FL-192 is the Judicial Council of California notice that explains how parents with a child support order handle childcare and uninsured health care costs, including the 90-day itemized statement and the reimbursement steps. It also carries an information sheet on changing a child support order and a page on support for incarcerated or confined parents. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form and its translations are published by the California courts at courts.ca.gov.
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What is FL-192?
Form FL-192, Notice of Rights and Responsibilities Regarding Child Support, is a three-page Judicial Council of California notice, subtitled "Childcare and Health Care Costs and Reimbursement Procedures," that tells parents what the law requires when a child support order covers childcare or uninsured health care costs.
Page 1 sets out eight points: the itemized statement a parent must give the other parent within a reasonable time, and no more than 90 days after the costs were given to them; proof of full or partial payment; payment by the notified parent; going to court over disputes, nonpayment, paid charges and attorney's fees; court-ordered insurance coverage; preferred health providers; and where to get help.
Page 2 is the Information Sheet on Changing a Child Support Order. It says an order stays the same until a parent asks the court to modify it, and lists the forms involved: FL-300, FL-390, FL-350, FL-150, FL-155, FL-320, FL-340 and FL-342, plus FW-001 and FW-003 for a fee waiver.
Page 3 covers Information About Child Support for Incarcerated or Confined Parents, including when support automatically stops and restarts.
The form is printed "Adopted for Mandatory Use" and cites Family Code, §§ 4007.5, 4010, 4062, 4063. The California courts' self-help page also lists it in Chinese Simplified, Korean, Spanish and Vietnamese. It is a notice, not a request: it does not ask the court for anything on its own.
Who needs to file FL-192?
The main audience is parents who have a California child support order that includes childcare costs or uninsured health care costs. The notice speaks to both sides: the parent who pays a cost and asks for reimbursement, and the parent who receives notice of a cost and owes a share.
- Parent who paid a cost: must give the other parent an itemized statement, and proof of payment when asking for reimbursement or direct payment to the provider.
- Parent who is notified: must pay their share within the time the court orders or, if none is set, within the periods listed on page 1.
- Parent who provides court-ordered health insurance: must use that coverage and any preferred provider the order designates.
- Parent who wants to change an order: page 2 explains which forms to file, how to serve the other parent, and that the existing order must be followed meanwhile. If the local child support agency is involved in the case, it must be served with any request to change support and must approve any agreement.
- Parent paying support who is confined: page 3 applies if the paying parent is confined against their will for more than 90 days in a row.
The form does not say who may sign for another person, and it asks for no signature. For help choosing forms, it points to the family law facilitator in your county.
When to file FL-192
FL-192 is not filed with a deadline of its own; its timing rules govern what you do once a childcare or uninsured health care cost arises. The statement of charges must reach the other parent within a reasonable time, and no more than 90 days after those costs were given to you. A parent who receives notice must pay their share within the time the court orders. If the court set no period, payment is due within 30 days of notice of the amount due, or under the health care provider's payment schedule, a written agreement between the parents, or a schedule the court adopted.
To change an order, the information sheet says the other parent must be served at least 16 court days before the hearing (add 5 calendar days if served by mail within California), and the Proof of Service filed at least one week before the hearing.
For incarcerated parents, support restarts on the first day of the first full month after release if the parent was released before January 1, 2024, and on the first day of the 10th month after release if released after January 1, 2024.
Documents you need
- Itemized statement of childcare or uninsured health care charges: give it to the other parent within a reasonable time, and no more than 90 days after the costs were given to you.
- Proof of payment, if you paid all of the costs: give it to the other parent and ask for reimbursement of their court-ordered share.
- Proof that you paid your share, if you paid only your share: give it to the other parent with a request that they pay their share directly to the provider, and the information they need to pay the bill.
- Form FL-300, Request for Order, or Form FL-390, Notice of Motion and Motion for Simplified Modification of Order for Child, Spousal, or Family Support, only if you are asking to change a child support order.
- Form FL-150, Income and Expense Declaration, or Form FL-155, Financial Statement (Simplified), with proof of income for the past two months, only if you are asking to change an order.
- Form FW-001, Request to Waive Court Fees, and Form FW-003, Order on Court Fee Waiver (Superior Court), only if the clerk asks for a filing fee and you cannot afford it.
- Proof of Service, signed by the person who served the other parent: take it with one copy to the clerk at least one week before your hearing.
- Tax returns from the last two years and proof of income for the past two months: bring them to the hearing if you are asking to change support.
How to fill out FL-192
Read the childcare and health care notice
Page 1 explains how your order may handle childcare and uninsured health care costs, either in the monthly payment or as a percentage reimbursement. The form has no entries to complete, so confirm what your own order says.
Prepare the itemized statement (point 1)
If you paid a cost, list the charges billed and give the statement to the other parent within a reasonable time, and no more than 90 days after the costs were given to you.
Gather proof of payment (points 2 and 3)
If you paid everything, give proof and ask for reimbursement of the other parent's court-ordered share. If you paid only your share, give proof, ask them to pay the provider directly, and give them the information needed to pay.
Check your payment deadline (point 4)
If you are notified of a cost, pay your share within the time the court orders. Without a court period, use the 30-day rule or one of the three other schedules listed.
Review the court and insurance points
Points 5 to 7 cover disputes, nonpayment, paid charges, attorney's fees, court-ordered coverage and preferred providers. Use forms FL-300 and FL-490 to get a court date.
Review the changing-an-order sheet
Page 2 lists the forms for a modification: FL-300 or FL-390, with FL-150 or FL-155 and proof of income. It also covers filing, fee waiver forms, service, the hearing and FL-340 and FL-342 afterwards.
Check the incarceration rules
Page 3 explains when support automatically stops (more than 90 days in a row of confinement), the exceptions, and the restart dates depending on release before or after January 1, 2024.
Review and download the completed PDF
Check the revision (Rev. September 1, 2024), then download or print the PDF from FillingPDF and keep it with your court papers.
How to submit FL-192
FL-192 names no address, portal or filing office of its own: it is a notice, and no step on it asks you to send the form to the court. What the notice does describe is how you act on it, through these channels:
- Between parents: give the other parent the itemized statement of childcare or uninsured health care charges, proof of payment, and the information needed to pay the provider.
- Court clerk: to dispute a request for payment, claim nonpayment, or change a support order, the form says to use forms FL-300 and FL-490 to get a court date (see FL-300-INFO), or FL-300 or FL-390 for a modification. File them with the court clerk and ask for a hearing date. The clerk may ask for a filing fee; if you cannot afford it, FW-001 and FW-003 are listed.
- Service: someone 18 or over, not you, must deliver copies of the filed forms to the other parent (and the local child support agency, if involved), and a Proof of Service is then filed with the clerk.
- Help: contact the family law facilitator in your county (www.courts.ca.gov/selfhelp-facilitators.htm) or visit https://selfhelp.courts.ca.gov/child-support.
FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Giving the other parent the itemized statement of charges more than 90 days after the costs were given to you.
- Paying only your share of a cost but not giving the other parent proof of payment and the information needed to pay the provider.
- Filing a request for the court to resolve a disputed payment request without first paying the requested amount.
- Stopping payments on your own after a job loss or income change: the current order stays in force until the court modifies it.
- Delivering the filed court papers to the other parent yourself; the form says someone 18 or over, not you, must serve them.
- Serving the other parent late: the sheet requires at least 16 court days before the hearing, plus 5 calendar days if mailed within California.
- Using other health care insurance or a non-preferred provider and expecting the other parent to share the extra cost; that parent pays the difference or the uncovered amount.
- Forgetting to serve the local child support agency when it is involved in the case.
- Assuming support always stops when the paying parent is confined; it does not stop automatically if that parent has money available to pay.
Frequently asked questions
What is form FL-192?
FL-192 is the Judicial Council of California's Notice of Rights and Responsibilities Regarding Child Support. It explains how parents handle childcare and uninsured health care costs under a support order, how to change an order, and how confinement affects support.
How long do I have to send the other parent a statement of childcare or health care costs?
Give an itemized statement within a reasonable time, and no more than 90 days after those costs were given to you. The notice applies this to childcare costs and to health care costs not paid by insurance.
How long does the other parent have to pay their share?
They must pay within the time the court orders. If the court set no period, payment is due within 30 days of notice of the amount, by the provider's schedule, by a written agreement between the parents, or by a schedule the court adopted.
What if I dispute a request for payment from the other parent?
You may ask the court to resolve the dispute, but only if you pay the requested amount before filing. If you dispute charges already paid, you must show the court the costs were unreasonable. A court may order an unreasonable parent to pay attorney's fees.
Does child support stop if the paying parent is in jail?
It stops automatically if the paying parent is confined against their will for more than 90 days in a row, as of September 27, 2022. It does not stop if that parent has money available to pay support.
Do I stop owing support if I lose my job?
No. The information sheet says the order stays the same until the court changes it. You must file a request to modify and the court must order a reduction; unpaid support keeps accruing interest.
Is there a Spanish version of FL-192?
Yes. The California courts' self-help page lists FL-192 in Spanish, as well as Chinese Simplified, Korean and Vietnamese.
Can I fill out FL-192 online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is independent of the California courts and does not file anything; any court request uses the forms and channels the notice describes.
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