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SHC-D-10 (Rev. 01/01/2020)
Please visit our Self-Help Portal at: https://selfhelp.occourts.org
LamoreauxJusticeCenter
Room C-190
341TheCityDrive
Orange,CA
HarborJusticeCenter
R
oom107,Self‐HelpWindow
4601JamboreeRoad
NewportBeach,CA
Cen
tralJusticeCenter
RoomG‐100
700CivicCenterDrive
SantaAna,CA
SuperiorCourt
Ser
viceCenter
27573PuertaReal
MissionViejo,CA
NorthJusticeCenter
R
oom355
1275N.BerkeleyAvenue
Fullerton,CA
WestJusticeCenter
1
st
Floor
814113thStreet
Westminster,CA
SUPERIOR COURT OF CALIFORNIA
COUNTY
OF ORANGE
SELF-HELP CENTER
www.occourts.org/self-help
RESPONSE TO DISSOLUTION, LEGAL SEPARATION OR
NULLITY OF MARRIAGE OR DOMESTIC PARTNERSHIP
The Self-Help Center provides a free document review
service. To obtain an appointment to have your documents
reviewed, you must first fully complete the forms.
Pleaseuseblackink.
Self-Help Center Locations:
Legal Steps for a Divorce or Legal Separation
FL-107-INFO
Judicial Council of California, www.courts.ca.gov
Revise January 1, 2015, Optional Form
Cal. Rules of Court, rule 5.83
Legal Steps for a Divorce or Legal Separation
FL-107-INFO, Page 1 of 2
IMPORTANT NOTICES
The earliest you can be divorced is six months and one day from one of these three dates (whichever occurs first):
(1) the date Respondent was served with the Summons (form FL-110) and Petition (form FL-100), (2) the date the
Response (form FL-120) was filed, or (3) the date Appearance, Stipulations, and Waivers (form FL-130) was filed.
Legal separation has no waiting period. You are NOT divorced or legally separated until the court enters a Judgment in
your case.
If you need court orders for child support, custody, parenting time (visitation), spousal or partner support, restraining
orders, or other issues, file a Request for Order (form FL-300) asking for temporary orders. See “Request for Order
Information” at courts.ca.gov/divorcerequests for more information.

STEP 1. Start Your Case
The forms needed to start your case and information about filing fees and fee waivers are available at “Filing Your Case,” at
courts.ca.gov/filing.
The petitioner (the person who files the first divorce or legal separation forms with the court) fills out and files with the court
clerk at least a Petition—Marriage/Domestic Partnership (form FL-100) and a Summons (form FL-110) and, if there are
children of the relationship, a Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (form FL-105).
The court clerk will stamp and return copies of the filed forms to the petitioner.
The respondent has 30 days to file and serve a Response. So, the petitioner must wait 30 days before starting Step 4.
Someone 18 or older–not the petitioner–serves the spouse or domestic partner (called the respondent) with all the forms from
Step 1 plus a blank Response—Marriage/Domestic Partnership (form FL-120) and files with the court a proof-of-service form,
such as Proof of Service of Summons (form FL-115), telling when and how the respondent was served. (To serve means “to give
in the proper legal way.”) For more information, see “Serving Your First Set of Court Forms” at courts.ca.gov/filing.
STEP 2. Serve the Forms
Respondent files a Response
Respondent does not file a Response (called “default”)
No Response and NO
written agreement:
Petitioner waits 30 days after
Step 2 is complete and
prepares a proposed Judgment
(form FL-180), together with
all other needed forms. See
“True Default Case” at courts.
ca.gov/truedefault.
No Response BUT written
agreement: Petitioner attaches
the signed and notarized
agreement to the proposed
Judgment (form FL-180),
together with all other needed
forms. See “Default Case with
Written Agreement” at courts.
ca.gov/defaultagree.
Response AND written
agreement: Either party files
Appearance, Stipulations, and
Waivers (form FL-130) and the
proposed Judgment with
written agreement attached and
other needed forms. See
“Uncontested Case” at courts.
ca.gov/uncontested.
Response and NO
agreement: Parties must
go to trial to have a judge
resolve the issues. See
“Contested Case” at
courts.ca.gov/contested.
STEP 4. Finish the Divorce or Legal Separation Case in One of Four Ways
You must keep the court and the other party informed of any change in your mailing address or other contact
information. File and serve a Notice of Change of Address or Other Contact Information (form MC-040) on the other
party or his or her attorney to let them know about the change in your contact information.
At the same time as Step 1 or within 60 days of filing the Petition, the petitioner must fill out and have these documents served
on the respondent: Declaration of Disclosure (form FL-140), Income and Expense Declaration (form FL-150), Schedule of
Assets and Debts (form FL-142) or Property Declaration (form FL-160), and all tax returns filed by the party in the two years
before serving the disclosure documents. These disclosure documents are not filed with the court.
If the respondent files a Response, he or she must also complete and serve the same disclosure documents on the petitioner
within 60 da
y
s of filin
g
the Response.
The 60-day time frame for serving the disclosures may be changed by written agreement between the parties or by court order.
The petitioner and respondent each file a Declaration Regarding Service (form FL-141) with the court saying disclosures
were served. If the respondent does not serve disclosures, the petitioner can still finish the case without them. For more
information, see “Fill Out and Serve Your Financial Declaration of Disclosure Forms” at courts.ca.gov/filing (click on Step 4).
STEP 3. Disclose Financial Information
Annulments: See courts.ca.
g
ov/annulment for information about annulments.
Rev. January 1, 2015
FL-107-INFO, Page 2 of 2
Legal Steps for a Divorce or Legal Separation
You may prefer to resolve some or all of the issues in your divorce or legal separation case without having the court
decide for you. You and your spouse or domestic partner can put your agreement in writing and file it in your case. But
your agreement must follow all legal requirements.
Getting help to resolve divorce or legal separation cases
Do you have a registered domestic partnership? The process for a divorce or legal separation of a domestic partnership
is the same as on page 1. For information about ending your domestic partnership in the superior court, see courts.ca.
gov/filing. To find out if you are eligible to end your domestic partnership through the Secretary of State, see courts.ca.
gov/summdissodp. Note: There may be differences in federal taxes and other issues for domestic partnerships. Seek
advice from an attorney experienced in domestic partner law.
What if you want a legal separation? The process on page 1 is the same, except you will NOT get a Judgment for legal
separation unless both parties agree to a legal separation OR if respondent has not filed a Response. If both parties agree
to be legally separated but do not agree on other issues, the parties must go to trial to have a judge resolve those issues.
You are NOT legally separated until you receive a Judgment signed by the court. For more information, see “Legal
Separation” at courts.ca.gov/legalseparation. AFTER the court enters a judgment for legal separation, if you decide you
want a divorce, you must start a new case to request a divorce and pay another filing fee.
Legal Steps for a Divorce or Legal Separation
FL-107-INFO
Family Law Facilitators and Self-Help Centers
help with court forms and instructions. They can
provide samples of agreements and other
information and, in some cases, help with mediation.
This information sheet gives you only basic information on
the divorce or legal separation and is not legal advice. If you
want legal advice, ask a lawyer for help. You may also:
Contact the family law facilitator or self-help center in
your court for information, court forms, and referrals to
local legal resources. For more information, see
courts.ca.gov/courtresources.
What if there is domestic violence?
Private services (which you can hire
to help you resolve your case):
Where can I get help?
Lawyers. Also called attorneys, lawyers can help
work out agreements between the parties and
represent you at court hearings and trials.
Mediators. A lawyer or counselor who helps the
parties communicate to explore options and reach a
mutually acceptable resolution.
Collaborative Lawyers. Lawyers who represent
each party but do not go to court. They try to reach
an agreement. If court is necessary, the parties must
hire new lawyers.
Settlement Conferences. An informal process in
which a judge or an experienced lawyer meets with
the parties and their lawyers to discuss the case and
their positions and suggests a resolution. The parties
can either agree to the suggestions or use the
suggestions to help in further settlement discussions.
Family Court Services. If you and the other parent
already have a family law case and have filed a
Request for Order (form FL-300) seeking orders
about child custody and visitation (parenting time),
the court will refer you to Family Court Services.
They provide child custody mediation or child
custody recommending counseling to try to help you
both make a parenting plan that is in the best interest
of your child. Note: They cannot help with financial
issues.
Court Services
Find information at your local law library or public
library.
Find free and low-cost legal help (if you qualify) at
lawhelpcalifornia.org.
Hire a private mediator. For more information about
court and private services, see courts.ca.gov/selfhelp-adr.
htm.
If there is domestic violence or a protective or restraining
order, talk to a lawyer, counselor, or mediator before
making agreements.
For domestic violence help, call the National Domestic
Violence Hotline: 800-799-7233; TDD: 800-787-3224; or
211 (if available in your area).
Find information on the California Courts Online Self-
Help Center website: courts.ca.gov/selfhelp.
Find a lawyer through a certified lawyer referral service
on the State Bar of California's website:
calbar.ca.gov/LRS or by calling 866-442-2529
(toll-free).
Petitioner and Respondent signed a voluntary declaration of parentage or paternity. (Attach a copy if available.)
AMENDED
RESPONSE
Dissolution (Divorce) of:
Marriage
Domestic Partnership
Nullity of: Marriage
Domestic Partnership
Legal Separation of: Marriage Domestic Partnership
AND REQUEST FOR
FOR COURT USE ONLY
ATTORNEY FOR (name):
E-MAIL ADDRESS:
FAX NO.:TELEPHONE NO.:
ZIP CODE:STATE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
PARTY WITHOUT ATTORNEY OR ATTORNEY
STATE BAR NUMBER:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
RESPONDENT:
PETITIONER:
CASE NUMBER:
FL-120
LEGAL RELATIONSHIP (check all that apply):
a. We are married.
b.
We are domestic partners and our domestic partnership was established in California.
We are domestic partners and our domestic partnership was NOT established in California.
c.
1.
Page 1 of 3
Form Adopted for Mandatory Use
Judicial Council of California
FL-120 [Rev. January 1, 2020]
RESPONSE—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
Family Code, § 2020
www.courts.ca.gov
MINOR CHILDREN
If there are minor children of Petitioner and Respondent, a completed Declaration Under Uniform Child Custody Jurisdiction
and Enforcement Act (UCCJEA) (form ) must be attached.
d.
4.
There are no minor children.
a.
The minor children are:b.
continued on Attachment 4b.
Child's name
Birthdate Age
a child who is not yet born.
(2)(1)
e.
RESIDENCE REQUIREMENTS (check all that apply):
has been a resident of this state for at least six months and of this county for at least
three months immediately preceding the filing of this Petition. (For a divorce, unless you are in the legal relationship
described in 1b., at least one of you must comply with this requirement.)
2.
a.
RespondentPetitioner
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
ORANGE
LAMOREAUX JUSTICE CENTER
ORANGE, CA 92868
341 THE CITY DRIVE SOUTH
341 THE CITY DRIVE SOUTH
FL-105
Respondent requests that the court make the following orders:
SPOUSAL OR DOMESTIC PARTNER SUPPORT8.
b.
5HVSRQGHQW3HWLWLRQHUTerminate (end) the court's ability to award support to
3HWLWLRQHU 5HVSRQGHQWa. Spousal or domestic partner support payable to
c.
Reserve for future determination the issue of support payable to
5HVSRQGHQW3HWLWLRQHU
Other (specify):
d.
9.
SEPARATE PROPERTY
Page 2 of 3
RESPONSE—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
CASE NUMBER:
RESPONDENT:
PETITIONER:
Respondent contends that the parties never legally married or registered a domestic partnership.
Respondent denies the grounds set forth in item 5 of the petition.
Respondent requests
(2) Nullity of void marriage or domestic partnership based on
(a) incest. (b) bigamy.
(3) Nullity of voidable marriage or domestic partnership based on
(a) respondent’s age at time of registration of
domestic partnership or marriage.
(b)
prior existing marriage or domestic partnership.
(c) unsound mind.
(d) fraud.
(e) force.
(f) physical incapacity.
Legal separation of the marriage or domestic partnership based onDivorce(1)
(a) irreconcilable differences. permanent legal incapacity to make decisions.(b)
a.
b.
5.
c.
LEGAL GROUNDS (Family Code sections 2200–2210; 2310–2312)
b.
Confirm as separate property the assets and debts in
the following list. Item Confirm to
Property Declaration (form ).
a. There are no such assets or debts that I know of to be confirmed by the court.
FL-120
6. CHILD CUSTODY AND VISITATION (PARENTING TIME)
Legal custody of children to
.........................................................
....................................................
Physical custody of children to
Child visitation (parenting time) be granted to
.............................
As requested in
Petitioner Respondent Joint Other
b.
c.
a.
Any party required to pay support must pay interest on overdue amounts at the "legal" rate, which is currently 10 percent.
7. CHILD SUPPORT
a.
b.
c.
Other (specify):
d.
If there are minor children born to or adopted by Petitioner and Respondent before or during this marriage or domestic
partnership, the court will make orders for the support of the children upon request and submission of financial forms by the
requesting party.
An earnings assignment may be issued without further notice.
FL-120 [Rev. January 1, 2020]
IRUP)/ IRUP)/ IRUP)/&
IRUP)/' IRUP)/( Attachment 6c(1)
FL-160
Attachment 9b.
Page 3 of 3
RESPONSE—MARRIAGE/DOMESTIC PARTNERSHIP
(Family Law)
CASE NUMBER:
RESPONDENT:
PETITIONER:
Date:
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
(TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT)
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR RESPONDENT)
a.
There are no such assets or debts that I know of to be divided by the court.
as follows (specify):
Determine rights to community and quasi-community assets and debts. All such assets and debts are listed
b.
Property Declaration (form ).
COMMUNITY AND QUASI-COMMUNITY PROPERTY10.
OTHER REQUESTS11.
Attorney's fees and costs payable by a.
b
Respondent's former name be restored to
(specify):
c.
Continued on Attachment 11c..
Other (specify):
NOTICE—CANCELLATION OF RIGHTS: Dissolution or legal separation may automatically cancel the rights of a domestic partner
or spouse under the other domestic partner's or spouse's will, trust, retirement plan, power of attorney, pay-on-death bank account,
survivorship rights to any property owned in joint tenancy, and any other similar thing. It does not automatically cancel the right of a
domestic partner or spouse as beneficiary of the other partner's or spouse's life insurance policy. You should review these matters,
as well as any credit cards, other credit accounts, insurance polices, retirement plans, and credit reports, to determine whether they
should be changed or whether you should take any other actions. Some changes may require the agreement of your partner or
spouse or a court order.
NOTICE: You may redact (black out) social security numbers from any written material filed with the court in this case other than a
form used to collect child, spousal or partner support.
The original response must be filed in the court with proof of service of a copy on Petitioner.
FL-120
5HVSRQGHQW3HWLWLRQHU
FL-120 [Rev. January 1, 2020]
FOR MORE INFORMATION: Read Legal Steps for a Divorce or Legal Separation ( ) and visit "Families Change"
at www.familieschange.ca.gov
— an online guide for parents and children going through divorce or separation.
Attachment 10b.
FL-160
form FL-107-INFO
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
ORANGE
341 THE CITY DRIVE SOUTH
ORANGE, CA 92868
LAMOREAUX JUSTICE CENTER
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.
Page 1 of 1
Approved for Optional Use
Form # L-1120
Rev. May 5, 2010
FAMILY LAW NOTICE RE RELATED CASE
Superior Court of Orange County
Local Rule 701.5
www.occourts.org
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address):
TELEPHONE NO.: FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name): BAR NO.:
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
JUSTICE CENTER:
Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045
Lamoreaux - 341 The City Drive, Orange, CA 92868-3205
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
FAMILY LAW NOTICE RE RELATED CASE
CASE NUMBER:
The parties must file this form with the Superior Court of Orange County, when a family law case is filed with the
Court and when a party discovers that there is a related case. A related case means one or both parties and/or
minor children of the parties are involved in other cases. Examples of related cases include another family law
case, a domestic violence case, a child support collection case, a criminal case, and a juvenile case involving a
minor child of one or both of the parties.
Fill in the requested information:
1. I also used
the name(s):
2. The other
party’s name is:
;
He/She has also used the name(
s):
3.
Other court cases involving either party or a child of either party:
(If known, please include the case numbers)
Court Location/
Case Number Case Name Justice Center Person Involved
a.
b.
c.
d.
4.
There are no other court cases involving either party or a child of either party.
Date:
(TYPE OR PRINT NAME OF PARTY OR ATTORNEY)
(SIGNATURE OF PARTY OR ATTORNEY)
✔
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.
&RPPXQLW\DQG4XDVL&RPPXQLW\3URSHUW\ 6HSDUDWH3URSHUW\
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:
ORANGE
LAMOREAUX JUSTICE CENTER
ORANGE, CA 92868
341 THE CITY DRIVE
✖
✖
✖✖
✖
✖
✖
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
Oran
e
Lamoreaux Justice Center
Oran
g
e, CA 92868
341 The Cit
y
Drive South
✖
✖
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]
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
Oran
e
Lamoreaux Justice Center
Oran
g
e, CA 92868
341 The Cit
y
Drive
✖
✖
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]
(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 ORANGE
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.
341 The City Drive
Orange, CA 92868
Lamoreaux Justice Center
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):
2WKHU
on (date):
(specify):
2WKHU
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):
ZDVILOHGRQ
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.
ORANGE
LAMOREAUX JUSTICE CENTER
ORANGE, CA 92868
341 THE CITY DRIVE SOUTH
✖
✖
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):
ORANGE
341 THE CITY DRIVE SOUTH
ORANGE, CA 92868
LAMOREAUX JUSTICE CENTER
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SUPERIOR COURT OF CALIFORNIA OF ORANGE COUNTY SELF-HELP (The Superior Court of California - County of Orange)

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Completed 8 February 2021

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