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:
PETITIONER:
RESPONDENT:
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. July 1, 2016]
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 FL-105
) must be attached.
d.
4.
There are no minor children.
a.
The minor children are:b.
continued on Attachment 4b.
Child's name
Birthdate SexAge
a child who is not yet born.
(2)(1)
attached.
Petitioner and Respondent signed a voluntary declaration of paternity. A copy
is not
is
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, at least one person in the legal relationship
described in items 1a and 1c 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
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.:
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
Self-Represented
San Bernardino
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
FL-120 [Rev. July 1, 2016]
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 Attachment 9b.
Property Declaration (form FL-160).
the following list. Item Confirm to
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 form FL-311 form FL-312 form FL-341(C)
form FL-341(D) form FL-341(E) Attachment 6c(1)
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.
Print This Form
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This Form button after you have printed the form.
FL-120 [Rev. July 1, 2016] 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.
in Attachment 10b.
in Property Declaration (form FL-160).
as follows (specify):
Determine rights to community and quasi-community assets and debts. All such assets and debts are listed
b.
COMMUNITY AND QUASI-COMMUNITY PROPERTY10.
OTHER REQUESTS11.
Attorney's fees and costs payable bya.
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.
FOR MORE INFORMATION: Read Legal Steps for a Divorce or Legal Separation (form FL-107-INFO) and visit "Families Change"
at www.familieschange.ca.gov
an online guide for parents and children going through divorce or separation.
FL-120
Respondent Petitioner
(1)
(2)
at
(day of week)
(time)
from
(b)
(a)
having the initial fifth weekend, which starts (date):
The parties will alternate the fifth weekends, with the petitioner respondent
even numbered months.
odd
The
other parent/party will have the fifth
respondent
petitioner
weekend in
other parent/party
1st 2nd 3rd 4th 5th weekend of the month
at
(day of week)
(time)
to
(Note: The first weekend of the month is the first weekend with a Saturday.)
a.m.
p.m./ if applicable, specify:
start of school
after school
a.m.
p.m./ if applicable, specify:
start of school
after school
Alternate weekends starting
(date):
(date):
Weekends starting
at
(day of week)
(time)
from
at
(day of week)
to
(time)
(3)
(date):
Weekdays starting
at
(day of week)
(time)
from
at
(day of week)
(time)
to
(4)
Other visitation (parenting time) days and restrictions are:
as follows:
listed in Attachment 2e(4)
a.m.
p.m./ if applicable, specify:
after school
start of school
a.m.
p.m./ if applicable, specify:
start of school
after school
a.m.
p.m./ if applicable, specify:
start of school
after school
a.m.
p.m./ if applicable, specify:
start of school
after school
Other Parent's/Party's parenting time (visitation) will be as follows:Respondent's
Petitioner's
d.
dated (specify date):
-page document
a.
b.
c.
e.
Reasonable right of parenting time (visitation) to the party without physical custody (not appropriate in cases
involving domestic violence).
See the attached
The parties will go to child custody mediation or child custody recommending counseling at (specify date, time, and
No visitation (parenting time).
Visitation (parenting time).
(Specify start and ending date and time. If applicable, check "start of" OR "after school.")
location):
Note: Unless specifically ordered, a child's holiday schedule order has priority over the regular parenting time.
CHILD CUSTODY AND VISITATION (PARENTING TIME) APPLICATION ATTACHMENT
—This is not a court order—
TO Petition Response Request for Order Responsive Declaration to Request for Order
(specify):
Other
CHILD CUSTODY AND VISITATION (PARENTING TIME)
APPLICATION ATTACHMENT
Form Approved for Optional Use
Judicial Council of California
FL-311 [Rev. July 1, 2016]
1. Custody. Custody of the minor children of the parties is requested as follows:
Child's Name Date of Birth
Legal Custody to (person who decides
about health, education, etc.)
Physical Custody to (person
with whom the child lives)
2.
Page 1 of 2
Family Code, § 6200 et seq.
www.courts.ca.gov
Visitation (Parenting Time).
FL-311
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
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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.:
Page 2 of 2
FL-311 [Rev. July 1, 2016]
4.
(address):
(name):
(address):
Transportation to begin the visits will be provided by
Transportation from the visits will be provided by
The exchange point at the beginning of the visit will be
The exchange point at the end of the visit will be
During the exchanges, the party driving the children will wait in the car and the other party will wait in his or her
home (or exchange location) while the children go between the car and the home (or exchange location).
Other
(specify):
The children will be driven only by a licensed and insured driver. The car or truck must have legal child restraint devices.
(name):
g.
a.
b.
c.
e.
f.
d.
6.
7.
8.
9.
3.
I request that (name):
have supervised visitation (parenting time)
with the minor children according to the schedule set out on page 1.
percent; respondent:
who is a
professional nonprofessional supervisor.
I request that any costs of supervision be paid as follows: petitioner:
percent;
other parent/party: percent.
If item 3 is checked, you must attach a declaration that shows why unsupervised visitation (parenting time)
would be bad for your children. The judge is required to consider supervised visitation if one parent or party is
alleging domestic violence and is protected by a restraining order.
d.
c.
b.
a.
I request that the visitation (parenting time) be supervised by (name):
e.
The supervisor's phone number is (specify):
The person who supervises the visitation (parenting time) must meet the requirements listed in Declaration of
Supervised Visitation Provider (form FL-324) under Family Code § 3200.5.
5.
a.
c.
(specify):
(specify):
the state of California.
the following counties
other places
b.
must have written permission from the other parent or party, or a court order, to take the children out of the following places:
10.
Supervised visitation (parenting time).
Transportation for visitation (parenting time) and place of exchange.
Travel with children. The
Child abduction prevention. There is a risk that one of the parties will take the children out of California without the other
party's permission. I request the orders set out on attached form FL-312.
Children's holiday schedule. I request the holiday and vacation schedule set out on the attached
Additional custody provisions. I request the additional orders regarding custody set out on the attached
Joint legal custody provisions. I request joint legal custody and want the additional orders set out on the attached
Other. I request the following additional orders (specify):
petitioner respondent other parent/party
form FL-341(C)
Other
(specify):
form FL-341(D)
Other
(specify):
form FL-341(E) Other
(specify):
FL-311
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
CHILD CUSTODY AND VISITATION (PARENTING TIME)
APPLICATION ATTACHMENT
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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
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seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
Self Represented Litigant
San Bernardino
Same
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.
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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)
c.
d.
e.
To keep other people from seeing what you entered on your form, please press the Clear This Form button at the end of the form when
finished.
Print This Form
Clear This Form
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button after you have printed the form.
Werecommendthatyouseeklegaladviceregardingthedivisionofyourproperty,especiallyretirement
accounts.Tofindalawyer,contacttheLawyerReferralServicesfromtheSanBernardinoCountyBar
Associationwww.sbcba.orgorWesternSanBernardinoCountyBarAssociationwww.wsbcba.org
Here are some general rules about property. However, there could be
exceptions based upon agreements between spouses, the conduct of spouses,
and the types of debt acquired (like student loans and necessaries of life)
Before Marriage It is your separate property.
During Marriage It is community property. This includes retirement
accounts and pensions. (exception for gifts or inheritance)
After You Separate It is your separate property, unless the money to
purchase came from your earnings during marriage. (You might be responsible
for spouse’s debts for the necessaries of life, too.)
Unless the parties agree otherwise, community property is to be
split evenly.
Failure to disclose your assets could result in a loss of valuable
property rights. If you hide an asset, the judge can award 100% of
it to your spouse, even if it is community property.
☆☆MANDATORY FINANCIAL DISCLOSURES OF PROPERTY/DEBT☆☆
Step #1: Disclosure to Spouse Even if you have no property, you must still fill out
the forms and serve on your spouse. Family Code Section 2104 requires that this
disclosure include the identity of all property owned by the party plus all debts,
regardless of whether the property/debts would be labeled community property or
separate property. This packet contains the forms needed to comply with this law.
Step #2: File Papers With Court (with Petition or no later than 60 days)
Declaration of Disclosure (FL-140) – NEVER filed with the clerk.
Property Declaration (FL-160) – ONLY FILED WHEN you use the form to list
out your property rather than write it on the Petition Question #5.
Income & Expense Declaration (FL-150) – ALWAYS filed with the clerk.
Declaration Regarding Service of Declaration of Disclosure and Income &
Expense Declaration (FL-141) - ALWAYS filed with the clerk.
YOUR PROPERTY RIGHTS
FL-160
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
PARTY WITHOUT ATTORNEY OR ATTORNEY
STATE BAR NUMBER:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
CASE NUMBER:
PETITIONER'S
RESPONDENT'S
COMMUNITY AND QUASI-COMMUNITY PROPERTY DECLARATION
SEPARATE PROPERTY DECLARATION
See Instructions on page 4 for information about completing this form. For additional space, use Continuation of Property Declaration
(form FL-161
).
A
B C - D = E
F
ITEM BRIEF DESCRIPTION
NO.
DATE
ACQUIRED
GROSS FAIR
MARKET
VALUE
AMOUNT
OF DEBT
NET FAIR
MARKET
VALUE
PROPOSAL FOR DIVISION
Award or Confirm to:
PETITIONER RESPONDENT
1. REAL ESTATE $ $ $ $ $
2. HOUSEHOLD FURNITURE,
FURNISHINGS, APPLIANCES
3. JEWELRY, ANTIQUES, ART,
COIN COLLECTIONS, etc.
4. VEHICLES, BOATS, TRAILERS
5. SAVINGS ACCOUNTS
6. CHECKING ACCOUNTS
Page 1 of 4
Form Approved for Mandatory Use
Judicial Council of California
FL-160 [Rev. July 1, 2016]
PROPERTY DECLARATION
(Family Law)
Family Code, §§ 115, 2104, 2500-2660
www.courts.ca.gov
Self-Represented
San Bernardino
A
B C - D = E
F
ITEM BRIEF DESCRIPTION
NO.
DATE
ACQUIRED
GROSS FAIR
MARKET
VALUE
AMOUNT
OF DEBT
NET FAIR
MARKET
VALUE
PROPOSAL FOR DIVISION
Award or Confirm to:
PETITIONER RESPONDENT
7. CREDIT UNION, OTHER
$ $ $ $ $
DEPOSITORY ACCOUNTS
8. CASH
9. TAX REFUND
10. LIFE INSURANCE WITH CASH
SURRENDER OR LOAN VALUE
11. STOCKS, BONDS, SECURED
NOTES, MUTUAL FUNDS
12. RETIREMENT AND PENSIONS
13. PROFIT-SHARING, IRAS,
DEFERRED COMPENSATION,
ANNUITIES
14. ACCOUNTS RECEIVABLE,
UNSECURED NOTES
15. PARTNERSHIP, OTHER
BUSINESS INTERESTS
16. OTHER ASSETS
17. ASSETS FROM CONTINUATION
SHEET
18. TOTAL ASSETS
Page 2 of 4
PROPERTY DECLARATION
(Family Law)
FL-160
FL-160 [Rev. July 1, 2016]
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]
Print This Form
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
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.
 Separate Property.
A Property Declaration (form FL-160) for (specify):
X
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).
z
z
Parties who agree to waive final declarations of disclosure must file their written agreement with the court (see form FL-144).
z
Service of preliminary declarations of disclosure may not be waived by an agreement between the parties.
z
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:
Self Represented Litigant
San Bernardino
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.:
FL-160
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
PARTY WITHOUT ATTORNEY OR ATTORNEY
STATE BAR NUMBER:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
CASE NUMBER:
PETITIONER'S
RESPONDENT'S
COMMUNITY AND QUASI-COMMUNITY PROPERTY DECLARATION
SEPARATE PROPERTY DECLARATION
See Instructions on page 4 for information about completing this form. For additional space, use Continuation of Property Declaration
(form FL-161
).
A
B C - D = E
F
ITEM BRIEF DESCRIPTION
NO.
DATE
ACQUIRED
GROSS FAIR
MARKET
VALUE
AMOUNT
OF DEBT
NET FAIR
MARKET
VALUE
PROPOSAL FOR DIVISION
Award or Confirm to:
PETITIONER RESPONDENT
1. REAL ESTATE $ $ $ $ $
2. HOUSEHOLD FURNITURE,
FURNISHINGS, APPLIANCES
3. JEWELRY, ANTIQUES, ART,
COIN COLLECTIONS, etc.
4. VEHICLES, BOATS, TRAILERS
5. SAVINGS ACCOUNTS
6. CHECKING ACCOUNTS
Page 1 of 4
Form Approved for Mandatory Use
Judicial Council of California
FL-160 [Rev. July 1, 2016]
PROPERTY DECLARATION
(Family Law)
Family Code, §§ 115, 2104, 2500-2660
www.courts.ca.gov
Self-Represented
San Bernardino
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.:
A
B C - D = E
F
ITEM BRIEF DESCRIPTION
NO.
DATE
ACQUIRED
GROSS FAIR
MARKET
VALUE
AMOUNT
OF DEBT
NET FAIR
MARKET
VALUE
PROPOSAL FOR DIVISION
Award or Confirm to:
PETITIONER RESPONDENT
7. CREDIT UNION, OTHER
$ $ $ $ $
DEPOSITORY ACCOUNTS
8. CASH
9. TAX REFUND
10. LIFE INSURANCE WITH CASH
SURRENDER OR LOAN VALUE
11. STOCKS, BONDS, SECURED
NOTES, MUTUAL FUNDS
12. RETIREMENT AND PENSIONS
13. PROFIT-SHARING, IRAS,
DEFERRED COMPENSATION,
ANNUITIES
14. ACCOUNTS RECEIVABLE,
UNSECURED NOTES
15. PARTNERSHIP, OTHER
BUSINESS INTERESTS
16. OTHER ASSETS
17. ASSETS FROM CONTINUATION
SHEET
18. TOTAL ASSETS
Page 2 of 4
PROPERTY DECLARATION
(Family Law)
FL-160
FL-160 [Rev. July 1, 2016]
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]
Print This Form
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Clear This Form
(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.
Self Represented Litigant
San Bernardino
Same
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
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?
$
$
$
$
$
$
$
$
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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.
X
SIGNATURE
(TYPE OR PRINT NAME)
Date:
(Form FL-144 may be used for this purpose.)
1.
Self Represented Litigant
San Bernardino
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Clear This Form
FL-335
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
CASE NUMBER:
PROOF OF SERVICE BY MAIL
NOTICE: To serve temporary restraining orders you must use personal service (see form FL-330).
I am at least 18 years of age, not a party to this action, and I am a resident of or employed in the county where the mailing took
place.
My residence or business address is:
I served a copy of the following documents (specify):
by enclosing them in an envelope AND
a. depositing the sealed envelope with the United States Postal Service with the postage fully prepaid.
b.
The envelope was addressed and mailed as follows:
Name of person served:
Date mailed:
Place of mailing (city and state):
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 PERSON COMPLETING THIS FORM)
Page 1 of 1
Form Approved for Optional Use
Judicial Council of California
FL-335 [Rev. January 1, 2012]
PROOF OF SERVICE BY MAIL
Code of Civil Procedure, §§ 1013, 1013a
1.
2.
3.
placing the envelope for collection and mailing on the date and at the place shown in item 4 following our ordinary
business practices. I am readily familiar with this business’s practice for collecting and processing correspondence for
mailing. On the same day that correspondence is placed for collection and mailing, it is deposited in the ordinary course of
business with the United States Postal Service in a sealed envelope with postage fully prepaid.
4.
Address:b.
a.
c.
d.
6.
www.courts.ca.gov
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
OTHER PARENT/PARTY:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
I served a request to modify a child custody, visitation, or child support judgment or permanent order which included an
5.
address verification declaration. (Declaration Regarding Address Verification—Postjudgment Request to Modify a Child
Custody, Visitation, or Child Support Order (form FL-334) may be used for this purpose.)
HEARING DATE:
DEPT.:
HEARING TIME:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
TELEPHONE NO.:
(If applicable, provide):
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
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.:
Self Represented Litigant
San Bernardino
Response to Dissolution of Marriage, Child Custody and Visitation Attachment, Community Property
declaration, Separate Property declaration, Declaration of Disclosure, UCCJEA, and Income and Expense
Declaration.
Follow these simple steps in order to successfully proceed with your case.
Review
After you have completed your forms, bring them back to the Resource Center to have them
reviewed. It is important to follow this step because our staff has been trained to review these
forms and help you make any necessary changes.
Copy
After you have had your forms reviewed you will need to make (2) copies of your corrected
originals.
Serve
You will need to have the other party served with a copy of your documents before you can file
with the court clerk. The proper way to perform the service is to have another adult (not you)
mail one copy of your documents to your spouse. If you need assistance with this step you can
visit your local Resource Center. The person that served the documents will need to complete
and sign the Proof of Service form. After the other party is served you will be ready to file.
File
Take the original paperwork, your copy, and the completed proof of service form to the clerk’s
office within the court listed in your paperwork to file. You will also need to bring your request
for fee waiver forms or cash/check/credit card.
Final step. . .
Filing your response p
aperwork does not complete your divorce case. There are two ways to
finalize a divorce case. If both parties can reach an agreement with all
of the issues within the
divorce case (for example: property, debts, child custody, support), then you can consider
completing a stipulated judgment. The requirements for a stipulated judgment are that both
parties sign the judgment and agree on all issues. If you are interested in more information on a
stipulated judgment you can visit your local Resource Center for assistance and forms.
The other opti
on to finalize your divorce is to go to trial. In order to set the case for trial you will
need to file an “At Issue Memorandum” with the court. Either party can file an At Issue
Memorandum with the court to continue the process. If you need additional information on the
At Issue Memorandum, you can visit your local Resource Center for assistance and forms or visit
the self-help website for a form kit.
Please remember that in California the minimum time for a divorce to be final is 6 months from
the date that the Respondent is served with the summons and complaint. Even though the
minimum time for a divorce is 6 months, depending on your case the process may take longer.
Ultimately, you are divorced when you receive a divorce judgment signed by a judge and
it has
been at least 6 months since the date in which the Respondent was served.