ATTACHMENT CR-6089
PEOPLE OF THE STATE OF CALIFORNIA VS.
DEFENDANT:
CASE NUMBER:
OTHER PERSONAL PROPERTY (Do not list household furniture and furnishings, appliances, or clothing.)
13. List anything of value not listed above owned in your name or jointly (continue on attached sheet if necessary):
Address where property is located
ASSETS
14. List all other assets, including stocks, bonds, mutual funds and other securities (specify):
15. Is anyone holding assets for you? Yes No If yes, describe the assets and give the name and address of the
person on entity holding each asset (specify):
16. Except for attorney fees in this matter and ordinary and routine household expenses, have you disposed of or transferred
any assets since your arrest on this matter? Yes No
If yes, give the name and address of each person or entity who received any asset and describe each asset (specify):
DEBTS
17. Loans (give detai
ls):
18. Taxes (give details):
19. Support arrearages (attach copies of orders and statements):
20. Credit cards (give creditor’s name and address and the account number):
21. Other debts (specify):
22. Monthly living expenses (other than what is listed above):
a. Housing costs: $
b. Utilities
: $
c. Food: $
d. Other: $
23. Any other information you want the Court to consider or
that the C
ourt has requested you provide.
I declare under penalty of perjury under the laws of the State of California that the information contained in this form is true and
correct.
Date:
(TYPE OR PRINT NAME) (SIGNATURE)
I, (name) , a certified interpreter, having been duly sworn, truly translated this form to the defendant in the (specify
language): language. The defendant indicated that he/she understood the contents of the form and he/she
completed the form.
Date:
(TYPE OR PRINT NAME) (SIGNATURE)
CR-6089 REV 11/05/15
DEFENDANT’S FINANCIAL STATEMENT IN SUPPORT
OF ANCILLARY FEES REQUEST
Page 2 of 2
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