Start Your Divorce Packet
FamLaw-001 Rev 1/1/20
Superior Court of California, County of Contra Costa
STARTING YOUR DIVORCE
Marriage / Domestic Partnership
What you will find in this packet:
Additional Resources (FamLaw-101-INFO)
Requirements for Filing Court Papers (MC-500-INFO)
Start Your Divorce Online Workshop (FamLaw-102)
Legal Steps for a Divorce (Dissolution) (FL-107-INFO)
Start Divorce (Dissolution), Legal Separation or Nullity (FamLaw-001a)
Announcing the “FLARe” Program
TurboCourt.com Flyer
Petition-Marriage (FL-100)
Property Declaration (FL-160) 2 copies
Declaration Under Uniform Child Custody Jurisdiction
and Enforcement ACT (UCCJEA) (FL-105/GC-120)
Attachment to Declaration Under Uniform Child Custody
Jurisdiction and Enforcement ACT (UCCJEA) (FL-105(A)/GC-120(A))
Summons (Family Law) (FL-110)
Serving the Other Party (FamLaw-104)
Proof of Service of Summons (FL-115)
Notice and Acknowledgment of Receipt (FL-117)
Response-Marriage (FL-120)
Declaration of Disclosure Instructions (FamLaw-105)
Declaration of Disclosure (FL-140)
Schedule of Assets and Debts (FL-142)
Income and Expense Declaration (FL-150)
After Service of Disclosure Documents… (FamLaw-106)
Declaration Regarding Service of Declaration of Disclosure (FL-141)
You Can Get Court Forms FREE at: www.cc-courts.org/forms
If you don’t find what you’re looking for here, you may want to
check out the additional resources listed on the back of this page
Family Law - Information
FamLaw-101-INFO Rev. 12/8/16
~ Additional Resources ~
Contra Costa Superior Court
www.cc-courts.org/familylaw
Virtual Self-Help Law Center
www.cc-courthelp.org/familylawtopics
Family Law court is for people who are ending a marriage or other committed relationship, dividing what
they own and owe, working out child custody and visitation issues, dealing with child support or spousal
support, addressing domestic violence issues, or identifying a child's legal parents.
Often, people involved in court cases need more than just legal help. It's important that you understand
what is happening to you and get the help you need. For some suggestions about where to get other
help, go to the California Court's Self-Help Center at www.courts.ca.gov/selfhelp.htm or check out one of
the sites below:
Contra Costa County Bar Association's Lawyer Referral Service
www.cccba.org/community/find-a-lawyer/index.php
Contra Costa County (CA) Resource Center (211)
65.166.193.134/IFTWSQL4/cccc/public.aspx
(or do an internet search for 211 Contra Costa County Resource Center)
Legal glossaries in 12 languages, prepared by the Superior Court in Sacramento
www.saccourt.ca.gov
A Guide to California's Free Website for Legal Help
www.lawhelpcalifornia.org
* ************************************************************
The
Contra Costa County
Bar Association
is proud to sponsor
the
Family Law
MODERATE MEANS PROGRAM
IF you qualify*,
we will refer you to an experienced Family Law Attorney
who has agreed to represent clients at a reduced rate.
Please telephone us at:
925 / 677- 0234
Monday - Friday 1:00-4:00 p.m.
*This is not a low income or pro-bono service.
Info / Instructions
MC-500-INFO Rev. 10/6/16
The Clerk of the Court cannot accept for filing any papers that do
not comply with California Rules of Court 2.100 et seq. (CRC 2.118)
To avoid having your papers rejected by the clerk:
Use Judicial Council forms whenever possible
If you print Judicial Council forms from your computer, print them out single-
sided. (Don’t print double-sided unless you know how to tumble the pages).
Judicial Council forms can be found at http://www.courts.ca.gov/forms.htm.
If the form you need is not on the Judicial Council website, you will have to make
your own form which follows these rules
1. White or unbleached paper – 8 1/2 by 11 inches
2. One-sided paper only one side of each page may be used
3. 12 pt font (Courier, Times New Roman, Arial or equivalent (Handwritten
papers are OK but write legibly)
4. Line spacing - One and one-half or double-spaced (use pleading paper
either the Judicial Council form MC-20 or create your own using the legal
template in your word processor)
5. Margins – at least 1 inch from the left edge and ½ inch from right edge
6. Page Numbers pages must be numbered consecutively on the bottom
(1, 2, 3 …)
7. Binding Original and copies must be firmly bound (e.g. stapled) AND the
Original must be 2-hole punched at the top.
You will need the Original document, signed in ink (blue is best), and correct
number of identical copies (original for the Court, a copy for each party) for
the clerk to file.
The Rules are importantRemember - You want the Judge to
understand what you have written. Don’t make that impossible
by submitting papers that are too hard to read because they
are upside down, the print is too small or too light, or the
pages have fallen out of the file because they are too
small or too large and/or not properly fastened.
Family Law Information
FamLaw-102 Rev. 3/28/18
Start Your Divorce Online Workshop
Family Law Facilitators Office
The Start Your Divorce workshop is now online!
Go To:
www.cc-courts.org/divorceworkshop
To complete the workshop you will need the following packet(s):
___ Divorce: Start Your Divorce
___ Fee Waiver
YOU CAN ALSO DOWNLOAD THESE PACKETS AT THE COURT WEBSITE
www.cc-courts.org/forms-family
| Form Packets Family Law Packets and Forms
YOU CAN PURCHASE THESE PACKETS AT THE LAW LIBRARY
(20¢ per page, cash only), LOCATED AT:
1020 WARD STREET, MARTINEZ, CA 94553 (20¢ per page, cash only)
100 37th STREET, RICHMOND, CA 94805
**** The Facilitator’s Office will continue to review your forms at a
Review Workshop. To get your ticket into the Review Workshop,
complete the Start Your Divorce Online Workshop.****
Notice: If you do not have a home computer, smart phone, or tablet,
you can complete the Start Your Divorce Online Workshop
on the computers located in the Family Law building,
at your local public library or at any
Contra Costa Superior Court Law Library
Family Law Information
FamLaw-102s Rev. 3/29/18
La Oficina de Asistencia de Derecho Familiar
Taller en Español para
iniciar y responder a un divorcio
DONDE: CONTRA COSTA COUNTY SUPERIOR COURT MARTINEZ
751 PINE STREET (CUARTO 144)
MARTINEZ, CA 945536
HORAS: El 1° y el 3 ° miércoles de cada mes a las 1:00 del tarde.
CERRADO TODOS LOS DIAS DE FIESTA DE LA CORTE
TRAIGA: ___ El paquete de formularios: DIVORCE: START YOUR DIVORCE
___ El paquete de formularios: FEE WAIVER
___ prueba de sus ingresos para los últimos dos meses y sus formas W-2
mas recientes.
Los paquetes de formularios se pueden comprar en la Biblioteca de Leyes localizada en:
1020 Ward Street, Martínez
100 37th Street, Cuarto 237 (segundo piso), Richmond
También, los puede imprimir gratis del internet en:
www.cc-courts.org/forms| Form Packets Family Law Packets and Forms
TENGA EN CUENTA QUE:
El taller dura aproximadamente 3 horas.
Traiga todas las cosas mencionadas anteriormente y una pluma.
No es necesario hacer cita, pero hay poco espacio. Por lo tanto, debe llegar temprano
si quiere asistir.
Por favor no traiga a amigos o familiares. NO SE PERMITEN NIÑOS EN EL TALLER.
Es importante llegar a tiempo porque no se admiten personas que llegan tarde.
Legal Steps for a Divorce or Legal Separation
FL-107-INFO
Judicial Council of California, www.courts.ca.gov
Revise January 1, 2015, Optional Form
Cal. Rules of Court, rule 5.83
Legal Steps for a Divorce or Legal Separation
FL-107-INFO, Page 1 of 2
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IMPORTANT NOTICES
The earliest you can be divorced is six months and one day from one of these three dates (whichever occurs first):
(1) the date Respondent was served with the Summons (form FL-110) and Petition (form FL-100), (2) the date the
Response (form FL-120) was filed, or (3) the date Appearance, Stipulations, and Waivers (form FL-130) was filed.
Legal separation has no waiting period. You are NOT divorced or legally separated until the court enters a Judgment in
your case.
If you need court orders for child support, custody, parenting time (visitation), spousal or partner support, restraining
orders, or other issues, file a Request for Order (form FL-300) asking for temporary orders. See “Request for Order
Information” at courts.ca.gov/divorcerequests for more information.
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STEP 1. Start Your Case
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The forms needed to start your case and information about filing fees and fee waivers are available at “Filing Your Case,” at
courts.ca.gov/filing.
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The petitioner (the person who files the first divorce or legal separation forms with the court) fills out and files with the court
clerk at least a Petition—Marriage/Domestic Partnership (form FL-100) and a Summons (form FL-110) and, if there are
children of the relationship, a Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (form FL-105).
The court clerk will stamp and return copies of the filed forms to the petitioner.
The respondent has 30 days to file and serve a Response. So, the petitioner must wait 30 days before starting Step 4.
Someone 18 or older–not the petitioner–serves the spouse or domestic partner (called the respondent) with all the forms from
Step 1 plus a blank Response—Marriage/Domestic Partnership (form FL-120) and files with the court a proof-of-service form,
such as Proof of Service of Summons (form FL-115), telling when and how the respondent was served. (To serve means “to give
in the proper legal way.”) For more information, see “Serving Your First Set of Court Forms” at courts.ca.gov/filing.
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STEP 2. Serve the Forms
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Respondent files a Response
Respondent does not file a Response (called “default”)
No Response and NO
written agreement:
Petitioner waits 30 days after
Step 2 is complete and
prepares a proposed Judgment
(form FL-180), together with
all other needed forms. See
“True Default Case” at courts.
ca.gov/truedefault.
No Response BUT written
agreement: Petitioner attaches
the signed and notarized
agreement to the proposed
Judgment (form FL-180),
together with all other needed
forms. See “Default Case with
Written Agreement” at courts.
ca.gov/defaultagree.
Response AND written
agreement: Either party files
Appearance, Stipulations, and
Waivers (form FL-130) and the
proposed Judgment with
written agreement attached and
other needed forms. See
“Uncontested Case” at courts.
ca.gov/uncontested.
Response and NO
agreement: Parties must
go to trial to have a judge
resolve the issues. See
“Contested Case” at
courts.ca.gov/contested.
STEP 4. Finish the Divorce or Legal Separation Case in One of Four Ways
You must keep the court and the other party informed of any change in your mailing address or other contact
information. File and serve a Notice of Change of Address or Other Contact Information (form MC-040) on the other
party or his or her attorney to let them know about the change in your contact information.
At the same time as Step 1 or within 60 days of filing the Petition, the petitioner must fill out and have these documents served
on the respondent: Declaration of Disclosure (form FL-140), Income and Expense Declaration (form FL-150), Schedule of
Assets and Debts (form FL-142) or Property Declaration (form FL-160), and all tax returns filed by the party in the two years
before serving the disclosure documents. These disclosure documents are not filed with the court.
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If the respondent files a Response, he or she must also complete and serve the same disclosure documents on the petitioner
within 60 da
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the Response.
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The 60-day time frame for serving the disclosures may be changed by written agreement between the parties or by court order.
The petitioner and respondent each file a Declaration Regarding Service (form FL-141) with the court saying disclosures
were served. If the respondent does not serve disclosures, the petitioner can still finish the case without them. For more
information, see “Fill Out and Serve Your Financial Declaration of Disclosure Forms” at courts.ca.gov/filing (click on Step 4).
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STEP 3. Disclose Financial Information
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Annulments: See courts.ca.
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ov/annulment for information about annulments.
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Rev. January 1, 2015
FL-107-INFO, Page 2 of 2
Legal Steps for a Divorce or Legal Separation
You may prefer to resolve some or all of the issues in your divorce or legal separation case without having the court
decide for you. You and your spouse or domestic partner can put your agreement in writing and file it in your case. But
your agreement must follow all legal requirements.
Getting help to resolve divorce or legal separation cases
Do you have a registered domestic partnership? The process for a divorce or legal separation of a domestic
partnership is the same as on page 1. For information about ending your domestic partnership in the superior court, see
courts.ca.gov/filing. To find out if you are eligible to end your domestic partnership through the Secretary of State, see
courts.ca.gov/summdissodp. Note: There may be differences in federal taxes and other issues for domestic
partnerships. Seek advice from an attorney experienced in domestic partner law.
What if you want a legal separation? The process on page 1 is the same, except you will NOT get a Judgment
for legal separation unless both parties agree to a legal separation OR if respondent has not filed a Response. If both
parties agree to be legally separated but do not agree on other issues, the parties must go to trial to have a judge resolve
those issues. You are NOT legally separated until you receive a Judgment signed by the court. For more information, see
“Legal Separation” at
courts.ca.gov/legalseparation. AFTER the court enters a judgment for legal separation, if you
decide you want a divorce, you must start a new case to request a divorce and pay another filing fee.
Legal Steps for a Divorce or Legal Separation
FL-107-INFO
Family Law Facilitators and Self-Help Centers
help with court forms and instructions. They can
provide samples of agreements and other
information and, in some cases, help with mediation.
This information sheet gives you only basic information on
the divorce or legal separation and is not legal advice. If you
want legal advice, ask a lawyer for help. You may also:
Contact the family law facilitator or self-help center in
your court for information, court forms, and referrals to
local legal resources. For more information, see
courts.ca.gov/courtresources.
What if there is domestic violence?
Private services (which you can hire
to help you resolve your case):
Where can I get help?
Lawyers. Also called attorneys, lawyers can help
work out agreements between the parties and
represent you at court hearings and trials.
Mediators. A lawyer or counselor who helps the
parties communicate to explore options and reach a
mutually acceptable resolution.
Collaborative Lawyers. Lawyers who represent
each party but do not go to court. They try to reach
an agreement. If court is necessary, the parties must
hire new lawyers.
Settlement Conferences. An informal process in
which a judge or an experienced lawyer meets with
the parties and their lawyers to discuss the case and
their positions and suggests a resolution. The parties
can either agree to the suggestions or use the
suggestions to help in further settlement discussions.
Family Court Services. If you and the other parent
already have a family law case and have filed a
Request for Order (form FL-300) seeking orders
about child custody and visitation (parenting time),
the court will refer you to Family Court Services.
They provide child custody mediation or child
custody recommending counseling to try to help you
both make a parenting plan that is in the best interest
of your child. Note: They cannot help with financial
issues.
Court Services
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Find information at your local law library or public
library.
Find free and low-cost legal help (if you qualify) at
lawhelpcalifornia.org.
Hire a private mediator. For more information about
court and private services, see courts.ca.gov/selfhelp-adr.
htm.
If there is domestic violence or a protective or restraining
order, talk to a lawyer, counselor, or mediator before
making agreements.
For domestic violence help, call the National Domestic
Violence Hotline: 800-799-7233; TDD: 800-787-3224; or
211 (if available in your area).
Find information on the California Courts Online Self-
Help Center website: courts.ca.gov/selfhelp.
Find a lawyer through a certified lawyer referral service
on the State Bar of California's website:
calbar.ca.gov/LRS or by calling 866-442-2529
(toll-free).
Family Law Info / Instructions
FamLaw-001a-INFO Rev. 6/20/19
Superior Court of California, County of Contra Costa
START DIVORCE (DISSOLUTION),
LEGAL SEPARATION OR NULLITY
Marriage / Domestic Partnership
General Information
The divorce process can be confusing and overwhelming. The information below is
designed to help you understand the basic steps you will need to take to successfully
complete the process. If you have complicated issues of property, support, custody,
pensions or other questions about your rights and responsibilities, you may want to
consult an attorney outside the court. Court staff, including Family Law Facilitators, can
provide procedural assistance; they cannot give legal advice. Check the court website
at www.cc-courts.org/findlawyer for information about attorney referral services.
1. If you need help with these forms, go to the “Start Your Divorceonline workshop.
The workshop flyer is included in this packet. You can also find information about
the divorce, legal separation and nullity process at the Virtual Self-Help Law
Center at the court website, divorce.cc-courthelp.org.
2. There is a filing fee to file your divorce, legal separation or nullity case. If you can’t
afford to pay the court filing fee, you may qualify for a waiver of court filing fees.
“Fee Waiver” packets are available from the clerk at the Reception Desk in the
Spinetta Family Law Center in Martinez or download a “Fee Waiver” packet from
the court’s website, www.cc-courts.org/forms.
3. Use the Divorce/Legal Separation/Nullity checklist included in this packet to keep
track of the documents that you have filed.
4. This packet contains the forms to open your case, serve those documents and
complete the Preliminary Declaration of Disclosure.
REMEMBERthe Court will not automatically divorce you. You have to submit all of
the forms to the Court to finish your case.
Family Law Info / Instructions
FamLaw-001a-INFO Rev. 6/20/19
Instructions For Starting Your Case
1. Complete the Petition Form (FL-100). Attach the Property Declaration Form (FL-160) if you
have property. Use one FL-160 to list separate property; use one FL-160 to list your
community property.
2. If you have children with the other party, complete the Declaration Under Uniform Child
Custody Jurisdiction and Enforcement Act (UCCJEA) Form (FL-105) and attach it to the
Petition.
3. Complete the Summons Form (FL-110).
4. Make 2 copies of each document. File the original and 2 copies at the Clerk’s Office at
751 Pine Street, Martinez, CA 94553.
5. If you think you qualify for a waiver of court fees, ask the clerk at the Reception Desk in the
Spinetta Family Law center in Martinez or at any filing window for a free packet of forms or
download a Fee Waiver packet from the court’s website, www.cc-courts.org/forms. Make 1
copy of the fee waiver documents and file those documents with the Summons and Petition.
The completed Summons and Petition can only be filed in the Spinetta Family Law Center at
751 Pine Street in Martinez. Do not serve a copy of the fee waiver documents on the other side.
6. Serve a copy of the filed Summons and Petition (with any attachments) on the Respondent
following the instructions in this packet to serve the other party.
Information for the Respondent
1. You have 30 days to file your Response Form (FL-120) if you do not want the Petitioner to
take your default. Complete the Response Form (FL-120.) Attach the Property Declaration
Form (FL-160) if you have property. Use one FL-160 to list separate property; use one
FL-160 to list your community property.
2. If you have children with the other party, complete the Declaration Under Uniform Child
Custody Jurisdiction and Enforcement Act (UCCJEA) Form (FL-105) and attach it to the
Response.
3. Make 2 copies of the Response and any attachments. File the original and 2 copies at the
Clerk’s Office at 751 Pine Street, Martinez, CA 94553.
4. If you think you qualify for a waiver of court fees, ask the clerk at the Reception Desk in the
Spinetta Family Law center in Martinez or at any filing window for a free packet of forms or
download a Fee Waiver packet from the court’s website, www.cc-courts.org/forms. Make 1
copy of the fee waiver documents and file those documents with the Response. Do not
serve a copy of the fee waiver documents on the other side.
5. Serve a copy of the filed Response and any attachments on the Petitioner. You cannot
serve your own documents. Someone over 18 years old and not a party must serve the
documents; mail service is acceptable. The person who serves the documents must
complete Proof of Service by Mail Form (FL-335.) Make a copy of the completed Proof of
Service by Mail form and file it at the Clerk’s Office.
6. If you file a Response or sign a Stipulated Judgment or Marital Settlement Agreement, you
must complete the Declaration of Disclosure.
Family Law Info / Instructions
FamLaw-001a-INFO Rev. 6/20/19
For Petitioner and Respondent: Declaration of Disclosure
1. Complete the Declaration of Disclosure (FL-140) and serve a copy on the other party. Do
not file FL-140.
2. Complete the Schedule of Assets and Debts (FL-142) and serve a copy of FL-142 on the
other party. Do not file FL-142.
3. Complete the Income and Expense Declaration (FL-150) and serve a copy of FL-150 on
the other party. File FL-150 with the Court.
4. Complete the Declaration Re: Service of Declaration of Disclosure (FL-141.) This is your
Preliminary Declaration of Disclosure, so check the boxes that say “Preliminary.” Make a
copy of FL-141 and file it the Family Law Court in Martinez. Serve a copy on the
other party. You can serve your Preliminary Declaration of Disclosure with the
Summons and Petition, or Response, or you can serve it later by mail or personal
service.
DIVORCE/LEGAL SEPARATION/NULLITY CHECKLIST
1. STEP ONE: Opening a case:
Complete, make 2 copies and file the following documents:
PETITION (FL-100)
If you and the other party have children, complete and attach to the Petition:
DECLARATION UNDER UCCJEA (FL-105)
If you and the other party have community property, complete and attach to the
Petition:
PROPERTY DECLARATION (FL-160)
(check the box “Community and Quasi-Community Property Declaration”)
If you have separate property, complete and attach to the Petition:
PROPERTY DECLARATION (FL-160)
(check the box “Separate Property Declaration”)
Note: If you have both community property and separate property, you will
need to complete two Property Declaration forms (FL-160), one form for each
type of property, and attach both forms to the Petition.
SUMMONS (FL-110)
Documents filed on: _______________ (date)
2. STEP TWO: Service on the Respondent:
“Service” means that copies of the documents you have filed are delivered to the
Respondent.
It’s best to serve the Respondent within 30 days of filing the Petition.
Family Law Info / Instructions
FamLaw-001a-INFO Rev. 6/20/19
YOU can’t serve your documents. Someone who is over 18 and not a party must
serve the documents.
Serve a copy of each filed document, a blank Response (FL-120), a blank
Declaration Under UCCJEA (FL-105) if you have children with the other party, and
a blank Property Declaration (FL-160) if you have property with the other party.
FILE:
Proof of Service of Summons (FL-115)
Proof of Service filed on: _______________ (date)
You must FILE the Proof of Service of Summons form with the Court.
IF YOU NEED INFORMATION ABOUT SERVICE OF PROCESS, COME TO THE
HELP DESK OR LOOK ON THE COURT’S SELF-HELP WEBSITE, DIVORCE.CC-
COURTHELP.ORG.
3. STEP THREE: Exchange of Financial Information:
You must complete and serve the Preliminary Declaration of Disclosure on the other
party. It’s best to do this within 60 days of the filing of the Petition. Complete the following
forms and give a copy to the other party, but do not file them with the court:
DECLARATION OF DISCLOSURE (FL-140)
SCHEDULE OF ASSETS AND DEBTS (FL-142)
Complete, file a copy with the court and give a copy to the other party:
INCOME AND EXPENSE DECLARATION (FL-150)
COMPLETE AND FILE IN YOUR ASSIGNED COURT
DECLARATION RE: SERVICE OF DECLARATION OF DISCLOSURE (FL-141)
FL-141 filed on: ________________ (date)
YOU CAN GET HELP WITH THESE FORMS AT THE COURT’S SELF-HELP
WEBSITE, WWW.CC-COURTHELP.ORG/FORMSINSTRUCTIONS.
4. STEP FOUR: Finish Your Case:
YOU HAVE TO COMPLETE THE JUDGMENT FORMS TO FINISH YOUR CASE.
The “FLARe” Program
(Family Law Alternative Resolution)
FLARe is a voluntary mediation program that is designed to be less expensive, less stressful, and less time
consuming than traditional litigation. The program is staffed by trained family law attorney mediators who will
meet with parties to assist them in settling their family law cases amicably and early. The use of this program is
voluntary and must be agreed to by both parties.
MEDIATION IS APPROPRIATE AT ANY TIME DURING THE LITIGATION
PROCESS
Mediation is useful at any point in litigation and is not binding unless an agreement is reached and an Order is
signed by the Judge. Either party may consult another attorney from the mediation panel or other private attorney
before any agreements are finalized. Either the mediator or your lawyer can help you finalize orders.
MEDIATION IS CONDUCTED BY A TRAINED NEUTRAL PARTY
WHO MEETS WITH THE PARTIES TOGETHER AND:
May facilitate the settlement of a single issue or an entire case
Helps parties learn to cooperate
Allows parties to make informed decisions
Is private and confidential
Does not require court appearances
SERVICE OPTIONS AND COST:
There are 3 options for mediation services, OPTION A) Joint Mediation Session for 90 minutes for $150.00;
OPTION B) Joint Mediation Orientation for 30 minutes for $35.00; and OPTION C) Individual Pre-Mediation
Consultation for 30 minutes for $35.00. SEE REVERSE SIDE FOR SERVICE PROGRAM DESCRIPTIONS.
To schedule an appointment, call the Contra Costa County Bar Association
LAWYER REFERRAL & INFORMATION SERVICE
(925) 825-5700
The Court strongly recommends the use of mediation. However the Court does not endorse the skills of any
particular mediator or guarantee the results in any particular case. Results depend on the cooperation of the parties.
Both parties are encouraged to enter the program with good faith settlement intentions.
Voluntary mediation with an attorney is not a substitute for mandatory custody mediation with Family
Court Services required by current law where custody remains in dispute. However, if a settlement
regarding custody is reached, the mediation at Family Court Services may not be necessary.
VOLUNTARY MEDIATION IS NOT RECOMMENDED
IN CASES INVOLVING DOMESTIC VIOLENCE.
F
L
A
R
e
(Family Law Alternative Resolution
Program)
This Family Law mediation panel is made up of attorneys with special training in mediation and a
commitment to finding an alternative to litigation. Each person on the panel . . .
has been licensed to practice law for at least five years;
has completed at least 40 hours of MCLE-approved basic training in family law mediation;
has had at least 20 hours of MCLE-approved training in family law issues during the last two
years,
including at least 6 hours of advanced MCLE-approved mediation training each year;
is a Certified Specialist in Family Law or devotes at least 50% of his/her practice to family law;
is a member of the CCCBA’s Lawyer Referral & Information Service (LRIS);
maintains professional liability insurance in an amount of not less than $100,000.00 for each
occurrence, and $300,000.00 aggregate per year; and
agrees to provide the first 90 minutes of mediation for $150.00 (option "A" only).
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Use of the FLARe program through the Contra Costa County Bar
Association:
(Attorney-mediators selected on a rotational basis. Consumer cannot choose.)
Option "A"
Joint Mediation Session
90-minute session for $150.00
(Parties generally split cost.
$30.00 goes to LRIS; $120.00
goes to attorney-mediator.
Money collected up-front by
LRS. Any services and fees
after 90 minute session
negotiated directly between
attorney-mediator and clients).
Both parties participate
Actual mediation session
Attorney-mediator can write
up and file agreement
(although 90-minute session
probably will not cover that
service)
Option
"B"
Joint Mediation
Orientation
30-minute session for $35.00
($35.00 fee covers LRIS
administrative expense.
Attorney- mediator donates
his/her time for 30-minute
session. Any fees thereafter
negotiated directly between
attorney-mediator and clients).
Joint mediation orientation
Both parties attend
Attorney-mediator explains
mediation process
Generally recommended when
parties are undecided about
mediation
Parties can opt to hire attorney-
mediator to mediate their
dispute, but at attorney-
mediator's regular hourly rate;
- or -
Parties can opt for Option A
Option "C"
Individual Pre-Mediation
Consultation
30-minute session for $35.00
($35.00 fee covers LRIS
administrative expense.
Attorney- mediator donates
his/her time for 30-minute
session. Any fees thereafter
negotiated directly between
attorney-mediator and client).
Mediation support (or pre-
mediation) consultation with
one party only
Generally recommended when
consumer undecided between
opting for mediation or
litigation as dispute resolution
process
Client can opt to hire attorney as
consulting attorney to
mediation;
- or -
Client can opt to hire attorney
to represent him/her in
litigation
A $25 annual fee is collected on collections over $500.
50 Douglas Drive, Suite 100, Martinez, CA 94553 • Email: childsupport@dcss.cccounty.us • Toll Free: 866-901-3212
Contra Costa County Department of Child Support Services
Have Children Younger than 18?
The Contra Costa County Department of Child Support Services
works with both parents, and legal guardians to ensure children
receive court ordered financial and medical support.
What can we do for you?
Locate Absent Parents
DNA Testing to Establish Paternity
Obtain Child and Medical Support Orders
Enforce Support Orders
Use of collection tools such as tax intercepts, and suspending drivers and
professional licenses may be used.
Collect and Distribute Child Support Payments
Payments are processed within 48-hours with payment information posted
on a secure web site.
Receive payments by direct deposit, check, or payment card.
State mandated 10% interest on unpaid support will be applied.
When Situations Change, Support Orders can be Modified.
Visit Our Website or Facebook page:
www.cccounty.us/depart/famsupp/index.html
http://www.facebook.com/CCCDCSS
Apply for Services at
www.TurboCourt.com
Petitioner and Respondent signed a voluntary declaration of parentage or paternity. (Attach a copy if available.)
AMENDED
PETITION FOR
Dissolution (Divorce) of:
Marriage
Domestic Partnership
Nullity of:
Marriage
Domestic Partnership
Legal Separation of:
Marriage Domestic Partnership
FOR COURT USE ONLY
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
ZIP CODE:STATE: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:
RESPONDENT:
PETITIONER:
CASE NUMBER:
FL-100
LEGAL RELATIONSHIP (check all that apply):
a. We are married.
b.
We are domestic partners and our domestic partnership was established in California.
We are domestic partners and our domestic partnership was NOT established in California.
c.
1.
RESIDENCE REQUIREMENTS (check all that apply):
has been a resident of this state for at least six months and of this county for at least three
months immediately preceding the filing of this Petition. (For a divorce, unless you are in the legal relationship described
in 1b., at least one of you must comply with this requirement.)
2.
a. Respondent Petitioner
STATISTICAL FACTS
Date of marriage (specify): Date of separation (specify):
Years
a.
b.
(3)
3.
(1)
(1)
(2)
(3)
(2)
Date of separation (specify):
Registration date of domestic partnership with the California Secretary of State or other state equivalent (specify below):
Page 1 of 3
Form Adopted for Mandatory Use
Judicial Council of California
FL-100 [Rev. January 1, 2020]
PETITION—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
Family Code, §§ 297, 299, 2320, 2330, 3409
www.courts.ca.gov
MINOR CHILDREN
If there are minor children of Petitioner and Respondent, a completed Declaration Under Uniform Child Custody Jurisdiction
and Enforcement Act (UCCJEA) (form ) must be attached.
d.
4.
There are no minor children.
a.
The minor children are:
b.
Child's name
Birthdate Age
a child who is not yet born.
(2)
continued on Attachment 4b.
(1)
e.
Our domestic partnership was established in California. Neither of us has to be a resident or have a domicile in California
to dissolve our partnership here.
b.
If any children listed above were born before the marriage or domestic partnership, the court has the authority to determine
those children to be children of the marriage or domestic partnership.
c.
c.
W
e are the same sex, were married in California
, but currently live in
a jurisdiction that does not recognize, and will not
dissolve, our marriage.This Petition is filed in the county where we married.
Respondent lives in (specify):Petitioner lives in (specify):
Months
Time from date of marriage to date of separation (specify):
Time from date of registration of domestic partnership to date of separation (specify):
MonthsYears
FL-105
Petitioner requests that the court make the following orders:
5. LEGAL GROUNDS (Family Code sections 2200–2210, 2310–2312)
b. Nullity of void marriage or domestic partnership based on
(1) incest. (2) bigamy.
c.
Nullity of voidable marriage or domestic partnership based on
(1) petitioner’s age at time of registration of domestic
partnership or marriage.
(2)
prior existing marriage or domestic partnership.
(3) unsound mind.
(4) fraud.
(5) force.
(6) physical incapacity.
Legal separation of the marriage or domestic partnership based on (check one):
Divorce or
a.
(1) irreconcilable differences. permanent legal incapacity to make decisions.(2)
6. CHILD CUSTODY AND VISITATION (PARENTING TIME)
Legal custody of children to
.........................................................
....................................................
Physical custody of children to
Child visitation (parenting time) be granted to
.............................
As requested in form FL-311 form FL-312 form FL-341(C)
form FL-341(D) form FL-341(E) Attachment 6c(1)
Any party required to pay support must pay interest on overdue amounts at the "legal" rate, which is currently 10 percent.
7. CHILD SUPPORT
a.
b.
c.
Other (specify):
Respondent PetitionerTerminate (end) the court's ability to award support to
Petitioner Respondent Spousal or domestic partner support payable to
Reserve for future determination the issue of support payable to
Respondent Petitioner
Other (specify):
d.
SPOUSAL OR DOMESTIC PARTNER SUPPORT8.
b.
a.
c.
d.
b.
Confirm as separate property the assets and debts in
Property Declaration (form ).
the following list. Item Confirm to
9. SEPARATE PROPERTY
a. There are no such assets or debts that I know of to be confirmed by the court.
FL-100 [Rev. January 1, 2020]
Page 2 of 3
PETITION—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
CASE NUMBER:
RESPONDENT:
PETITIONER:
FL-100
Petitioner Respondent Joint Other
b.
c.
a.
If there are minor children born to or adopted by Petitioner and Respondent before or during this marriage or domestic
partnership, the court will make orders for the support of the children upon request and submission of financial forms by the
requesting party.
An earnings assignment may be issued without further notice.
Attachment 9b.
FL-160
Page 3 of 3
PETITION—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
FL-100 [Rev. January 1, 2020]
CASE NUMBER:
RESPONDENT:
PETITIONER:
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF PETITIONER)
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
a.
There are no such assets or debts that I know of to be divided by the court.
in
in Property Declaration (form )
Determine rights to community and quasi-community assets and debts. All such assets and debts are listed
b.
as follows (specify):
COMMUNITY AND QUASI-COMMUNITY PROPERTY10.
OTHER REQUESTS11.
Attorney's fees and costs payable by Respondent Petitioner
a.
b Petitioner's former name be restored to
(specify):
c.
Continued on Attachment 11c.
Other (specify):
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF ATTORNEY FOR PETITIONER)
12. I HAVE READ THE RESTRAINING ORDERS ON THE BACK OF THE SUMMONS, AND I UNDERSTAND THAT THEY APPLY
TO ME WHEN THIS PETITION IS FILED.
NOTICE—CANCELLATION OF RIGHTS: Dissolution or legal separation may automatically cancel the rights of a domestic partner
or spouse under the other domestic partner's or spouse's will, trust, retirement plan, power of attorney, pay-on-death bank account,
survivorship rights to any property owned in joint tenancy, and any other similar thing. It does not automatically cancel the right of a
domestic partner or spouse as beneficiary of the other partner's or spouse's life insurance policy. You should review these matters,
as well as any credit cards, other credit accounts, insurance polices, retirement plans, and credit reports, to determine whether they
should be changed or whether you should take any other actions. Some changes may require the agreement of your partner or
spouse or a court order.
NOTICE: You may redact (black out) social security numbers from any written material filed with the court in this case other than a
form used to collect child, spousal or partner support.
FL-100
FOR MORE INFORMATION: Read Legal Steps for a Divorce or Legal Separation ( ) and visit "Families Change"
at www.familieschange.ca.gov
an online guide for parents and children going through divorce or separation.
FL-160
Attachment 10b.
Print this form
Save this form
Clear this form
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
form FL-107-INFO
FL-160
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NO.:
PARTY WITHOUT ATTORNEY OR ATTORNEY
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).
B C - D = E
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
B C - D = E
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]
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]
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]
FL-160
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NO.:
PARTY WITHOUT ATTORNEY OR ATTORNEY
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).
B C - D = E
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
B C - D = E
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]
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]
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]
American LegalNet, Inc.
www.FormsWorkflow.com
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Additional children are listed on form FL-105(A)/GC-120(A). (Provide all requested information for additional children.)
FL-105/GC-120
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
CASE NUMBER:
DECLARATION UNDER UNIFORM CHILD CUSTODY
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
1. I am a party to this proceeding to determine custody of a child.
2. My present address and the present address of each child residing with me is confidential under Family Code section 3429 as
I have indicated in item 3.
3. There are (specify number):
(Insert the information requested below. The residence information must be given for the last FIVE years.)
a. Child’s name
Place of birth Date of birth Sex
Period of residence
Address
Relationship
Confidentialto present
to
to
to
b. Child’s name
Place of birth Date of birth Sex
Residence information is the same as given above for child a.
(If NOT the same, provide the information below.)
Period of residence
Address
Relationship
Confidential
to present
to
to
to
Additional residence information for a child listed in item a or b is continued on attachment 3c.
c.
Page 1 of 2
Family Code, § 3400 et seq.; Form Adopted for Mandatory Use
Judicial Council of California
FL-105/GC-120 [Rev. January 1, 2009]
DECLARATION UNDER UNIFORM CHILD CUSTODY
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
Probate Code, §§ 1510(f), 1512
minor children who are subject to this proceeding, as follows:
www.courtinfo.ca.gov
TELEPHONE NO.:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
PETITIONER:
RESPONDENT:
GUARDIANSHIP OF (Name):
Minor
OTHER PARTY:
Child's residence (City, State)
Child's residence (City, State)
Child's residence (City, State)
d.
Child's residence (City, State)
Child's residence (City, State)
Child's residence (City, State)
(This section applies only to family law cases.)
(This section apples only to guardianship cases.)
Confidential
Confidential
Juvenile Delinquency/
Juvenile Dependency
and provide the following information):
5. One or more domestic violence restraining/protective orders are now in effect. (Attach a copy of the orders if you have one
a. Criminal
b. Family
d. Other
Court State Case number (if known) County Orders expire (date)
Court
(name, state, location)
Court order
or judgment
(date)
Case status
b. Guardianship
c. Other
Name of each child
a. Family
Case number
Court (name, state, location)
e. Adoption
Juvenile Delinquency/
Juvenile Dependency
Case Number
Your
connection to
the case
CASE NUMBER:
SHORT TITLE:
Do you have information about, or have you participated as a party or as a witness or in some other capacity in, another court case
or custody or visitation proceeding, in California or elsewhere, concerning a child subject to this proceeding?
Yes
(If yes, attach a copy of the orders (if you have one) and provide the following information):
Do you know of any person who is not a party to this proceeding who has physical custody or claims to have custody of or
visitation rights with any child in this case?
(If yes, provide the following information):Yes
a. Name and address of person
b. Name and address of person
c. Name and address of person
Has physical custody
Has physical custody
Has physical custody
Claims custody rights
Claims custody rights
Claims custody rights
Claims visitation rights
Claims visitation rights
Claims visitation rights
Name of each child Name of each child Name of each child
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT)
7. Number of pages attached:
NOTICE TO DECLARANT: You have a continuing duty to inform this court if you obtain any information about a custody
FL-105/GC-120 [Rev. January 1, 2009]
Page 2 of 2
DECLARATION UNDER UNIFORM CHILD CUSTODY
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
4.
6.
No
proceeding in a California court or any other court concerning a child subject to this proceeding.
No
FL-105/GC-120
Proceeding
Proceeding
c.
d.
Family Code, § 3400 et seq.; Form Adopted for Mandatory Use
Judicial Council of California
FL-105(A)/GC-120(A)
[New January 1, 2009]
ATTACHMENT TO
DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION
AND ENFORCEMENT ACT (UCCJEA)
Probate Code, §§ 1510(f), 1512
www.courtinfo.ca.gov
FL-105(A)/GC-120(A)
CASE NAME:
ATTACHMENT TO
DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
Page____ of ____
CASE NUMBER:
Child’s name
Place of birth Date of birth
Sex
Residence information is the same as given on form
FL-105/GC-120 for child a. (If NOT the same, provide the
information below.)
Child’s name
Place of birth Date of birth Sex
Child’s name
Place of birth Date of birth Sex
Residence information is the same as given on form
FL-105/GC-120 for child a. (If NOT the same, provide the
information below.)
Residence information is the same as given on form
FL-105/GC-120 for child a. (If NOT the same, provide the
information below.)
Period of residence
Present address
Relationship
to present
to
to
to
Child's residence (City, State)
Child's residence (City, State)
Child's residence (City, State)
Period of residence
Address
Person child lived with (name and complete current address) Relationship
Confidentialto present
to
to
to
Child's residence (City, State)
Child's residence (City, State)
Child's residence (City, State)
Period of residence
Address
Relationship
Confidentialto present
to
to
to
Child's residence (City, State)
Child's residence (City, State)
Child's residence (City, State)
Confidential
Confidential
Confidential
Confidential
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
Person child lived with (name and complete current address)
American LegalNet, Inc.
www.FormsWorkflow.com
You have been sued. Read the information below and on the next page.
Lo han demandado. Lea la información a continuación y en la página siguiente.
EXENCIÓN DE CUOTAS: Si no puede pagar la cuota de
presentación, pida al secretario un formulario de exención de
cuotas. La corte puede ordenar que usted pague, ya sea en
parte o por completo, las cuotas y costos de la corte previamente
exentos a petición de usted o de la otra parte.
FL-110
SUMMONS (Family Law)
FOR COURT USE ONLY
(SOLO PARA USO DE LA CORTE)
CASE NUMBER (NÚMERO DE CASO):
You have 30 calendar days after this Summons and
Petition are served on you to file a Response (form
FL-120) at the court and have a copy served on the
petitioner. A letter, phone call, or court appearance
will not protect you.
If you do not file your Response on time, the court
may make orders affecting your marriage or domestic
partnership, your property, and custody of your
children. You may be ordered to pay support and
attorney fees and costs.
For legal advice, contact a lawyer immediately. Get
help finding a lawyer at the California Courts Online
Self-Help Center (www.courts.ca.gov/selfhelp), at the
California Legal Services website (www.lawhelpca.org),
or by contacting your local county bar association.
NOTICE—RESTRAINING ORDERS ARE ON PAGE 2:
These restraining orders are effective against both
spouses or domestic partners until the petition is
dismissed, a judgment is entered, or the court makes
further orders. They are enforceable anywhere in
California by any law enforcement officer who has
received or seen a copy of them.
The name and address of the court are (El nombre y dirección de la corte son):
Date (Fecha):
, Deputy (Asistente)
Form Adopted for Mandatory Use
Judicial Council of California
FL-110 [Rev. January 1, 2015]
SUMMONS
(Family Law)
Family Code, §§ 232, 233, 2024.7, 2040, 7700;
Code of Civil Procedure, §§ 412.20, 416.60–416.90
www.courts.ca.gov
Page 1 of 2
Clerk , by (Secretario, por)
CITACIÓN (Derecho familiar)
Tiene 30 días de calendario después de haber recibido la
entrega legal de esta Citación y Petición para presentar una
Respuesta (formulario FL-120) ante la corte y efectuar la
entrega legal de una copia al demandante. Una carta o llamada
telefónica o una audiencia de la corte no basta para protegerlo.
Si no presenta su Respuesta a tiempo, la corte puede dar
órdenes que afecten su matrimonio o pareja de hecho, sus
bienes y la custodia de sus hijos. La corte también le puede
ordenar que pague manutención, y honorarios y costos legales.
Para asesoramiento legal, póngase en contacto de inmediato
con un abogado. Puede obtener información para encontrar un
abogado en el Centro de Ayuda de las Cortes de California
(www.sucorte.ca.gov), en el sitio web de los Servicios Legales
de California (www.lawhelpca.org) o poniéndose en contacto
con el colegio de abogados de su condado.
AVISO—LAS ÓRDENES DE RESTRICCIÓN SE
ENCUENTRAN EN LA PÁGINA 2: Las órdenes de restricción
están en vigencia en cuanto a ambos cónyuges o miembros de
la pareja de hecho hasta que se despida la petición, se emita un
fallo o la corte dé otras órdenes. Cualquier agencia del orden
público que haya recibido o visto una copia de estas órdenes
puede hacerlas acatar en cualquier lugar de California.
[SEAL]
1.
2.
FEE WAIVER: If you cannot pay the filing fee, ask the
clerk for a fee waiver form. The court may order you to
pay back all or part of the fees and costs that the court
waived for you or the other party.
NOTICE TO RESPONDENT (Name):
Petitioner's name is:
The name, address, and telephone number of the petitioner’s attorney, or the petitioner without an
attorney, are: (El nombre, dirección y número de teléfono del abogado del demandante, o del
demandante si no tiene abogado, son):
AVISO AL DEMANDADO (Nombre):
Nombre del demandante:
STANDARD FAMILY LAW RESTRAINING ORDERS
Starting immediately, you and your spouse or domestic
partner are restrained from:
removing the minor children of the parties from the state
or applying for a new or replacement passport for those
minor children without the prior written consent of the
other party or an order of the court;
cashing, borrowing against, canceling, transferring,
disposing of, or changing the beneficiaries of any
insurance or other coverage, including life, health,
automobile, and disability, held for the benefit of the
parties and their minor children;
transferring, encumbering, hypothecating, concealing, or in
any way disposing of any property, real or personal,
whether community, quasi-community, or separate, without
the written consent of the other party or an order of the
court, except in the usual course of business or for the
necessities of life; and
You must notify each other of any proposed extraordinary
expenditures at least five business days prior to incurring these
extraordinary expenditures and account to the court for all
extraordinary expenditures made after these restraining orders
are effective. However, you may use community property,
quasi-community property, or your own separate property to
pay an attorney to help you or to pay court costs.
SUMMONS
(Family Law)
FL-110 [Rev. January 1, 2015]
Page 2 of 2
ÓRDENES DE RESTRICCIÓN ESTÁNDAR DE DERECHO
FAMILIAR
En forma inmediata, usted y su cónyuge o pareja de hecho
tienen prohibido:
1.
llevarse del estado de California a los hijos menores de las
partes, o solicitar un pasaporte nuevo o de repuesto para los
hijos menores, sin el consentimiento previo por escrito de la
otra parte o sin una orden de la corte;
2.
cobrar, pedir prestado, cancelar, transferir, deshacerse o
cambiar el nombre de los beneficiarios de cualquier seguro u
otro tipo de cobertura, como de vida, salud, vehículo y
discapacidad, que tenga como beneficiario(s) a las partes y
su(s) hijo(s) menor(es);
3.
transferir, gravar, hipotecar, ocultar o deshacerse de
cualquier manera de cualquier propiedad, inmueble o
personal, ya sea comunitaria, cuasicomunitaria o separada,
sin el consentimiento escrito de la otra parte o una orden de
la corte, excepto en el curso habitual de actividades
personales y comerciales o para satisfacer las necesidades
de la vida; y
4.
crear o modificar una transferencia no testamentaria de
manera que afecte la asignación de una propiedad sujeta a
transferencia, sin el consentimiento por escrito de la otra
parte o una orden de la corte. Antes de que se pueda
eliminar la revocación de una transferencia no
testamentaria, se debe presentar ante la corte un aviso del
cambio y hacer una entrega legal de dicho aviso a la otra
parte.
Cada parte tiene que notificar a la otra sobre cualquier gasto
extraordinario propuesto por lo menos cinco días hábiles antes
de realizarlo, y rendir cuenta a la corte de todos los gastos
extraordinarios realizados después de que estas órdenes de
restricción hayan entrado en vigencia. No obstante, puede usar
propiedad comunitaria, cuasicomunitaria o suya separada para
pagar a un abogado que lo ayude o para pagar los costos de la
corte.
FL-110
1.
4.
3.
2.
creating a nonprobate transfer or modifying a nonprobate
transfer in a manner that affects the disposition of property
subject to the transfer, without the written consent of the
other party or an order of the court. Before revocation of a
nonprobate transfer can take effect or a right of
survivorship to property can be eliminated, notice of the
change must be filed and served on the other party.
WARNING—IMPORTANT INFORMATION
ADVERTENCIA—IMFORMACIÓN IMPORTANTE
De acuerdo a la ley de California, las propiedades adquiridas
por las partes durante su matrimonio o pareja de hecho en
forma conjunta se consideran propiedad comunitaria para
fines de la división de bienes que ocurre cuando se produce
una disolución o separación legal del matrimonio o pareja de
hecho. Si cualquiera de las partes de este caso llega a
fallecer antes de que se divida la propiedad comunitaria de
tenencia conjunta, el destino de la misma quedará
determinado por las cláusulas de la escritura
correspondiente que describen su tenencia (por ej., tenencia
conjunta, tenencia en común o propiedad comunitaria) y no
por la presunción de propiedad comunitaria. Si quiere que la
presunción comunitaria quede registrada en la escritura de
la propiedad, debería consultar con un abogado.
AVISO—ACCESO A SEGURO DE SALUD MÁS ECONÓMICO:
¿Necesita seguro de salud a un costo asequible, ya sea para usted
o alguien en su hogar? Si es así, puede presentar una solicitud con
Covered California. Covered California lo puede ayudar a reducir el
costo que paga por seguro de salud asequible y de alta calidad.
Para obtener más información, visite www.coveredca.com. O llame
a Covered California al 1-800-300-0213.
NOTICE—ACCESS TO AFFORDABLE HEALTH
INSURANCE: Do you or someone in your household need
affordable health insurance? If so, you should apply for
Covered California. Covered California can help reduce the
cost you pay towards high quality affordable health care. For
more information, visit www.coveredca.com. Or call Covered
California at 1-800-300-1506.
California law provides that, for purposes of division of
property upon dissolution of a marriage or domestic
partnership or upon legal separation, property acquired
by the parties during marriage or domestic partnership in
joint form is presumed to be community property. If either
party to this action should die before the jointly held
community property is divided, the language in the deed
that characterizes how title is held (i.e., joint tenancy,
tenants in common, or community property) will be
controlling, and not the community property
presumption. You should consult your attorney if you
want the community property presumption to be written
into the recorded title to the property.
Family Law Info / Instructions
FamLaw-104 Rev. 4/6/16
1
SERVING THE OTHER PARTY
AND FILING PROOF OF SERVICE OF SUMMONS
WHO: Who do I have to have served?
The Respondent in your case. If your case has other parties in it, they will
also need to be served.
Who does the service?
You cannot serve your own papers. Someone 18 years old or older and who
is not a party to the case must serve the Respondent. That person must hand
the documents to the Respondent personally.
If you have a fee waiver, the Sheriff will serve your papers for you. (Civil
Division, 920 Mellus Street, Martinez, CA, 8 am - 4 pm)
You can also hire a professional process server to do the service. You can
find professional process servers in the Yellow Pages of your phone book or
by searching the Internet.
WHAT: What papers do I have served on the other party to the case?
ALL of the papers you filed with the Court, and blank responsive documents
such as:
Petition (FL-100) (completed)
Summons (FL-110) (completed)
Response (FL-120) (blank)
Declaration Under UCCJEA (FL-105) (completed)
Declaration Under UCCJEA (FL-105) (blank)
Declaration of Disclosure, (if you have completed the following
documents at the time you serve the Summons and Petition.) This
consists of: completed and blank Declaration of Disclosure
(FL-140), Schedule of Assets and Debts (FL-142), Income and
Expense Declaration (FL-150).
If you file a Request for Order(s) at the same time you file your Summons and
Petition, you will need to serve a filed copy of those papers and a blank
Responsive Declaration on the Respondent.
What should I do after the other party has been served?
Have the person who served the Respondent complete and sign the
Proof of Service of Summons (FL-115).
Make 1 copy of the Proof of Service of Summons
File the completed Proof of Service and 1 copy at the Clerk’s Office,
in Martinez.
Family Law Info / Instructions
FamLaw-104 Rev. 4/6/16
2
WHEN: When do I have to have the other party served?
If you filed a Request for Order with the Summons and Petition, at
least 16 court days before the hearing or as otherwise stated on
your Court papers.
If you did not file a Request for Order with the Summons and
Petition, as soon as possible.
WHERE: Where do I get a Proof of Service?
Contra Costa County Public Law Library, AF Bray Building, 1020 Ward
Street, 1st Floor, Martinez, or online at www.cc-courts.org/forms.
WHY: Why do I have to have the other party served?
Nothing else may happen in your case if you do not file a Proof of Service.
For instance, you can’t take the other party’s default until you have filed the
Proof of Service of Summons.
If you filed a Request for Order when you filed the Petition and Summons
and the other party is not served, or is not served on time, the Judge may
not hear your case on the date set and may postpone your case until the
other party is properly served.
IF YOU HAVE QUESTIONS ABOUT SERVICE OR FILING YOUR PROOF
OF SERVICE OF SUMMONS AND YOU DO NOT HAVE AN ATTORNEY,
COME TO THE HELP DESK IN THE MARTINEZ, PITTSBURG OR
RICHMOND COURTHOUSES:
For addresses, days and times, check the Court’s website at:
www.cc-courts.org/FLF_days-hours
At the time of service I was at least 18 years of age and not a party to this action. I served the respondent with copies of:
PROOF OF SERVICE OF SUMMONS
(Family Law—Uniform Parentage—Custody and Support)
Form Approved for Optional Use
Judicial Council of California
FL-115 [Rev. January 1, 2015]
FL-115
1.
and
a.
(1)
(2)
(3)
(7)
b.
c.
–or–
–or–
(5)
(6)
(4)
a.
I served the respondent by the following means (check proper boxes):
on (date): at (time):
b.
(1)
(2)
(name):
d.
Page 1 of 2
(8)
Code of Civil Procedure, § 417.10
www.courts.ca.gov
who is (specify title or relationship to respondent):
PROOF OF SERVICE OF SUMMONS
FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
CASE NUMBER:
Family Law—Marriage/Domestic Partnership: Petition—Marriage/Domestic Partnership (form FL-100), Summons (form
FL-110), and blank Response—Marriage/Domestic Partnership (form FL-120)
Uniform Parentage: Petition to Establish Parental Relationship (form FL-200), Summons (form FL-210), and blank
Response to Petition to Establish Parental Relationship (form FL-220)
Custody and Support: Petition for Custody and Support of Minor Children (form FL-260), Summons (form FL-210), and
blank Response to Petition for Custody and Support of Minor Children (form FL-270)
Completed and blank Declaration Under
Uniform Child Custody Jurisdiction and
Enforcement Act (form FL-105)
Completed and blank Declaration of
Disclosure (form FL-140)
Completed and blank Schedule of Assets
and Debts (form FL-142)
Completed and blank Income and
Expense Declaration (form FL-150)
Completed and blank Financial Statement
(Simplified) (form FL-155)
Completed and blank Property
Declaration (form FL-160)
Request for Order (form FL-300), and blank
Responsive Declaration to Request for Order (form
FL-320)
Other (specify):
2.
3.
Personal service. I personally delivered the copies to the respondent (Code Civ. Proc., § 415.10)
Substituted service. I left the copies with or in the presence of
(Business) a person at least 18 years of age who was apparently in charge at the office or usual place of
business of the respondent. I informed him or her of the general nature of the papers.
(Home) a competent member of the household (at least 18 years of age) at the home of the respondent. I
informed him or her of the general nature of the papers.
on (date):
A declaration of diligence is attached, stating the actions taken to first attempt personal service.
I thereafter mailed additional copies (by first class, postage prepaid) to the respondent at the place where the
copies were left (Code Civ. Proc., § 415.20b) on
(date):
at (time):
Address where respondent was served:
Person who served papers
The fee for service was (specify): $
a.
b.
c.
(1)
Registration no.:
County:
5.
6.
PROOF OF SERVICE OF SUMMONS
(Family Law—Uniform Parentage—Custody and Support)
FL-115 [Rev. January 1, 2015]
4.
This person is
(2)
c.
(1)
(2)
(specify code section):
d.
–or–
Name:
Telephone number:
d.
Page 2 of 2
CASE NUMBER:
RESPONDENT:
PETITIONER:
3.
Mail and acknowledgment service. I mailed the copies to the respondent, addressed as shown in item 2, by
first-class mail, postage prepaid, on
Other
with two copies of the Notice and Acknowledgment of Receipt (form FL-117) and a postage-paid return
envelope addressed to me. (Attach completed Notice and Acknowledgment of Receipt (form FL-117).)
(Code Civ. Proc., § 415.30.)
to an address outside California (by registered or certified mail with return receipt requested). (Attach signed
return receipt or other evidence of actual delivery to the respondent.) (Code Civ. Proc., §§ 415.40, 417.20.)
Continued on Attachment 3d.
Address:
exempt from registration under Business and Professions Code section 22350(b).
not a registered California process server.
a registered California process server:
an employee or
an independent contractor
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
I am a California sheriff, marshal, or constable, and I certify that the foregoing is true and correct.
Date:
(NAME OF PERSON WHO SERVED PAPERS) (SIGNATURE OF PERSON WHO SERVED PAPERS)
(date):
from (city):
FL-115
I agree I received the following:
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
(Family LaW)
Form Approved for Optional Use
Judicial Council of California
FL-117 [Rev. January 1, 2015]
FL-117
a.
b.
c.
Page 1 of 1
Code of Civil Procedure, § 415.30, 417.10
www.courts.ca.gov
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
CASE NUMBER:
Family Law: Petition—Marriage/Domestic Partnership (form FL-100), Summons (form FL-110), and blank Response—
Marriage/Domestic Partnership (form FL-120)
Uniform Parentage: Petition to Establish Parental Relationship (form FL-200), Summons (form FL-210), and blank
Response to Petition to Establish Parental Relationship (form FL-220)
Custody and Support: Petition for Custody and Support of Minor Children (form FL-260), Summons (form FL-210), and
blank Response to Petition for Custody and Support of Minor Children (form FL-270)
ACKNOWLEDGMENT OF RECEIPT
NOTICE
The documents identified below are being served on you by mail with this acknowledgment form. You must personally sign, or a
person authorized by you must sign, this form to acknowledge receipt of the documents.
If the documents described below include a summons and you fail to complete and return this acknowledgment form to the sender
within 20 days of the date of mailing, you will be liable for the reasonable expenses incurred after that date in serving you or
attempting to serve you with these documents by any other methods permitted by law. If you return this form to the sender, service
of a summons is deemed complete on the date you sign the acknowledgment of receipt below. This is not an answer to the action.
If you do not agree with what is being requested, you must submit a completed Response form to the court within 30 calendar days.
To (name of individual being served):
Recipient signed this acknowledgment on (specify date):
Date of mailing (specify):
(TYPE OR PRINT SENDER'S NAME)
(SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE
AND MUST BE 18 YEARS OR OLDER)
(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT)
(TYPE OR PRINT NAME OF PERSON ACKNOWLEDGING RECEIPT)
(1)
(2)
(3)
(7)
(4)
d.
(8)
Completed and blank Declaration Under Uniform
Child Custody Jurisdiction and Enforcement Act
(form FL-105)
Completed and blank Declaration of Disclosure
(form FL-140)
Completed and blank Schedule of Assets and
Debts (form FL-142)
Completed and blank Property Declaration (form
FL-160)
Request for Order (form FL-300), and blank
Responsive Declaration to Request for Order
(form FL-320)
Other (specify):
(6)
Completed and blank Financial Statement
(Simplified) (form FL-155)
Completed and blank Income and Expense
Declaration (form FL-150)
(5)
4.
2.
1.
3.
5.
6.
(Sender completes items 1 through 4 and signs before mailing. Recipient completes items 5 and 6, signs, then returns)
Petitioner and Respondent signed a voluntary declaration of parentage or paternity. (Attach a copy if available.)
AMENDED
RESPONSE
Dissolution (Divorce) of:
Marriage
Domestic Partnership
Nullity of: Marriage
Domestic Partnership
Legal Separation of: Marriage Domestic Partnership
AND REQUEST FOR
FOR COURT USE ONLY
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
ZIP CODE:STATE: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:
RESPONDENT:
PETITIONER:
CASE NUMBER:
FL-120
LEGAL RELATIONSHIP (check all that apply):
a. We are married.
b.
We are domestic partners and our domestic partnership was established in California.
We are domestic partners and our domestic partnership was NOT established in California.
c.
1.
Page 1 of 3
Form Adopted for Mandatory Use
Judicial Council of California
FL-120 [Rev. January 1, 2020]
RESPONSE—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
Family Code, § 2020
www.courts.ca.gov
MINOR CHILDREN
If there are minor children of Petitioner and Respondent, a completed Declaration Under Uniform Child Custody Jurisdiction
and Enforcement Act (UCCJEA) (form ) must be attached.
d.
4.
There are no minor children.
a.
The minor children are:b.
continued on Attachment 4b.
Child's name
Birthdate Age
a child who is not yet born.
(2)(1)
e.
RESIDENCE REQUIREMENTS (check all that apply):
has been a resident of this state for at least six months and of this county for at least
three months immediately preceding the filing of this Petition. (For a divorce, unless you are in the legal relationship
described in 1b., at least one of you must comply with this requirement.)
2.
a.
Respondent Petitioner
Our domestic partnership was established in California. Neither of us has to be a resident or have a domicile in California
to dissolve our partnership here.
b.
STATISTICAL FACTS
Date of marriage (specify): Date of separation (specify):
a.
b.
3.
(1)
(1)
(2)
(2)
Date of separation (specify):
Registration date of domestic partnership with the California Secretary of State or other state equivalent (specify below):
If any children were born before the marriage or domestic partnership, the court has the authority to determine those children to
be children of the marriage or domestic partnership.
c.
c. We are the same sex, were married in California, but currently live in a jurisdiction that does not recognize, and will not
dissolve, our marriage. This Petition is filed in the county where we married.
Petitioner lives in (specify): Respondent lives in (specify):
Years(3) Months
Time from date of marriage to date of separation (specify):
(3)
Time from date of registration of domestic partnership to date of separation (specify):
MonthsYears
FL-105
Respondent requests that the court make the following orders:
SPOUSAL OR DOMESTIC PARTNER SUPPORT8.
b.
Respondent PetitionerTerminate (end) the court's ability to award support to
Petitioner Respondent a. Spousal or domestic partner support payable to
c.
Reserve for future determination the issue of support payable to
Respondent Petitioner
Other (specify):
d.
9.
SEPARATE PROPERTY
Page 2 of 3
RESPONSE—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
CASE NUMBER:
RESPONDENT:
PETITIONER:
Respondent contends that the parties never legally married or registered a domestic partnership.
Respondent denies the grounds set forth in item 5 of the petition.
Respondent requests
(2) Nullity of void marriage or domestic partnership based on
(a) incest. (b) bigamy.
(3) Nullity of voidable marriage or domestic partnership based on
(a) respondent’s age at time of registration of
domestic partnership or marriage.
(b)
prior existing marriage or domestic partnership.
(c) unsound mind.
(d) fraud.
(e) force.
(f) physical incapacity.
Legal separation of the marriage or domestic partnership based onDivorce (1)
(a) irreconcilable differences. permanent legal incapacity to make decisions.(b)
a.
b.
5.
c.
LEGAL GROUNDS (Family Code sections 2200–2210; 2310–2312)
b.
Confirm as separate property the assets and debts in
the following list. Item Confirm to
Property Declaration (form ).
a. There are no such assets or debts that I know of to be confirmed by the court.
FL-120
6. CHILD CUSTODY AND VISITATION (PARENTING TIME)
Legal custody of children to
.........................................................
....................................................
Physical custody of children to
Child visitation (parenting time) be granted to
.............................
As requested in
Petitioner Respondent Joint Other
b.
c.
a.
Any party required to pay support must pay interest on overdue amounts at the "legal" rate, which is currently 10 percent.
7. CHILD SUPPORT
a.
b.
c.
Other (specify):
d.
If there are minor children born to or adopted by Petitioner and Respondent before or during this marriage or domestic
partnership, the court will make orders for the support of the children upon request and submission of financial forms by the
requesting party.
An earnings assignment may be issued without further notice.
FL-120 [Rev. January 1, 2020]
form FL-311 form FL-312 form FL-341(C)
form FL-341(D) form FL-341(E) Attachment 6c(1)
FL-160
Attachment 9b.
Page 3 of 3
RESPONSE—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
CASE NUMBER:
RESPONDENT:
PETITIONER:
Date:
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
(TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT)
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR RESPONDENT)
a.
There are no such assets or debts that I know of to be divided by the court.
as follows (specify):
Determine rights to community and quasi-community assets and debts. All such assets and debts are listed
b.
Property Declaration (form ).
COMMUNITY AND QUASI-COMMUNITY PROPERTY10.
OTHER REQUESTS11.
Attorney's fees and costs payable by a.
b
Respondent's former name be restored to
(specify):
c.
Continued on Attachment 11c..
Other (specify):
NOTICE—CANCELLATION OF RIGHTS: Dissolution or legal separation may automatically cancel the rights of a domestic partner
or spouse under the other domestic partner's or spouse's will, trust, retirement plan, power of attorney, pay-on-death bank account,
survivorship rights to any property owned in joint tenancy, and any other similar thing. It does not automatically cancel the right of a
domestic partner or spouse as beneficiary of the other partner's or spouse's life insurance policy. You should review these matters,
as well as any credit cards, other credit accounts, insurance polices, retirement plans, and credit reports, to determine whether they
should be changed or whether you should take any other actions. Some changes may require the agreement of your partner or
spouse or a court order.
NOTICE: You may redact (black out) social security numbers from any written material filed with the court in this case other than a
form used to collect child, spousal or partner support.
The original response must be filed in the court with proof of service of a copy on Petitioner.
FL-120
Respondent Petitioner
FL-120 [Rev. January 1, 2020]
FOR MORE INFORMATION: Read Legal Steps for a Divorce or Legal Separation ( ) and visit "Families Change"
at www.familieschange.ca.gov
an online guide for parents and children going through divorce or separation.
Attachment 10b.
FL-160
Print this form
Save this form
Clear this form
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This Form button after you have printed the form.
form FL-107-INFO
Family Law Info / Instructions
FamLaw-105 Rev. 4/6/16
Superior Court of California, County of Contra Costa
DECLARATION OF DISCLOSURE
INSTRUCTIONS
1. Parties to dissolution, legal separation and nullity cases are required to exchange a
Preliminary Declaration of Disclosure with the other party. The following forms are
the Declaration of Disclosure forms:
[ ] Declaration of Disclosure (FL-140)
[ ] Schedule of Assets and Debts (FL-142)
[ ] Income and Expense Declaration (FL-150)
2. Complete these 3 forms. Make 1 copy each of forms FL-140 and FL-142. Do not
file these forms with the court.
3. Make 2 copies of form FL-150 and file with the court.
4. Serve a copy of each form (FL-140, FL-142, and a filed copy of FL-150) on the
other party in your case.
5. Complete and sign the Declaration Re: Service of Declaration of Disclosure
(FL- 141). This document is very important; it tells the Court that you have
completed and served your Preliminary Declaration of Disclosure.
6. Make 2 copies and file FL-141 with the court. File the completed Proof of Service and
copies at the Clerk’s Office, in Martinez.
7. Serve a copy of the filed FL-141 on the other party by mail. See Form FL-335,
Proof of Service by Mail.
There are instructions for filling out these forms on the court’s self-help website at
www.cc-courthelp.org/formsinstructions.
It is best to serve the Declaration of Disclosure on the other party as soon as possible
so your case will move forward.
You can prepare these forms and serve them with the Summons and Petition or you
can serve them later by mail or personal service.
There is a requirement to complete a Final Declaration of Disclosure but parties may
agree to waive this requirement as part of the judgment process.
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO. :
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
CASE NUMBER:
DECLARATION OF DISCLOSURE
Petitioner's
Respondent's
Preliminary
Final
DO NOT FILE DECLARATIONS OF DISCLOSURE OR FINANCIAL ATTACHMENTS WITH THE COURT
FL-140
Page 1 of 1
Form Adopted for Mandatory Use
Judicial Council of California
FL-140 [Rev. July 1, 2013]
DECLARATION OF DISCLOSURE
(Family Law)
Family Code, §§ 2102, 2104,
2105, 2106, 2112
www.courts.ca.gov
A completed Schedule of Assets and Debts (form FL-142) or
A completed Income and Expense Declaration (form FL-150).
A statement of all material facts and information regarding valuation of all assets that are community property or in which the
community has an interest (not a form).
A statement of all material facts and information regarding obligations for which the community is liable (not a form).
All tax returns filed by the party in the two years before the date that the party served the disclosure documents.
Community and Quasi-Community Property Separate Property.
A Property Declaration (form FL-160) for (specify):
SIGNATURE
An accurate and complete written disclosure of any investment opportunity, business opportunity, or other income-producing
opportunity presented since the date of separation that results from any investment, significant business, or other income-
producing opportunity from the date of marriage to the date of separation (not a form).
Attached are the following:
1.
2.
3.
4.
5.
6.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
(TYPE OR PRINT NAME)
In a dissolution, legal separation, or nullity action, both a preliminary and a final declaration of disclosure must be served on the other
party with certain exceptions. Neither disclosure is filed with the court. Instead, a declaration stating that service of disclosure
documents was completed or waived must be filed with the court (see form FL-141).
The petitioner must serve a preliminary declaration of disclosure at the same time as the Petition or within 60 days of filing the Petition.
The respondent must serve a preliminary declaration of disclosure at the same time as the Response or within 60 days of filing the
Response. The time periods may be extended by written agreement of the parties or by court order (see Family Code section 2104(f)).
In summary dissolution cases, each spouse or domestic partner must exchange preliminary disclosures as described in Summary
Dissolution Information (form FL-810). Final disclosures are not required (see Family Code section 2109).
Parties who agree to waive final declarations of disclosure must file their written agreement with the court (see form FL-144).
Service of preliminary declarations of disclosure may not be waived by an agreement between the parties.
In a default judgment case that is not a stipulated judgment or a judgment based on a marital settlement agreement, only the
petitioner is required to complete and serve a preliminary declaration of disclosure. A final disclosure is not required of either party
(see Family Code section 2110).
Date:
FL-142
TELEPHONE NO.:
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
PETITIONER:
RESPONDENT:
CASE NUMBER:
SCHEDULE OF ASSETS AND DEBTS
Petitioner's Respondent's
INSTRUCTIONS
List all your known community and separate assets or debts. Include assets even if they are in the possession of another person,
including your spouse. If you contend an asset or debt is separate, put P (for Petitioner) or R (for Respondent) in the first column
(separate property) to indicate to whom you contend it belongs.
All values should be as of the date of signing the declaration unless you specify a different valuation date with the description. For
additional space, use a continuation sheet numbered to show which item is being continued.
AMOUNT OF MONEY
OWED OR
ENCUMBRANCE
CURRENT GROSS
FAIR MARKET
VALUE
SEP.
PROP
DATE
ACQUIRED
ASSETS DESCRIPTION
ITEM
NO.
$$
1. REAL ESTATE (Give street addresses and attach copies of
deeds with legal descriptions and latest lender's statement.)
2. HOUSEHOLD FURNITURE, FURNISHINGS, APPLIANCES
(Identify.)
3. JEWELRY, ANTIQUES, ART, COIN COLLECTIONS, etc.
Page 1 of 4
Form Approved for Optional Use
Judicial Council of California
FL-142 [Rev. January 1, 2005]
SCHEDULE OF ASSETS AND DEBTS
(Family Law)
Code of Civil Procedure, §§ 2030(c), 2033.5
www.courtinfo.ca.gov
(Identify.)
THIS FORM SHOULD NOT BE FILED WITH THE COURT
JUDICIAL SUBPOENA
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
Courtat thethe Honorable
located at
County of
o'clock in theday of noon, and at any recessedin room , on the , 20 , at
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
I
Calendar No.
THE PEOPLE OF THE STATE OF NEW YORK
TO
Index No.
,
American LegalNet, Inc.
www.USCourtForms.com
Court in
Witness, Honorable , one of the Justices of the
day of , 20County,
COURT
COUNTY OF
Plaintiff(s)
-against-
Defendant(s)
:
:
:
:
:
:
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mobile Tel. No.:
4. VEHICLES, BOATS, TRAILERS (Describe and attach copy of
title document.)
5. SAVINGS ACCOUNTS (Account name, account number,
bank, and branch. Attach copy of latest statement.)
6. CHECKING ACCOUNTS (Account name and number, bank,
and branch. Attach copy of latest statement.)
7. CREDIT UNION, OTHER DEPOSIT ACCOUNTS (Account
name and number, bank, and branch. Attach copy of latest
statement.)
8. CASH (Give location.)
9. TAX REFUND
10. LIFE INSURANCE WITH CASH SURRENDER OR LOAN
VALUE (Attach copy of declaration page for each policy.)
SCHEDULE OF ASSETS AND DEBTS
(Family Law)
Page 2 of 4
FL-142 [Rev. January 1, 2005]
$$
AMOUNT OF MONEY
OWED OR
ENCUMBRANCE
CURRENT GROSS
FAIR MARKET
VALUE
SEP.
PROP
DATE
ACQUIRED
ASSETS DESCRIPTION
ITEM
NO.
11. STOCKS, BONDS, SECURED NOTES, MUTUAL FUNDS
(Give certificate number and attach copy of the certificate or
copy of latest statement.)
12. RETIREMENT AND PENSIONS (Attach copy of latest
summary plan documents and latest benefit statement.)
13. PROFIT - SHARING, ANNUITIES, IRAS, DEFERRED
COMPENSATION (Attach copy of latest statement.)
14. ACCOUNTS RECEIVABLE AND UNSECURED
NOTES (Attach copy of each.)
15. PARTNERSHIPS AND OTHER BUSINESS INTERESTS
(Attach copy of most current K-1 form and Schedule C.)
16. OTHER ASSETS
17. TOTAL ASSETS FROM CONTINUATION SHEET
$
$
18. TOTAL ASSETS
SCHEDULE OF ASSETS AND DEBTS
(Family Law)
FL-142 [Rev. January 1, 2005]
Page 3 of 4
$$
AMOUNT OF MONEY
OWED OR
ENCUMBRANCE
CURRENT GROSS
FAIR MARKET
VALUE
SEP.
PROP
DATE
ACQUIRED
ASSETS DESCRIPTION
ITEM
NO.
DEBTS—SHOW TO WHOM OWED
SEP.
PROP.
ITEM
NO.
TOTAL
DATE
OWING
INCURRED
$
19. STUDENT LOANS (Give details.)
20. TAXES (Give details.)
21. SUPPORT ARREARAGES (Attach copies of orders and statements.)
22. LOANS—UNSECURED (Give bank name and loan number and attach copy of latest
statement.)
23. CREDIT CARDS (Give creditor's name and address and the account number. Attach
copy of latest statement.)
24. OTHER DEBTS (Specify.):
25. TOTAL DEBTS FROM CONTINUATION SHEET
$
26. TOTAL DEBTS
pages are attached as continuation sheets.
27.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF DECLARANT)
SCHEDULE OF ASSETS AND DEBTS
(Family Law)
Page 4 of 4
FL-142 [Rev. January 1, 2005]
(Specify number):
(If you need more space to answer any questions on this form, attach an 8 1/2-by-11-inch sheet of paper and write the
question number before your answer.)
1.
Employment (Give information on your current job or, if you're unemployed, your most recent job.)
Form Adopted for Mandatory Use
Judicial Council of California
FL-150 [Rev. January 1, 2019]
INCOME AND EXPENSE DECLARATION
Family Code, §§ 2030–2032, 2100–2113,
3552, 3620–3634, 4050–4076, 4300–4339
www.courts.ca.gov
Page 1 of 4
Employer:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
OTHER PARTY/PARENT/CLAIMANT:
FOR COURT USE ONLY
CASE NUMBER:
INCOME AND EXPENSE DECLARATION
PARTY WITHOUT ATTORNEY OR ATTORNEY
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
STATE BAR NUMBER:
FL-150
Attach copies
of your pay
stubs for last
two months
(black out
Social
Security
numbers).
a.
Employer's address:
b.
Employer's phone number:
c.
Occupation:
d.
Date job started:
e.
If unemployed, date job ended:
f.
g. I work about hours per week.
h. I get paid $ gross (before taxes)
(If you have more than one job, attach an 8 1/2-by-11-inch sheet of paper and list the same information as above for your other
jobs. Write "Question 1—Other Jobs" at the top.)
2.
Age and education
My age is (specify):
a.
b.
I have completed high school or the equivalent:
Yes
No
If no, highest grade completed (specify):
Number of years of college completed (specify):
c.
Degree(s) obtained
(specify):
Number of years of graduate school completed (specify):
d.
Degree(s) obtained
(specify):
e. I have: professional/occupational license(s)
(specify):
vocational training
(specify):
3.
Tax information
a.
I last filed taxes for tax year
(specify year):
b.
My tax filing status is
single
head of household married, filing separately
married, filing jointly with
(specify name):
c.
I file state tax returns in
California other
(specify state):
I claim the following number of exemptions (including myself) on my taxes (specify):
d.
Other party's income. I estimate the gross monthly income (before taxes) of the other party in this case at (specify): $
4.
This estimate is based on (explain):
Number of pages attached:
I declare under penalty of perjury under the laws of the State of California that the information contained on all pages of this form and
any attachments is true and correct.
(SIGNATURE OF DECLARANT)
Date:
(TYPE OR PRINT NAME)
per month per week
per hour.
Spousal support
Spousal support that I pay by court order from a different marriage ..........................
Attach copies of your pay stubs for the last two months and proof of any other income. Take a copy of your latest federal tax
return to the court hearing. (Black out your Social Security number on the pay stub and tax return.)
Income (For average monthly, add up all the income you received in each category in the last 12 months
and divide the total by 12.)
FL-150 [Rev. January 1, 2019]
Page 2 of 4
INCOME AND EXPENSE DECLARATION
FL-150
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARTY/PARENT/CLAIMANT:
5.
Salary or wages (gross, before taxes).....................................................................................................a.
Overtime (gross, before taxes)................................................................................................................b.
Commissions or bonuses.........................................................................................................................c.
Public assistance (for example: TANF, SSI, GA/GR) ..................................d.
e.
Partner supportf.
currently receiving
f
rom this marriage
from a different marriage
from this domestic partnership from a different domestic partnership
Pension/retirement fund payments..........................................................................................................g.
Social Security retirement (not SSI).........................................................................................................h.
Disability:i. Social Security (not SSI)
State disability (SDI) Private insurance
Unemployment compensation.................................................................................................................j.
Workers' compensation............................................................................................................................k.
l.
Other (military allowances, royalty payments) (specify):
Investment income (Attach a schedule showing gross receipts less cash expenses for each piece of property.)
6.
Dividends/interest....................................................................................................................................a.
Rental property income...........................................................................................................................b.
Trust income............................................................................................................................................c.
d.
Other (specify):
Income from self-employment, after business expenses for all businesses.........................................7.
I am the owner/sole proprietor
business partner other
(specify):
Number of years in this business (specify):
Name of business (specify):
Type of business (specify):
Attach a profit and loss statement for the last two years or a Schedule C from your last federal tax return. Black out your
Social Security number. If you have more than one business, provide the information above for each of your businesses.
Additional income. I received one-time money (lottery winnings, inheritance, etc.) in the last 12 months (specify source and
amount):
8.
Change in income. My financial situation has changed significantly over the last 12 months because (specify):
9.
10.
Deductions
Required union dues....................................................................................................................................................a.
Required retirement payments (not Social Security, FICA, 401(k), or IRA)..................................................................b.
Medical, hospital, dental, and other health insurance premiums (total monthly amount).............................................
c.
Child support that I pay for children from other relationships.......................................................................................d.
e.
Partner support that I pay by court order from a different domestic partnership..........................................................f.
Necessary job-related expenses not reimbursed by my employer (attach explanation labeled "Question 10g").........
g.
11.
Assets
Cash and checking accounts, savings, credit union, money market, and other deposit accounts...............................a.
Stocks, bonds, and other assets I could easily sell.......................................................................................................b.
All other property, (estimate fair market value minus the debts you owe).....
c. real and
personal
$
$
$
$
$
$
$
$
$
$
$
$
Last month
Average
monthly
$
$
$
$
$
Last month
Total
federally taxable*
federally tax deductible*
* Check the box if the spousal support order or judgment was executed by the parties and the court before January 1, 2019, or if a court-ordered change
maintains the spousal support payments as taxable income to the recipient and tax deductible to the payor.
$
$
$
$
$
$
$
$
$
$
The following people live with me:
FL-150 [Rev. January 1, 2019]
Page 3 of 4
INCOME AND EXPENSE DECLARATION
FL-150
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARTY/PARENT/CLAIMANT:
12.
Attorney fees (This information is required if either party is requesting attorney fees):
15.
a.
b.
c.
d.
My attorney's hourly rate is (specify):
I confirm this fee arrangement.
Average monthly expenses13. Estimated expenses
Actual expenses Proposed needs
Installment payments and debts not listed above14.
To date, I have paid my attorney this amount for fees and costs (specify): $
The source of this money was (specify):
I still owe the following fees and costs to my attorney (specify total owed): $
(SIGNATURE OF DECLARANT)
Date:
(TYPE OR PRINT NAME)
Name
Age
How the person is
related to me (ex: son)
That person's gross
monthly income
Pays some of the
household expenses?
a.
b.
c.
d.
e.
Yes
No
Yes No
Yes No
Yes No
Yes No
a.
Home:
(1) Rent or
mortgage..........
$
$
$
$
$
$
If mortgage:
(a) average principal:
$
(b) average interest:
$
(2) Real property taxes..................................
(3)
Homeowner's or renter's insurance
(if not included above)..............................
(4) Maintenance and repair...........................
b.
Health-care costs not paid by insurance........
c.
Child care.......................................................
$
d.
Groceries and household supplies.................
$
e.
Eating out.......................................................
$
f.
Utilities (gas, electric, water, trash)................
$
g.
Telephone, cell phone, and e-mail.................
$
$
h.
Laundry and cleaning.....................................
i.
Clothes...........................................................
$
j.
Education.......................................................
$
k.
Entertainment, gifts, and vacation..................
$
l.
Auto expenses and transportation
(insurance, gas, repairs, bus, etc.).................
$
m.
Insurance (life, accident, etc.; do not include
auto, home, or health insurance)...................
$
$
$
$
$
n.
Savings and investments...............................
o.
Charitable contributions..................................
p.
Monthly payments listed in item 14
(itemize below in 14 and insert total here).....
q.
Other (specify):
r.
TOTAL EXPENSES (a–q) (do not add in
the amounts in a(1)(a) and (b))
$
s.
Amount of expenses paid by others
Paid to For Amount Balance Date of last payment
$
$
$
$
$
$
$
$
$
$
$
$
CHILD SUPPORT INFORMATION
(NOTE: Fill out this page only if your case involves child support.)
FL-150 [Rev. January 1, 2019]
Page 4 of 4
INCOME AND EXPENSE DECLARATION
FL-150
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARTY/PARENT/CLAIMANT:
a.
b.
d.
(Do not include the amount your employer pays.)
Number of children16.
I do
I do not
I have (specify number): children under the age of 18 with the other parent in this case.
a.
Name of insurance company:
The monthly cost for the children's health insurance is or would be (specify): $
The children spend percent of their time with me and percent of their time with the other parent.
b.
(If you're not sure about percentage or it has not been agreed on, please describe your parenting schedule here.)
Children's health-care expenses17.
have health insurance available to me for the children through my job.
Address of insurance company:c.
Additional expense for the children in this case18.
Childcare so I can work or get job training....................................................................a.
Children's health care not covered by insurance...........................................................b.
Travel expenses for visitation........................................................................................c.
Special hardships. I ask the court to consider the following special financial circumstances19.
Extraordinary health expenses not included in 18b...................................a.
Major losses not covered by insurance (examples: fire, theft, other
insured loss)...............................................................................................
b.
Expenses for my minor children who are from other relationships and
are living with me..................................................................................
c.
d.
Children's educational or other special needs (specify below):.....................................
(attach documentation of any item listed here, including court orders):
(1)
Names and ages of those children (specify):
(2)
Child support I receive for those children...............................................(3)
The expenses listed in a, b, and c create an extreme financial hardship because (explain):
Other information I want the court to know concerning support in my case (specify):
20.
Amount per month
Amount per month
For how many months?
$
$
$
$
$
$
$
$
AFTER SERVICE OF THE
DISCLOSURE DOCUMENTS,
COMPLETE, FILE AND SERVE
THE FOLLOWING FORM
Family Law - Information
FamLaw-106 Rev. 8/22/11
TELEPHONE NO.: FAX NO. :
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
CASE NUMBER:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
DECLARATION REGARDING SERVICE OF DECLARATION OF
DISCLOSURE AND INCOME AND EXPENSE DECLARATION
Final
PreliminaryPetitioner's
Respondent's
FL-141
Page 1 of 1
Form Adopted for Mandatory Use
Judicial Council of California
FL-141 [Rev. July 1, 2013]
DECLARATION REGARDING SERVICE OF DECLARATION OF
DISCLOSURE AND INCOME AND EXPENSE DECLARATION
(Family Law)
Family Code, §§ 2102, 2104,
2105, 2106, 2112
www.courts.ca.gov
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Preliminary Declaration of Disclosure (form FL-140), current* Income and Expense
Declaration (form FL-150), completed Schedule of Assets and Debts (form FL-142) or Community and Separate Property
Declarations (form FL-160) with appropriate attachments, all tax returns filed by the party in the two years before service of the
preliminary disclosures, and all other required information under Family Code section 2104 were served on:
I am the
Petitioner's
Respondent's
the other party
the other party's attorney by personal service mail
Final Declaration of Disclosure (form FL-140), current* Income and Expense Declaration
(form FL-150), completed Schedule of Assets and Debts (form FL-142) or Community or Separate Property Declarations (form
FL-160) with attachments, and the material facts and information required by Family Code section 2105 were served on:
2.
3.
Service of
4.
attorney for
petitioner respondent
in this matter.
Petitioner's
Respondent's
the other party other party's attorney by
personal service
mail
(specify):Other
on (date):
(specify):
Other
on (date):
Petitioner's preliminary final
declaration of disclosure
Respondent's
a. The parties agreed to waive final declaration of disclosure requirements under Family Code section 2105(d.)
current income and expense declaration has been waived as follows:
The party has failed to comply with disclosure requirements, and the court has granted the request for voluntary waiver of
b.
on (date):
receipt under Family Code section 2107
c. This is a default proceeding that does not include a stipulated judgment or settlement agreement. Petitioner waives final
disclosure requirements under Family Code section 2110.
(date):was filed on
The waiver
is being filed at the same time as this form.
*Current is defined as completed within the past three months providing no facts have changed. (Cal. Rules of Court, rule 5.260.)
NOTE: File this document with the court.
Do not file a copy of the Preliminary or Final Declaration of Disclosure or
any attachments to either declaration of disclosure with this document.
SIGNATURE
(TYPE OR PRINT NAME)
Date:
(Form FL-144 may be used for this purpose.)
1.
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