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FL-160 SUPERIOR COURT OF CALIFORNIA, COUNTY OF (FreeDivorce.Com)

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FL-160
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
PARTY WITHOUT ATTORNEY OR ATTORNEY
STATE BAR NUMBER:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
CASE NUMBER:
PETITIONER'S
RESPONDENT'S
COMMUNITY AND QUASI-COMMUNITY PROPERTY DECLARATION
SEPARATE PROPERTY DECLARATION
See Instructions on page 4 for information about completing this form. For additional space, use Continuation of Property Declaration
(form FL-161
).
A
B C - D = E
F
ITEM BRIEF DESCRIPTION
NO.
DATE
ACQUIRED
GROSS FAIR
MARKET
VALUE
AMOUNT
OF DEBT
NET FAIR
MARKET
VALUE
PROPOSAL FOR DIVISION
Award or Confirm to:
PETITIONER RESPONDENT
1. REAL ESTATE $ $ $ $ $
2. HOUSEHOLD FURNITURE,
FURNISHINGS, APPLIANCES
3. JEWELRY, ANTIQUES, ART,
COIN COLLECTIONS, etc.
4. VEHICLES, BOATS, TRAILERS
5. SAVINGS ACCOUNTS
6. CHECKING ACCOUNTS
Page 1 of 4
Form Approved for Mandatory Use
Judicial Council of California
FL-160 [Rev. July 1, 2016]
PROPERTY DECLARATION
(Family Law)
Family Code, §§ 115, 2104, 2500-2660
www.courts.ca.gov
IN PRO PER
(925) 955-0000
CA
94596
WALNUT CREEK
1 PENNY LANE
JOHN SMITH
CONTRA COSTA
751 PINE STREET
P.O. BOX 911
JOHN SMITH
MARY SMITH
D19-00000
✖
✖
1 PENNY LAND, WALNUT CREEK
01/01/2015
600,000.
400,000.
200,000.
50%
50%
(SELL & DIVIDE PROCEEDS)
FURNITURE AT 1 PENNY LANE
VARIOUS
5,000.
5,000.
50%
50%
(DIVIDE IN KIND)
FURNITURE AT 2 BROWN STREET
VARIOUS
4,000.
4,000.
50%
50%
(DIVIDE IN KIND)
NO COMMUNITY JEWELRY
2010 TOYOTA CAMRY
01/01/2010
8,000.
8,000.
8,000
2013 TOYOTA HIGHLANDER
01/01/2013
15,000.
4,500.
10,500
10,500
BANK OF AMERICA ACCT. #4444
VARIOUS
3,500.
3,500.
3,500
BANK OF AMERICA ACCT. #5555
VARIOUS
850.
850.
850
BANK OF AMERICA ACCT. #6666
VARIOUS
635.
635.
635
A
B C - D = E
F
ITEM BRIEF DESCRIPTION
NO.
DATE
ACQUIRED
GROSS FAIR
MARKET
VALUE
AMOUNT
OF DEBT
NET FAIR
MARKET
VALUE
PROPOSAL FOR DIVISION
Award or Confirm to:
PETITIONER RESPONDENT
7. CREDIT UNION, OTHER
$ $ $ $ $
DEPOSITORY ACCOUNTS
8. CASH
9. TAX REFUND
10. LIFE INSURANCE WITH CASH
SURRENDER OR LOAN VALUE
11. STOCKS, BONDS, SECURED
NOTES, MUTUAL FUNDS
12. RETIREMENT AND PENSIONS
13. PROFIT-SHARING, IRAS,
DEFERRED COMPENSATION,
ANNUITIES
14. ACCOUNTS RECEIVABLE,
UNSECURED NOTES
15. PARTNERSHIP, OTHER
BUSINESS INTERESTS
16. OTHER ASSETS
17. ASSETS FROM CONTINUATION
SHEET
18. TOTAL ASSETS
Page 2 of 4
PROPERTY DECLARATION
(Family Law)
FL-160
FL-160 [Rev. July 1, 2016]
NONE
NOMINAL
TO BE DETERMINED
TRANSAMERICA POLICY #8888
01/01/2008
6,500.
6,500.
6500
TD AMERITRADE ACCT. #9999
VARIOUS
15,000.
15,000.
15000
BOB'S BURGERS PENSION PLAN
VARIOUS
QDRO
QDRO
BOB'S BURGERS 401(K) ACCT.
VARIOUS
9,250.
9,250.
QDRO
QDRO
NONE
NONE
NONE
668,585.
404,500.
264,085.
A B C D
ITEM DEBTS—
NO. SHOW TO WHOM OWED
DATE INCURRED TOTAL OWING
PROPOSAL FOR DIVISION
Award or Confirm to:
PETITIONER RESPONDENT
19. STUDENT LOANS
$ $ $
20. TAXES
21. SUPPORT ARREARAGES
22. LOANS—UNSECURED
23. CREDIT CARDS
24. OTHER DEBTS
25. OTHER DEBTS FROM
CONTINUATION SHEET
26. TOTAL DEBTS
Page 3 of 4
PROPERTY DECLARATION
(Family Law)
FL-160
SIGNATURE
(TYPE OR PRINT NAME)
Date:
I declare under penalty of perjury under the laws of the State of California that, to the best of my knowledge, the foregoing is a true
and correct listing of assets and obligations and the amounts shown are correct.
A Continuation of Property Declaration (form FL-161) is attached and incorporated by reference.
FL-160 [Rev. July 1, 2016]
NO COMMUNITY STUDENT LOANS
TO BE DETERMINED
NONE
NONE
VISA ACCOUNT #2222
VARIOUS
1,800.
1800
MASTERCARD ACCOUNT #3333
VARIOUS
2,200.
2200
4,000.
1,800.
2,200.
JOHN SMITH
INFORMATION AND INSTRUCTIONS FOR COMPLETING FORM FL-160
Property Declaration (form FL-160) is a multipurpose form, which may be filed with the court as an attachment to a
Petition or Response or served on the other party to comply with disclosure requirements in place of a Schedule of
Assets and Debts (form FL-142). Courts may also require a party to file a Property Declaration as an attachment to a
Request to Enter Default (form FL-165) or Judgment (form FL-180).
When filing a Property Declaration with the court, do not include private financial documents listed below.
Identify the type of declaration completed
1. Check "Community and Quasi-Community Property Declaration" on page 1 to use Property Declaration (form FL-160)
to provide a combined list of community and quasi-community property assets and debts. Quasi-community property is
property you own outside of California that would be community property if it were located in California.
2. Do not combine a separate property declaration with a community and quasi-community property declaration. Check
"Separate Property Declaration" on page 1 when using Property Declaration to provide a list of separate property
assets and debts.
Description of the Property Declaration chart
Pages 1 and 2
1. Column A is used to provide a brief description of each item of separate or community or quasi-community property.
2. Column B is used to list the date the item was acquired.
3. Column C is used to list the item's gross fair market value (an estimate of the amount of money you could get if you
sold the item to another person through an advertisement).
4. Column D is used to list the amount owed on the item.
5. Column E is used to indicate the net fair market value of each item. The net fair market value is calculated by
subtracting the dollar amount in column D from the amount in column C ("C minus D").
6. Column F is used to show a proposal on how to divide (or confirm) the item described in column A.
Page 3
1. Column A is used to provide a brief description of each separate or community or quasi-community property debt.
2. Column B is used to list the date the debt was acquired.
3. Column C is used to list the total amount of money owed on the debt.
4. Column D is used to show a proposal on how to divide (or confirm) the item of debt described in column A.
When using this form only as an attachment to a Petition or Response
1. Attach a Separate Property Declaration (form FL-160) to respond to item 9. Only columns A and F on pages 1 and 2
and columns A and D on page 3 are required.
2. Attach a Community or Quasi-Community Declaration (form FL-160) to respond to item 10, and complete column A on
all pages.
When serving this form on the other party as an attachment to Declaration of Disclosure (form FL-140)
1. Complete columns A through E on pages 1 and 2, and columns A through C on page 3.
2. Copies of the following documents must be attached and served on the other party:
(a) For real estate (item 1): deeds with legal descriptions and the latest lender's statement.
(b) For vehicles, boats, trailers (item 4): the title documents.
(c) For all bank accounts (item 5, 6, 7): the latest statement.
(d) For life insurance policies with cash surrender or loan value (item 10): the latest declaration page.
(e) For stocks, bonds, secured notes, mutual funds (item 11): the certificate or latest statement.
(f) For retirement and pensions (item 12): the latest summary plan document and latest benefit statement.
(g) For profit-sharing, IRAs, deferred compensation, and annuities (item 13): the latest statement.
(h) For each account receivable and unsecured note (item 14): documentation of the account receivable or note.
(i) For partnerships and other business interests (item 15): the most current K-1 and Schedule C.
(j) For other assets (item 16): the most current statement, title document, or declaration.
(k) For support arrearages (item 21): orders and statements.
(l) For credit cards and other debts (items 23 and 24): the latest statement.
3. Do not file copies of the above private financial documents with the court.
When filing this form with the court as a attachment to Request to Enter Default (FL-165) or Judgment (FL-180)
Complete all columns on the form.
For more information about forms required to process and obtain a judgment in dissolution, legal separation, and nullity
cases, see
http://www.courts.ca.gov/8218.htm.
Page 4 of 4
PROPERTY DECLARATION
(Family Law)
FL-160
FL-160 [Rev. July 1, 2016]
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