DCSS 0569 web.pdf. DCSS 0569 web.pdf - childsup ca-2026

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The document is a form from the California Department of Child Support Services that provides instructions for completing a Declaration of Support Payment History. It requires individuals to detail monthly support payments, including amounts ordered and paid for various types of support such as child support and spousal support. The completed declaration may be shared with the other parent and must be accurate to determine any past due support owed.

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Click ‘Get Form’ to open the DCSS 0569 web.pdf in the editor.
Begin by entering your name in the designated field for the person completing the form.
Select your role by checking either 'Custodial Party' or 'Noncustodial Parent'.
Indicate the type of support payment history you are declaring by checking one of the options: Unreimbursed medical expenses, Child, Medical, Spousal, Family, or Other.
For each year listed, fill in the 'Amount Ordered' column with the support amounts due as per your court order.
In the 'Amount Paid' column, record the total payments made for each month. Ensure that these amounts correspond to when payments were actually made.
If necessary, attach additional sheets for more detailed entries and ensure all information is clear and accurate.
Finally, sign and date the declaration at the bottom of the form before submitting it.

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