1. Personal history. State your full name, current
12. Property valuations. During the past 12 months,
have you received written offers to purchase or had
written appraisals of any of the assets listed on your
completed Schedule of Assets and Debts? If your
answer is yes, identify the document.
residence address and work address, social security
number, any other names you have used, and the
dates between which you used each name.
2. Agreements. Are there any agreements between you
and your spouse or domestic partner, made before or
during your marriage or domestic partnership or after
your separation, that affect the disposition of assets,
debts, or support in this proceeding? If your answer is
yes, for each agreement state the date made and whether
it was written or oral, and attach a copy of the agreement
or describe its contents.
13. Property held by others. Is there any property
held by any third party in which you have any interest or
over which you have any control? If your answer is yes,
indicate whether the property is shown on the Schedule
of Assets and Debts completed by you. If it is not,
describe and identify each such asset, state its present
value and the basis for your valuation, and identify the
person holding the asset.
3. Legal actions. Are you a party or do you anticipate
being a party to any legal or administrative proceeding
other than this action? If your answer is yes, state your
role and the name, jurisdiction, case number, and a brief
description of each proceeding.
14. Retirement and other benefits. Do you have an
interest in any disability, retirement, profit-sharing, or
deferred compensation plan? If your answer is yes,
identify each plan and provide the name, address,
and telephone number of the administrator and
custodian of records.
4. Persons sharing residence. State the name, age,
and relationship to you of each person at your present
address.
15. Claims of reimbursement. Do you claim the legal
right to be reimbursed for any expenditures of your
separate or community property? If your answer is
yes, state all supporting facts.
5. Support provided others. State the name, age,
address, and relationship to you of each person for
whom you have provided support during the past 12
months and the amount provided per month for each.
16. Credits. Have you claimed reimbursement credits
6. Support received for others. State the name, age,
for payments of community debts since the date of
separation? If your answer is yes, identify the
source of payment, the creditor, the date paid, and
the amount paid. State whether you have added to
the debt since the separation.
address, and relationship to you of each person for
whom you have received support during the past 12
months and the amount received per month for each.
7. Current income. List all income you received during
17. Insurance. Identify each health, life, automobile,
the past 12 months, its source, the basis for its
computation, and the total amount received from
each. Attach your last three paycheck stubs.
and disability insurance policy or plan that you now
own or that covers you, your children, or your
assets. State the policy type, policy number, and
name of the company. Identify the agent and give
the address.
8. Other income. During the past three years, have you
received cash or other property from any source not
identified in item 7? If so, list the source, the date, and
the nature and value of the property.
18. Health. Is there any physical or emotional condition
that limits your ability to work? If your answer is yes,
state each fact on which you base your answer.
9. Tax returns. Attach copies of all tax returns and tax
19. Children’s needs. Do you contend that any of
schedules filed by or for you in any jurisdiction for the
past three calendar years.
your children have any special needs? If so, identify
the child with the need, the reason for the need, its
cost, and its expected duration.
10. Schedule of assets and debts. Complete the
Schedule of Assets and Debts (form FL-142) served
with these interrogatories.
20. Attorney fees. State the total amount of attorney
fees and costs incurred by you in this proceeding,
the amount paid, and the source of the money paid.
Describe the billing arrangements.
11. Separate property contentions. State the facts that
support your contention that an asset or debt is
separate property.
21. Gifts. List any gifts you have made without the
consent of your spouse or domestic partner in the
past 24 months, their values, and the recipients.
FORM INTERROGATORIES–FAMILY LAW
Page 2 of 2
FL-145 [Rev. January 1, 2006]
FL-145
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