issued.

23. tn the event that there is a contract between a party receiving support and a private child support collector, the party ordered to pay
support must pay the fee charged by the private child support collector. This fee must not exceed 33 1/3 percent of the total
amount if past due support nor may it exceed 50 percent of any fee charged by the private child support collector. The money
judgment created by this provision is in favor of the private child support collector and the party receiving support, jointly.

24. If "The parent ordered to pay support” box is checked in item 15, a health insurance coverage assignment must issue.

25.((_] Job search. (Specify name(s): must seek employment for
at least (specify number): jobs per week and report those job applications and results to the court and the local child
support agency at the continuance date, These job applications are to be made in person, not by phone, fax, or e-mail.

26.([—] For purposes of the licensing issue only, the parent ordered to pay support is found to be in compliance with the support
order in this action. The loca! child support agency must issue a release of license(s).

27.[] Notwithstanding any noncompliance issues with the support order in this action, the court finds that the needs of the party
ordered to pay support warrant a conditional release. The local child support agency must issue a release of license(s). Such
release is effective only as long as the parent ordered to pay support complies with all payment terms of this order.

28. [] A warrant of attachment/bench warrant issues for (specify name):
a. [_] Bailis set in the amount of $

b. [[] Senice is stayed until (date):
29, [] The court retains jurisdiction to make orders retroactive to (date):
30,7] The court reserves jurisdiction over [7] allissues [] the issues of (specify):

31. The parents must notify the local child support agency in writing within 10 days of any change in residence or employment.

32. The Notice of Rights and Responsibilities (Health-Care Costs and Reimbursement Procedures) and Information Sheet on
Changing a Child Support Order (form FL-192) are attached and Incorporated. .

33. [=] The following person (the “other parent’) is added as a party to this action (name):
34, [3] The court further orders (specify):

Resprndet wer present here The matter war cel led
oA, atyrted to the ew guideline amount .

 

 

 

Approved as conforming to court order.
AUG 2 5 2016
Date:
> Date: (YW
(SIGNATURE OF ATTORNEY FOR THE PARENT ORDERED TO PAY SUPPORT)
“TBIGNATURE OF ATTORNEY FOR LOCAL CHILD SUPPORT AGENCY) __ . JUDICIAL OFFICER

 

 

[—) Signature follows last attachment.

 

[1 Number of pages attached:

 

FL-802 [Rev. July 1, 2017] MINUTES AND ORDER OR JUDGMENT Page.or4
(Governmental)STATE OF CALIFORNIA - HEALTH ANO HUMAN SERVI: 3ENCY

DEPAr.snuelT OF CHILD SUPPORT SERVICES

Court Case Number; FAMO108047
Potitioner Name: DAVID NGUYEN

    

 

 

 

 

 

 

 

 

 

 

Respondent Nar STEPHANIE TSAN
Other Parent Name:
Guideline Calculation Results Summary
Monthly Support Totals NCP.
Monty hid Supper AnoURT 355.00 Other Parent
sic Su; Amount ‘
hid Suppor Add-Ons Amount Hore 000
Child Care : 0.00 421.00
Visits/Travel Expenses. 0.00 0.00
‘School Expenses 0.00 0.00
Uninsured Health Expenses 0.00 0.00
‘Total Arrears Support Amount 0.00 0.00
Temporary Spousal Support Amount (N/A) 0.00 0.00
Monthly Tax/income Information (Tax Year: 2016 ) NCP Other Parent
Monthly Net Disposable Income 1483.00 4894.00
Monthly Taxable & Non-Taxable Gross Income 1733.00 6227.00
Monthly Taxable Gross Income 1733.00 5563.00
Monthly Non-Taxabie Gross Income 0.00 0.00
Federal Adjusted Gross Income 1733.00 5563.00
Federal Taxable Income ‘ 875.00 4128.00
Net Income After Support 925.00 452,00
Federal Tax Filing Status SINGLE HEAD OF HOUSEHOLD
Number of Tax Exemptions (Federal) 1 2
State Tex Filing Status SAME AS FEDERAL SAME AS FEDERAL
Number of Tax Exemptions (State) 1 2
Federal Tax Liabilities 93.00 431,00
State Tax Liabilities 8.00 74,00
FICA (Social Security and/or Medicare) 133.00 476.00
Self-Employment Tax 0.00 0.00
CASDI 17.00 62.00
TANF/CalWORKS NO NO
(Other Monthly Deduction Totals NCP ‘Other Parent
Child Support Paid (Other Relationships) 0.00 0.00
Required Union Dues. 0,00 0.00
Mandatory Retirement 0.00 0.00
Job Related Expenses & Spousal Support Other Relationship 0.00 0,00
Health Insurance Premium 0.00 290.00
Hardship Deduction Amount 0.00 + 0.00
Hardship Deduction Children 0.0 0.0
Extraordinary Health Expenses 0.00 0.00
Uninsured Catastrophic Losses 0.00 0.00
Monthly Support Amounts Per Child - .
Child Name Date of Birth % Time with NCP___NCP Add-Ons NCP Support NCP Total OP Add-Ons OP Support ‘OP Total
KHLOE 2009-12-01 0.0 % 211.00 347.00 558.00 0.00 0.00 0.00
%
%
%
%
%
h
%
%
Average % Time with NCP: 0.0 % 211.00 347.00 558.00 0.00 0.00 0.00
| Guideline Findings:

 

 

DAVID QUANG NGUYEN Is required to pay STEPHANIE TSAN $558.00 In CURRENT ‘SUPPORT

Total Child Support Arrears Per Child

 

‘Child Name Prior Period WGP Add-Ons NCP Support NCP Total OP Add-Ono OP Support OP Total

 

KHLOE Not Applicable 0.00 0.00 0.00 \ 0.00 0.00 0,00

 

0,00 0.00 0,00 0.00 0.00 0,00

 

 

 

2016-08-25 11:49:26.233Court Case Number: FAM0108047
Petitioner Name: DAVID NGUYEN

 

 

 

 

Respondent Name: STEPHANIE TSAN
Other Parent Name: ©
[Guideline Calculation Results Detail NCP Other Parent
Tax Setting Information
Federal Tax Settings —
Include Self-Employment Taxes YES YES
Include FICA (Social Security and Medicare) YES YES
Include Medicare YES YES
Eamed Income Credit YES YES
Number of Children for Child Care Credits 0 4
Number of Children for Eamed income Credits ° 1
Number of Children for Child Tax Credits + 0 1
Parent is Blind NO NO
Parent is 65 or Older NO NO.
New Spouse is Blind NO NO
New Spouse is 65 or Older NO NO
Married Filing Separately, Lived with Spouse Part of the Year YES YES
State Tax Sottings
" Include Califomia State Income Taxes YES YES
California State Disability Insurance YES YES
Dependency Credit for Dependent Parent(s) NO NO
Joint Custody Head of Household Credit . NO. NO.
California Renter's Credit YES YES
Califomia Eamed Income Tax Credit NO NO.
Number of Children for Child Tax Credits 0 4
include Other State Income Taxes NO NO
Other State Tax Rate
Other State Tax Amount
Deduction type when NCP and Other Parent are Married Filing Separately
NCP Other Parent

 

Monthly Income Information
Wages/Salary 1733.00 6227.00

NCP; Based on eamed income: $10.00 HOURLY WAGE, 40 hours / week

 

Other Parent: Based on eamed income: $2874.00 BI-WEEKLY

 

| Self-Employment income 0.00 0.00
Unemployment Compensation 0.00 0.00
Disability (Taxable) 0.00 0.00
imputed Income NONE NONE
Total Other Taxable Income 0.00 0.00
Social Security Income (Taxable) 0.00 0.00
Other Income (Retirement, Annuity, SS Other Rel, Operating Losses, etc) . 0.00 0.00
‘Short-Term Capital Gains 0.00 0.00
Long-Term Capital Gains 0.00 0.00
Line 4e from IRS Form 4952 0.00 0.00
Unrecaptured Section 1250 Gains 0.00 0.00
Nonqualified Dividends 0.00 0.00
Qualified Dividends 0,00 0,00
Interest Received 0.00 0,00
Royalties 0.00 0.00
Rental Income 0,00 0,00
Other Taxable Income Adjustments 0.00 0.00
Total Other Non-Taxable Income 0.00 0.00
Other Non-Taxable Income 0.00 0.00
Social Security Income (Non-Taxable) 0.00 0.00
Tax Exempt Interest 0.00 0.00
Disabllity 9.00 0.00
Worker's Compensation : 0.00 0.00
Public Assistance and Child Support Recelved 0.00 0.00
Public Assistance 0.00 0.00
Child Support Received 0.00 0.00
|New Spouse Income & Deductions .
Wages/Selery 0.00 0.00
Self-Employment Income : 0.00 0.00
Social Security Income (Taxable) 0.00 0.00
‘Social Security Income (Non-Taxable) 0.00 0.00
Other Taxable Income 0.00 0.00
Spousal Support Paid Other Marriage 0.00 0.00
Retirement Contribution if Adjustments to Income 0.00 0,00
Required Union Dues 0.00 0.00
Necessary Job-Related Expenses 0.00 0.00

 

 

2016-08-25 11:49:26,233Court Case Number:

  

 

 

 

FAM0108047
Petitioner Name: DAVID NGUYEN
Respondent Name: STEPHANIE TSAN
Other Parent Name:
(Guideline Calculation Reaulte etal NCP Other Parent
Monthly Deduction Information
[Child Support Paid (Other Relationships) 0.00 0.00
Spousal Support Paid (This Relationship) . 0.00 0.00
Property Tax 0.00 0.00)
Mortgage Interest ‘0.00 0.00
Other Itemized Deductions 0.00 0.00
Other Medical Expenses . 0.00 0.00
Deductable Interest Expenses 0.00 0.00
Contribution Deduction 0.00 0.00
Miscellaneous Itemized 0.00 0,00;
Required Union Dues . 0.00 0.00,
‘Total Heatth insurance Premium . 0.00 290.00
Health insurance (Pre-Tax) 0.00 0.00
Health Insurance (Post-Tax) 0.00 0.00
Wage Deduction (Pre-Tax) 0.00 290.00
Wage Deduction (Post-Tax) 0.00 0.00
Retirement Contributions 0.00 374.00
Mandatory Retirement (Tax-Deferred) 0.00 0.00
Mandatory Retirement (Non-Tax-Deferred) : 0.00 0.00
Voluntary Retirement (Tax-Deferred) 0.00 974.00
|Other Guideline Deductions 0.00 0.00
‘Spousal/Other Partner Support Paid Other Relationship 0.00 0.00
Necessary Job-Related Expenses . 0.00 0.00
‘State Adjustments
‘State Adjustments to Income 0.00 0.00
State Adjustments to Itemized Deductions ‘ 0.00 0.00
Monthly Hardship Deduction - :
Hardship Deduction Amount 0.00 0.00
Hard