Homepage Blank Dcss 0053 Form
Outline

The DCSS 0053 form, also known as the Visitation Verification form, serves a critical function within the California child support system. Designed by the Department of Child Support Services, this form captures essential information regarding visitation arrangements between noncustodial parents and their children. It requires the individual completing the form to provide a detailed history of actual visitation over the past twelve months, including the number of hours spent with the child(ren) each month. The form distinguishes between custodial and noncustodial parents, ensuring that both parties can accurately report their visitation experiences. Additionally, it includes sections for shared custody and various types of visitation, such as regular, vacation, and holiday visitation, allowing for a comprehensive overview of the parenting arrangement. By requiring declarations of truthfulness and potential sharing of information between parents, the DCSS 0053 form promotes transparency and accountability in child custody matters.

Sample - Dcss 0053 Form

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY DEPARTMENT OF CHILD SUPPORT SERVICES
VISITATION VERIFICATION
DCSS 0053 (08/21/2016)
CSE Case Number:
Name of person completing form: I am the Custodial Party Noncustodial Parent
PART 1. ACTUAL VISITATION BY THE NONCUSTODIAL PARENT
INSTRUCTIONS:
Complete the visitation history by filling in the last 12 months and number of hours for each month the noncustodial parent
visited with the child(ren). If visitation is different for each child(ren), please complete one form for each child.
Example: If the last 12 months are June 2014 through May of 2015, you will complete June through December on the left
side of the chart below. You would put 2014 for the year. Then you would complete the right side of the chart with
January through May and put 2015 for the year.
MONTH/YEAR
NUMBER OF HOURS
THE NONCUSTODIAL
PARENT VISITED WITH
THE CHILD(REN) EACH
MONTH
MONTH/YEAR
NUMBER OF HOURS
THE NONCUSTODIAL
PARENT VISITED WITH
THE CHILD(REN) EACH
MONTH
January/ January/
February/ February/
March/ March/
April/ April/
May/ May/
June/ June/
July/ July/
August/ August/
September/ September/
October/ October/
November/ November/
December/ December/
TOTAL: TOTAL:
Page 1 of 2
PART 2. SHARED CUSTODY/VISITATION
CHECK ONE: Shared Custody
Visitation Only Neither
VISITATION HOURS:
Regular Visitation:
From
(specify day of the week) at (specify time)
(Circle one)
a.m./p.m.
To
(specify day of the week) at (specify time)
(Circle one)
a.m./p.m.
Vacation Visitation: Yes No
If Yes, please specify dates/times:
Summer Visitation: Yes No
If Yes, please specify dates/times:
Holiday Visitation: Yes No
If Yes, please specify dates/times:
Overnight Visitation: Yes No
If Yes, please specify dates/times:
Court-ordered custody/visitation arrangement: Yes No
Additional Information:
I declare to the best of my knowledge and belief that the above information is true and correct. I am aware that
this information may be provided to the other parent for their verification and that either party may be
required to provide documentation.
PRINT NAME
SIGNATURE
DATE
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY DEPARTMENT OF CHILD SUPPORT SERVICES
VISITATION VERIFICATION
DCSS 0053 (08/21/2016)
Page 2 of 2

Form Information

Fact Name Description
Form Purpose The DCSS 0053 form is used to verify visitation details between a noncustodial parent and child(ren) in California.
Governing Law This form is governed by California Family Code, specifically sections related to child custody and visitation rights.
Completion Instructions Users must document visitation history for the last twelve months, detailing the number of hours the noncustodial parent spent with the child(ren).
Shared Custody Option The form includes a section to indicate whether there is shared custody or visitation only, allowing for clarity in arrangements.
Legal Declaration By signing the form, the individual declares that the information provided is accurate to the best of their knowledge, acknowledging potential verification by the other parent.

Detailed Guide for Filling Out Dcss 0053

Completing the DCSS 0053 form involves providing detailed information about visitation arrangements and actual visitation history. Once you have filled out the form, it will be submitted to the appropriate child support services office for processing.

  1. Begin by entering the CSE Case Number at the top of the form.
  2. Fill in your name in the section labeled Name of person completing form.
  3. Indicate whether you are the Custodial Party or Noncustodial Parent.
  4. In Part 1, complete the visitation history for the last 12 months:
    • List each month from the past year in the MONTH/YEAR column.
    • For each month, enter the number of hours the noncustodial parent visited with the child(ren) in the corresponding NUMBER OF HOURS column.
    • If there are multiple children and visitation differs, complete a separate form for each child.
    • Calculate the total hours for the year and enter this in the TOTAL section.
  5. In Part 2, indicate the type of custody/visitation by checking one of the boxes:
    • Shared Custody
    • Visitation Only
    • Neither
  6. Provide details for VISITATION HOURS:
    • For Regular Visitation, specify the days and times.
    • If applicable, indicate dates/times for Vacation, Summer, and Holiday Visitation.
    • Indicate if there is Overnight Visitation and provide details.
  7. State whether there is a court-ordered custody/visitation arrangement by checking Yes or No.
  8. In the Additional Information section, declare the accuracy of the information provided.
  9. Finally, print your name, sign the form, and include the date.

Obtain Answers on Dcss 0053

  1. What is the purpose of the DCSS 0053 form?

    The DCSS 0053 form, also known as the Visitation Verification form, is used to document the visitation history between a noncustodial parent and their child or children. It helps establish the actual time spent with the child over the past year, which can be important for custody and support discussions.

  2. Who should fill out the DCSS 0053 form?

    Either the custodial party or the noncustodial parent can complete this form. It is essential that the person filling it out is accurately representing the visitation history to ensure the information is reliable and truthful.

  3. How should I complete the visitation history section?

    In the visitation history section, you will need to record the number of hours the noncustodial parent visited with the child each month for the past 12 months. If visitation differs for each child, a separate form must be filled out for each child. Make sure to enter the months and corresponding hours clearly.

  4. What if the visitation schedule changes frequently?

    If the visitation schedule changes often, it is still important to document the hours accurately as they occurred. Consider keeping a personal log of visits to help with this process. Consistency and accuracy are key in providing a true representation of visitation.

  5. What does “Shared Custody” mean on the form?

    Shared custody indicates that both parents have equal rights and responsibilities regarding the child’s upbringing. If you select this option, it suggests that both parents are actively involved in the child's life and share visitation rights. If you do not have shared custody, you should choose either “Visitation Only” or “Neither” based on your situation.

  6. Are there specific visitation types that need to be documented?

    Yes, the form includes sections for various types of visitation, such as regular visitation, vacation visitation, summer visitation, holiday visitation, and overnight visitation. You should specify the details for each type, including days, times, and any relevant dates.

  7. What should I do if I do not have a court-ordered custody arrangement?

    If there is no court-ordered custody arrangement, you can still complete the form by selecting “No” for that section. However, it may be beneficial to seek legal advice to understand your rights and responsibilities regarding visitation and custody.

  8. Is my information confidential?

    While the information provided on the DCSS 0053 form is intended for verification purposes, it may be shared with the other parent. It’s crucial to be aware that either party may be required to provide documentation to support the information given.

  9. What happens after I submit the DCSS 0053 form?

    After submitting the form, it will be reviewed by the appropriate authorities. They may contact you or the other parent for further clarification or documentation if needed. Keeping a copy of the submitted form for your records is advisable.

Common mistakes

When filling out the DCSS 0053 form, many people make mistakes that can lead to delays or complications in the child support process. One common error is failing to provide the correct CSE case number. This number is crucial for identifying the case and ensuring that the information is processed accurately. Double-check this number to avoid unnecessary issues.

Another frequent mistake is not completing the visitation history for the full 12 months. It’s essential to fill in each month accurately, as incomplete information can raise questions and may require you to resubmit the form. Make sure to account for every month in the specified period.

Some individuals forget to specify the number of hours the noncustodial parent visited with the child each month. This detail is vital for understanding the visitation pattern and should not be overlooked. Take the time to accurately record these hours to provide a clear picture of visitation.

Many people also fail to indicate if the visitation is different for each child. If there are multiple children involved, it's important to complete a separate form for each child. This ensures that each child's visitation history is documented correctly and avoids confusion.

In Part 2 of the form, checking the wrong box for custody type is another common error. Be sure to select either Shared Custody or Visitation Only based on your situation. Selecting the incorrect option can lead to misunderstandings about custody arrangements.

Another mistake involves not providing details for visitation hours. When specifying regular visitation times, it’s crucial to include the day of the week and exact times. Missing this information can create uncertainty about the visitation schedule.

Some individuals neglect to indicate whether vacation or holiday visitation applies. If the answer is yes, it’s important to specify the dates and times. This information helps clarify the visitation arrangement and ensures that both parties are aware of the schedule.

People often forget to sign and date the form before submitting it. A signature confirms that the information provided is accurate to the best of your knowledge. Without a signature, the form may be considered incomplete.

Lastly, failing to declare the information as true and correct can lead to serious consequences. It’s important to understand that this declaration is a legal statement, and inaccuracies can have repercussions. Always ensure that the information provided is honest and accurate.

By being mindful of these common mistakes, you can help ensure that your DCSS 0053 form is completed correctly and processed smoothly. Taking the time to review your form can save you from potential delays and complications in the future.

Documents used along the form

The DCSS 0053 form is a vital document used in child support cases to verify visitation arrangements between parents. Alongside this form, several other documents may be required to provide a complete picture of the custody and visitation situation. Below is a list of commonly used forms and documents that may accompany the DCSS 0053.

  • DCSS 0054 - Custody Verification Form: This form is used to confirm the custody arrangement between parents, detailing who has legal and physical custody of the child.
  • DCSS 0055 - Child Support Income Declaration: This document outlines the income of both parents, which is essential for calculating child support obligations.
  • DCSS 0056 - Visitation Agreement: A formal agreement that specifies the visitation schedule and conditions agreed upon by both parents.
  • DCSS 0057 - Request for Modification: This form is used to request changes to existing child support or visitation orders due to changes in circumstances.
  • DCSS 0058 - Notice of Hearing: This document notifies both parents of upcoming court hearings related to child support or custody issues.
  • DCSS 0059 - Parenting Plan: A comprehensive plan that outlines the responsibilities and rights of each parent regarding the child's upbringing and visitation.
  • DCSS 0060 - Child Support Worksheet: This worksheet helps calculate the amount of child support owed based on income and expenses.
  • DCSS 0061 - Affidavit of Support: A sworn statement detailing financial support provided by one parent to the other for the child's needs.
  • DCSS 0062 - Declaration of Noncompliance: This form is used to report any failure to comply with court-ordered visitation or support agreements.

These documents work together to ensure that all aspects of child support and visitation are clearly understood and legally recognized. Having the right forms completed accurately can help facilitate smoother communication and resolution between parents.

Similar forms

The DCSS 0053 form, used for documenting visitation verification in child support cases, shares similarities with several other legal forms. Each of these forms serves a purpose in family law, particularly concerning custody and visitation arrangements. Below is a list of eight documents that are comparable to the DCSS 0053 form:

  • Child Custody Agreement: This document outlines the custody arrangement between parents, detailing physical and legal custody terms, similar to how the DCSS 0053 records visitation specifics.
  • Visitation Schedule: A structured outline of when and how often a noncustodial parent can visit their child. Like the DCSS 0053, it provides a clear timeline and expectations for visitation.
  • Parenting Plan: This comprehensive document includes details about custody, visitation, and decision-making responsibilities. It parallels the DCSS 0053 by addressing visitation and the overall parenting framework.
  • Affidavit of Visitation: A sworn statement that provides evidence of visitation history. This form serves a similar purpose as the DCSS 0053, as both require verification of visitation details.
  • Modification of Custody Order: This document requests changes to an existing custody arrangement. It relates to the DCSS 0053 in that both may involve visitation adjustments based on the child's needs.
  • Child Support Worksheet: Used to calculate child support obligations, this form is connected to the DCSS 0053 since visitation can impact support calculations and obligations.
  • Visitation Log: A record maintained by parents to track visitation dates and times. This log is similar to the DCSS 0053 as it documents actual visitation occurrences.
  • Court Order for Visitation: A legal document issued by a court that specifies visitation rights. It is akin to the DCSS 0053 because both establish and confirm visitation arrangements.

Dos and Don'ts

When filling out the DCSS 0053 form, it is essential to be thorough and accurate. Here are six important do's and don'ts to keep in mind:

  • Do provide accurate visitation history for the last 12 months. Include the number of hours for each month.
  • Do complete a separate form for each child if visitation varies.
  • Do specify the exact times and days for regular and vacation visitation.
  • Do ensure your signature is included to verify the information you provide.
  • Don't leave any sections blank. Incomplete forms may delay processing.
  • Don't forget to check the appropriate box for shared custody or visitation only.

By following these guidelines, you can help ensure that your form is completed correctly and efficiently. Accurate information is crucial for effective communication and cooperation between parents.

Misconceptions

Misconceptions about the DCSS 0053 form can lead to confusion regarding its purpose and use. Here are nine common misconceptions:

  • The form is only for custodial parents. This form can be completed by both custodial and noncustodial parents to document visitation history.
  • It is not necessary to fill out the entire 12 months. The form requires a complete visitation history for the last 12 months, as this information is crucial for accurate record-keeping.
  • One form can be used for multiple children. If visitation differs for each child, a separate form must be completed for each child.
  • The form is optional. While it may not always be required, it is often necessary for legal proceedings related to child support and custody.
  • Visitation hours do not need to be documented. Accurate documentation of visitation hours is essential, as it may impact custody arrangements and child support calculations.
  • Only regular visitation needs to be recorded. The form allows for the documentation of various types of visitation, including vacation, holiday, and overnight visits.
  • It is not important to provide additional information. Providing additional information can help clarify visitation arrangements and any special circumstances.
  • Signing the form is not necessary. The form must be signed by the individual completing it, affirming that the information provided is true and correct.
  • The information is kept confidential. While efforts are made to protect privacy, the information may be shared with the other parent for verification purposes.

Key takeaways

When filling out the DCSS 0053 form, it is essential to keep several key points in mind to ensure accuracy and compliance with requirements.

  • Complete the visitation history: Record the actual visitation hours for the noncustodial parent over the last 12 months. This includes noting the number of hours spent with the child(ren) each month.
  • One form per child: If visitation differs for each child, complete a separate DCSS 0053 form for each child to provide a clear record.
  • Specify visitation details: Clearly indicate regular, vacation, summer, holiday, and overnight visitation hours, including specific dates and times when applicable.
  • Accuracy is crucial: Ensure all information is true and correct, as it may be shared with the other parent for verification purposes. Documentation may also be required from either party.