Sworn Statement for Stipulations

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A pro se stipulation form (Form # FA-604) can be prepared by parties to an action for those issues upon which both parties agree.  Both parties need to be present when submitting the stipulation form for approval.  However, for those circumstances where arrears are being forgiven, the Sworn Statement is to be used.

The Sworn Statement form should ONLY be used with Pro-Se Stipulations (Form # FA-604) where:
             *parties are agreeing that any amount of arrears owed to one of the parties is being forgiven.

This form must be attached to the signed pro se stipulation form that is being submitted for approval and cannot stand alone.  It also requires that the signature be notarized.

The Sworn Statement form is linked for you to download and print out to be attached to the pro se stipulation form if the above conditions are met.

Download Sworn Statement for Stipulation Form


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