Fillable Packet #2 1. Who has to complete the (California)

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Packet #2
1. Who has to complete the forms?
All Petitioners.
Any Respondent who files a Response.
A Respondent who does not file a response, but signs a “Marital
Settlement Agreement” with the petitioner.
2. What are the “Disclosures” forms?
The forms tell the other person what you earn, what you owe and
what you own.
The other side needs to know what you think about the money
involved in your marriage.
3. But, we don’t have anything; do I still have to do the forms?
Yes.
It doesn’t matter if you:
have nothing,
were together for a short time, or
have not seen the other side for years.
4. What do I do with the forms after I finish them?
You must give or mail a copy of the forms to the other side.
You can give or mail the copies yourself.
5. Do I file the forms with the court?
Forms File with the Court?
Declaration of Disclosure (FL-140)
No
List of Property and Debts
No
Income and Expense Declaration (FL-150)
No
If asking for support:
Yes
Declaration Regarding Service of Declaration of
Declaration of Disclosure (FL-141)
Yes
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 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.
 
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).
A completed Income and Expense Declaration (form FL-150).
Date:
LIST OF PROPERTY AND DEBTS
_______________________________________________________________________________________________________________________________________________________________________________________________
List all property and debts, even if it is not in your name or it is with someone else.
In General, Separate Property = property or debts you or your husband/wife/partner had before you were married or after
you separated, or are gifts or property you inherited.
In General, Community Property = property or debts you or your husband/wife/partner got between the date you were
married and the date you separated.
Value = how much money you could get if you sold the item, not what you paid for it or what it would cost to replace it.
1. Property
Items you own, for example, house, furniture,
jewelry, cars:
Check if
Separate
Property
List Date Value Money
owed,
if any
Petitioner Respondent
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
TOTAL
$
$
Bank accounts, credit union accounts, retirement
funds:
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
__/__/__
$
$
TOTAL
$
$
2. Debts
Bills, loans, credit cards, taxes:
Check if
Separate
Property Debt
Date Debt
occurred
Money
owed
Petitioner Respondent
__/__/__
$
__/__/__
$
__/__/__
$
__/__/__
$
__/__/__
$
__/__/__
$
__/__/__
$
TOTAL
$
I declare under penalty of perjury under the laws of the State of California that the forgoing is true and correct.
________________ _________________________________ ___________________________________
Date Print Name Signature
Optional Forms
VN236 (Rev. 07/11)
LIST OF PROPERTY AND DEBTS
Case Number
_______________________
VN236
(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
All other property, (estimate fair market value minus the debts you owe).....
c. real and
personal
* 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.
$
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.
$
$
$
$
$
$
$
$
$
$
$
$
Last month
Average
monthly
$
$
$
$
$
Last month
Total
federally taxable*
federally tax deductible*
$
$
$
$
$
$
$
$
$
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.
Children's health-care expenses17.
have health insurance available to me for the children through my job.
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)
20.
(If you're not sure about percentage or it has not been agreed on, please describe your parenting schedule here.)
Address of insurance company:
Amount per month
Other information I want the court to know concerning support in my case (specify):
The expenses listed in a, b, and c create an extreme financial hardship because (explain):
Amount per month
For how many months?
$
$
$
$
$
$
$
$
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
Preliminary
Petitioner'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):

on (date):
(specify):

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):

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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Completed 9 March 2021

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