SUMMONS (Family Law) CITACIÓN (Derecho familiar) · PDF fileSUMMONS (Family Law) NOTICE TO RESPONDENT ... las partes de este caso llega a fallecer antes de que se divida la propiedad

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FL-110

SUMMONS (Family Law)

NOTICE TO RESPONDENT (Name):FOR COURT USE ONLY

(SÓLO PARA USO DE LA CORTE)

You are being sued. Lo están demandando.

Petitioner's name is:

CASE NUMBER (NÚMERO DE CASO):

You have 30 calendar days after this Summons andPetition are served on you to file a Response (formFL-120 or FL-123) at the court and have a copyserved on the petitioner. A letter or phone call will notprotect you.

If you do not file your Response on time, the courtmay make orders affecting your marriage or domesticpartnership, your property, and custody of yourchildren. You may be ordered to pay support andattorney fees and costs. If you cannot pay the filingfee, ask the clerk for a fee waiver form.

If you want legal advice, contact a lawyer immediately.You can get information about finding lawyers at theCalifornia Courts Online Self-Help Center(www.courtinfo.ca.gov/selfhelp), at the California LegalServices Web site (www.lawhelpcalifornia.org), or bycontacting your local county bar association.

NOTICE: The restraining orders on page 2 are effective against both spouses or domestic partners until the petition is dismissed, ajudgment is entered, or the court makes further orders. These orders are enforceable anywhere in California by any lawenforcement officer who has received or seen a copy of them.

1. The name and address of the court are (El nombre y dirección de la corte son):

2. The name, address, and telephone number of the petitioner s attorney, or the petitioner without an attorney, are:

(El nombre, dirección y número de teléfono del abogado del demandante, o del demandante si no tiene abogado, son):

Date (Fecha): , Deputy (Asistente)

[SEAL] NOTICE TO THE PERSON SERVED: You are served

a. as an individual. (a usted como individuo.)

on behalf of respondent who is a (en nombre de un demandado que es):b.

minor (menor de edad)

other (specify) (otro especifique):

ward or conservatee (dependiente de la corte o pupilo)

(Read the reverse for important information.) (Lea importante información al dorso.)

Form Adopted for Mandatory UseJudicial Council of CaliforniaFL-110 [Rev. July 1, 2009]

SUMMONS Family Code §§ 232, 233, 2040,7700;Code of Civil Procedure, §§ 412.20, 416.60 416.90

Government Code, § 68637(Family Law)www.courtinfo.ca.gov

(1)

(2)

(3)

Page 1 of 2

Clerk, by (Secretario, por)

CITACIÓN (Derecho familiar)

AVISO AL DEMANDADO (Nombre):

Nombre del demandante:

Tiene 30 días corridos después de haber recibido la entrega legalde esta Citación y Petición para presentar una Respuesta(formulario FL-120 ó FL-123) ante la corte y efectuar la entregalegal de una copia al demandante. Una carta o llamada telefónicano basta para protegerlo.

Si no presenta su Respuesta a tiempo, la corte puede dar órdenesque afecten su matrimonio o pareja de hecho, sus bienes y lacustodia de sus hijos. La corte también le puede ordenar que paguemanutención, y honorarios y costos legales. Si no puede pagar lacuota de presentación, pida al secretario un formulario de exenciónde cuotas.

Si desea obtener asesoramiento legal, póngase en contacto deinmediato con un abogado. Puede obtener información paraencontrar a un abogado en el Centro de Ayuda de las Cortes deCalifornia (www.sucorte.ca.gov), en el sitio Web de los ServiciosLegales de California (www.lawhelpcalifornia.org) o poniéndose encontacto con el colegio de abogados de su condado.

AVISO: Las órdenes de restricción que figuran en la página 2 valen para ambos cónyuges o pareja de hecho hasta que se despidala petición, se emita un fallo o la corte dé otras órdenes. Cualquier autoridad de la ley que haya recibido o visto una copia de estasórdenes puede hacerlas acatar en cualquier lugar de California.

AVISO A LA PERSONA QUE RECIBIÓ LA ENTREGA: Esta entrega se realiza

NOTE: If a judgment or support order is entered, the court may order you to pay all or part of the fees and costs that the court waivedfor yourself or for the other party. If this happens, the party ordered to pay fees shall be given notice and an opportunity to request ahearing to set aside the order to pay waived court fees.

AVISO: Si se emite un fallo u orden de manutención, la corte puede ordenar que usted pague parte de, o todas las cuotas y costos dela corte previamente exentas a petición de usted o de la otra parte. Si esto ocurre, la parte ordenada a pagar estas cuotas debe recibiraviso y la oportunidad de solicitar una audiencia para anular la orden de pagar las cuotas exentas.

Jane Doe

John Doe

321 Elm Street, Glendale, CA 91203

(323) 962-8600

Superior Court of California, County of Orange

Lamoreaux Justice Center341 The City Drive South, Orange, CA 92868

John Doe

X

SAMPLE

WARNING IMPORTANT INFORMATION

WARNING: California law provides that, for purposes of division of property upon dissolution of a marriage or domestic

partnership or upon legal separation, property acquired by the parties during marriage or domestic partnership in joint

form is presumed to be community property. If either party to this action should die before the jointly held community

property is divided, the language in the deed that characterizes how title is held (i.e., joint tenancy, tenants in common,

or community property) will be controlling, and not the community property presumption. You should consult your

attorney if you want the community property presumption to be written into the recorded title to the property.

STANDARD FAMILY LAW RESTRAINING ORDERS

Starting immediately, you and your spouse or domestic partner are restrained from

1. Removing the minor child or children of the parties, if any, from the state without the prior written consent of the other party oran order of the court;

2. Cashing, borrowing against, canceling, transferring, disposing of, or changing the beneficiaries of any insurance or othercoverage, including life, health, automobile, and disability, held for the benefit of the parties and their minor child or children;

3. Transferring, encumbering, hypothecating, concealing, or in any way disposing of any property, real or personal, whethercommunity, quasi-community, or separate, without the written consent of the other party or an order of the court, except in theusual course of business or for the necessities of life; and

4. Creating a nonprobate transfer or modifying a nonprobate transfer in a manner that affects the disposition of property subject tothe transfer, without the written consent of the other party or an order of the court. Before revocation of a nonprobate transfer cantake effect or a right of survivorship to property can be eliminated, notice of the change must be filed and served on the otherparty.

You must notify each other of any proposed extraordinary expenditures at least five business days prior to incurring theseextraordinary expenditures and account to the court for all extraordinary expenditures made after these restraining orders areeffective. However, you may use community property, quasi-community property, or your own separate property to pay an attorneyto help you or to pay court costs.

SUMMONS(Family Law)

FL-110 [Rev. July 1, 2009] Page 2 of 2

ADVERTENCIA INFORMACIÓN IMPORTANTE

ADVERTENCIA: De acuerdo a la ley de California, las propiedades adquiridas por las partes durante su matrimonio

o pareja de hecho en forma conjunta se consideran propiedad comunitaria para los fines de la división de bienes

que ocurre cuando se produce una disolución o separación legal del matrimonio o pareja de hecho. Si cualquiera de

las partes de este caso llega a fallecer antes de que se divida la propiedad comunitaria de tenencia conjunta, el

destino de la misma quedará determinado por las cláusulas de la escritura correspondiente que describen su

tenencia (por ej., tenencia conjunta, tenencia en común o propiedad comunitaria) y no por la presunción de

propiedad comunitaria. Si quiere que la presunción comunitaria quede registrada en la escritura de la propiedad,

debería consultar con un abogado.

ÓRDENES DE RESTRICCIÓN NORMALES DE DERECHO FAMILIAR

En forma inmediata, usted y su cónyuge o pareja de hecho tienen prohibido:

1. Llevarse del estado de California a los hijos menores de las partes, si los hubiera, sin el consentimiento previo por escrito dela otra parte o una orden de la corte;

2. Cobrar, pedir prestado, cancelar, transferir, deshacerse o cambiar el nombre de los beneficiarios de cualquier seguro u otrotipo de cobertura, tal como de vida, salud, vehículo y discapacidad, que tenga como beneficiario(s) a las partes y su(s)hijo(s) menor(es);

3. Transferir, gravar, hipotecar, ocultar o deshacerse de cualquier manera de cualquier propiedad, inmueble o personal, ya seacomunitaria, cuasicomunitaria o separada, sin el consentimiento escrito de la otra parte o una orden de la corte, con excepciónlas operaciones realizadas en el curso normal de actividades o para satisfacer las necesidades de la vida; y

4. Crear o modificar una transferencia no testamentaria de manera que afecte el destino de una propiedad sujeta a transferencia,sin el consentimiento por escrito de la otra parte o una orden de la corte. Antes de que se pueda eliminar la revocación de unatransferencia no testamentaria, se debe presentar ante la corte un aviso del cambio y hacer una entrega legal de dicho aviso ala otra parte.

Cada parte tiene que notificar a la otra sobre cualquier gasto extraordinario propuesto, por lo menos cinco días laborales antes derealizarlo, y rendir cuenta a la corte de todos los gastos extraordinarios realizados después de que estas órdenes de restricciónhayan entrado en vigencia. No obstante, puede usar propiedad comunitaria, cuasicomunitaria o suya separada para pagar a unabogado o para ayudarle a pagar los costos de la corte.

SAMPLE

Jane Doe

John Doe

X

SAMPLE

John Doe

321 Elm Street

Glendale, CA 91203

341 The City Drive South

Orange, 92868

Lamoreaux Justice Center

John Doe

Jane Doe

X

X X

X

September 30, 2006

March 23, 2013 56

X

(323) 962-8600

[email protected]

ORANGE

In Pro Per

Peter Ryan Doe April 10, 2005 9 Male

Mary Megen Doe August 3, 2008 5 Female

The Auto Lease Petitioner

The Auto Loan account Petitioner

The real property located at 9876 Mum Street, Glendale, CA 91203

SAMPLE

X

X

X

John Doe

X

X

X

X

Doe, John and Doe, Jane

House hold Funiture

The 2006 Harley Davidson Sportster Motorcycle

SAMPLE

Page 1 of 1Approved for Optional UseForm # L-1120Rev. May 5, 2010

FAMILY LAW NOTICE RE RELATED CASE Superior Court of Orange CountyLocal 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 ORANGEJUSTICE CENTER:

Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045Lamoreaux - 341 The City Drive, Orange, CA 92868-3205

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

FAMILY LAW NOTICE RE RELATED CASECASE NUMBER:

The parties must file this form with the Superior Court of Orange County, when a family law case is filed with theCourt and when a party discovers that there is a related case. A related case means one or both parties and/orminor children of the parties are involved in other cases. Examples of related cases include another family lawcase, a domestic violence case, a child support collection case, a criminal case, and a juvenile case involving aminor 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)

X

John Doe

Jane Doe

John Doe

John Doe

321 Elm Street

Glendale, CA 91203

(323) 962-8600

Jane Doe

Jane Eod

[email protected]

X

SAMPLE

Expedited Attachment (Children) L-1300 (rev. 07/10) Page 1

EXPEDITED PROCESSING ATTACHMENT TODISSOLUTION OR SEPARATION JUDGMENT (Children)

CASE NUMBER:

I. DISCLOSURE (Family Code 2104, 2105)

The parties have fully complied with the Disclosure requirements of FC 2102, 2104 and 2105

Preliminary Declaration of Disclosures (FC 2104)Petitioner filed the Declaration of Service (FL-141) on: or

Submitted with JudgmentRespondent filed the Declaration of Service (FL-141) on: ____________ or

Submitted with Judgment

Final Declaration of Disclosures (FC 2105)Petitioner filed the Declaration of Service (FL-141) on: or

Submitted with JudgmentRespondent filed the Declaration of Service (FL-141) on: ____________ or

Submitted with JudgmentMutually Waived by:

use of Stipulation and Waiver of Final Declaration of Disclosure Form (FL-144)Filed on: ________________Submitted with Judgment

use of the statutory language in a separate stipulation signed under penalty of perjuryStipulation submitted with JudgmentSee page _________ of Judgment

II. CHILD CUSTODY/VISITATION (FC 3048)

(1) This court has jurisdiction to make child custody orders in this case under the Uniform ChildCustody Jurisdiction and Enforcement Act (part 3 of the California Family Code commencing withsection 3400).

(2) The responding party was given notice and an opportunity to be heard as provided by the lawsof the State of California.

(3) The country of habitual residence of the child(ren) is:The United StatesOther (specify country):

(4) If you violate this order you may be subject to civil or criminal penalties, or both.

(5) The judgment contains a clear description of the custody and visitation rights of each party.

WARNING: The Expedited Processing Attachment is only intended to include the

minimum statutory requirements at the time of entry of judgment. It is not intendedto replace the stipulated judgment or other required documents.

X

X

X

X

X

X

SAMPLE


III. CHILD SUPPORT (FC 3901/4065)

(1) The parties are fully informed of their rights concerning child support.

(2) The order is being agreed to without coercion or duress.

(3) The agreement is in the best interests of the child(ren) involved.

(4) The needs of the child(ren) will be adequately met by the stipulated amount.

(5) The right to support has not been assigned to the county pursuant to Section 11477 of theWelfare and Institutions Code and no public assistance application is pending.

Please check all appropriate boxes. At least one (1) box must be checked:AGREED UPON CHILD SUPPORT

Father Mother shall pay to Father Mother child support of $ ______________per week month, payable $_________________ on_____________________ and$__________________ on ______________ of each week month commencing______________________ and continuing until the child for whom support is payablemarries, dies, is emancipated, until further order of the court or, as to an unmarried child whohas attained the age of 18 years old, is a full-time high school student, and who is not self-supporting, until the time the child completes the 12th grade or attains the age of 19 years old,whichever first occurs.

MONEY JUDGMENT IN COURT ORDER (FC 5616)

In the event that there is a contract between a party receiving support and a private childsupport collector, the party ordered to pay support must pay the fee charged by the privatechild support collector. This fee must not exceed 33 1/3 percent of the total amount of pastdue support nor may it exceed 50 percent of any fee charged by the private child supportcollector. The money judgment created by this provision is in favor of the private childsupport collector and the party receiving support, jointly.

CHILD SUPPORT IS RESERVED

DEPARTMENT OF CHILD SUPPORT SERVICES INVOLVEDThe parties currently have an open case with the Department of Child Support Services

(DCSS) and a DCSS representative has signed the proposed judgment

The parties currently have an open case with DCSS, no child support orders are containedin this judgment and the court reserves jurisdiction over the issue of child support, healthinsurance coverage, and mandatory additional child support. If checked, skip items IV andV.

X

X X 300.00

X

X

01/02/2014

SAMPLE


IV. HEALTH INSURANCE COVERAGE (FC 3751)At least one (1) box must be checked:

Health insurance coverage for the minor child(ren) must be maintained by Father Motherif that insurance is available at no cost or at reasonable cost to the parent through their respectiveplaces of employment or self-employment. Both parties are ordered to cooperate in the presentation,collection, and reimbursement of any health care claims.

Father Mother shall maintain the existing health insurance coverage for the minor child(ren).

Health insurance is not available to Father Mother at a reasonable cost at this time. Uponhealth insurance coverage at no or reasonable cost becoming available to a parent, that parent shallapply for that coverage.

V. MANDATORY ADDITIONAL CHILD SUPPORT (FC 4062)

Father Mother shall pay child care costs related to employment or reasonably necessaryeducation/job training:

in the amount of $_______________ per week month or ________% of total.no child care costs orders are contained in this judgment, and court reserves jurisdiction

over the issue of child care costs

Father Mother shall pay the reasonable uninsured health care costs for the child(ren):in the amount of $_______________ per week month or _________% of total.

VI. REQUIRED ATTACHMENTS (FC 4063/7600)

The parties have attached the following form:Notice of Rights and Responsibilities: Health Care Costs and Reimbursement Procedures andInformation Sheet on Changing a Child Support Order (Form FL-192)

VII. ORDER/NOTICE TO WITHHOLD INCOME FOR CHILD SUPPORT (FC 5230)

An Order/Notice to Withhold Income for Child Support (form FL-195) must issue. The payor ofchild support is responsible for the payment of support directly to the recipient until supportpayments are deducted from the payor’s wages, and for any support not paid by the assignment.

VIII. EMPLOYER INFORMATION (FC 4014)

The parties shall notify the other parent of the name and address of his or her current employer.

IX. SPOUSAL SUPPORT (FC 4336)

The parties had a marriage of 10 years or more, from the date of marriage to the date ofseparation, and spousal support has been addressed in the Marital Settlement Agreement/StipulatedJudgment.

The parties agree to terminate the court’s jurisdiction (ability) to award spousal support.

X

X

X X

X

X

X

100.00 50%

X

X 50%X

X X

SAMPLE


X. MISCELLANEOUS PROVISIONS

The Marital Settlement Agreement/Stipulated Judgment contains further orders.

All provisions are deemed incorporated into the Judgment. As to the provisions that contain acheckbox ( ), only those provisions that are checked become part of the Judgment.

If there is any express conflict between the Marital Settlement Agreement/Stipulated Judgment andthis Expedited Processing Attachment, the Expedited Processing Attachment shall prevail.However, this Expedited Processing Attachment is not intended to be all inclusive. The fact that thisExpedited Processing Attachment is less detailed is not a conflict. The Expedited ProcessingAttachment is only intended to include the minimum statutory requirements at the time of entry ofjudgment. It is not intended to replace the stipulated judgment or other required documents.

I declare under penalty of perjury under the laws of the State of California that the foregoing is trueand correct and agreed to by:

________________________________________ __________________________________________Petitioner Date Respondent Date

Approved as to form and content:

________________________________________ __________________________________________Attorney for Petitioner Date Attorney for Respondent Date

SAMPLE

John Doe

Glendale, CA 91203321 Elm Street

In Pro [email protected]

(323) 962-8600



Orange, 92868

ORANGE

John DoeJane Doe

2

04/10/05

123 Main Street

Glendale, CA 91203 John Doe of 321 Elm Street, Glendale, CA 91203 and Jane Doe of

123 Main Street, Glendale, CA 91203 Father and Mother

X

04/10/05

123 Main Street

Glendale, CA 91203 John Doe of 321 Elm Street, Glendale, CA 91203 and Jane Doe of

123 Main Street, Glendale, CA 91203 Father and Mother

Peter Ryan Doe Los Angeles April 10, 2005 Male

Mary Megen Doe Los Angeles August 3, 2008 FemaleSAMPLE

Doe v. Doe

X

X

John Doe

SAMPLE

SAMPLE

SAMPLE

FL-130

FOR COURT USE ONLY

CASE NUMBER:

APPEARANCE, STIPULATIONS, AND WAIVERS

1. Appearance by respondent (you must choose one):

a. By filing this form, I make a general appearance.

I have previously made a general appearance.b.

Page 1 of 1

APPEARANCE, STIPULATIONS, AND WAIVERS(Family Law—Uniform Parentage—Custody and Support)

Form Approved for Optional UseJudicial Council of California

FL-130 [Rev. January 1, 2011]www.courtinfo.ca.gov

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

2. Agreements, stipulations, and waivers (choose all that apply):

a.

The parties waive their rights to notice of trial, a statement of decision, a motion for new trial, and the right to appeal.b.

c. This matter may be decided by a commissioner sitting as a temporary judge.

None of these agreements or waivers will apply unless the court approves the stipulation for judgment or incorporates

the written settlement agreement into the judgment.

e.

This is a parentage case, and both parties have signed an Advisement and Waiver of Rights Re: Establishment of Parental

Relationship (form FL-235) or its equivalent.f.



ATTORNEY FOR (Name):

The parties agree that this cause may be decided as an uncontested matter.

d. The parties have a written agreement that will be submitted to the court, or a stipulation for judgment will be submitted to

the court and attached to Judgment (Family Law) (form FL-180).

c. I am a member of the military services of the United States of America. I have completed and attached to this form

Declaration and Conditional Waiver of Rights Under the Servicemembers Civil Relief Act of 2003 (form FL-130(A)).

Government Code, § 70673

Date:

(SIGNATURE OF PETITIONER)(TYPE OR PRINT NAME)

Date:

(SIGNATURE OF RESPONDENT)(TYPE OR PRINT NAME)

Date:

(TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR PETITIONER)

Date:

(TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR RESPONDENT)

3. Other (specify):

John Doe

321 Elm StreetGlendale, CA 91203

(323) 962-8600


Orange, 92868

ORANGE

John Doe

Jane Doe


John Doe

Jane Doe


X

X

X

X

X

X

SAMPLE

X

X

X

John Doe



Orange, 92868

John Doe

Jane Doe

John Doe

Glendale, CA 91203

321 Elm Street

ORANGE

(323) 962-8600

X

In Pro Per

SAMPLE

X

Jane Doe

X



Orange, 92868

John Doe

Jane Doe

Jane Doe

Glendale, CA 91203

123 Main Street

ORANGE

(323) 962-8600

In Pro Per

SAMPLE

FL-141FOR COURT USE ONLY


STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

DECLARATION REGARDING SERVICE OF DECLARATION CASE NUMBER:

OF DISCLOSURE AND INCOME AND EXPENSE DECLARATIONPetitioner’s PreliminaryRespondent’s Final

petitioner1. I am the attorney for respondent in this matter.

Petitioner’s2. respondent’s Preliminary Declaration of Disclosure (form FL-140) and current* Income and Expense

mail

the other party

by: personal service other (specify):

on (date):

4.

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)

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.

Page 1 of 1

DECLARATION REGARDING SERVICE OF DECLARATION OFDISCLOSURE AND INCOME AND EXPENSE DECLARATION

(Family Law)

Family Code, §§ 2104, 2105, 2106,

2107 211


a. The parties agreed to waive final declaration of disclosure requirements under Family Code section 2105(d). The

Petitioner’s3. respondent’s Final Declaration of Disclosure (form FL-140) and current Income and Expense

Declaration (form FL-150) were served on attorney for the other party

other (specify):

on (date):

petitioner's respondent's preliminary final declaration of disclosure





Service of

* "Current" is defined as completed within the past three months providing no facts have changed. (Cal. Rules of Court, rule 5.128.)

current income and expense declaration has been waived as follows:

The party has failed to comply with disclosure requirements and the court granted the request for voluntary waiverb.

of receipt under Family Code section 2107 on (date):

waiver was filed on (date):

c. This is a default proceeding. Petitioner waives the final declaration disclosure requirements under Family Code

section 2110.

mailby: personal service

www.courts.ca.gov2107, 2112

Declaration (form FL-150) were served on attorney for



Orange, 92868

John Doe

Jane Doe

John Doe

Glendale, CA 91203

321 Elm Street

ORANGE

(323) 962-8600

X

X

X

John Doe

X

X

X

In Pro Per

X X

X

[email protected]

SAMPLE

FL-141FOR COURT USE ONLY


STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

DECLARATION REGARDING SERVICE OF DECLARATION CASE NUMBER:

OF DISCLOSURE AND INCOME AND EXPENSE DECLARATIONPetitioner’s PreliminaryRespondent’s Final

petitioner1. I am the attorney for respondent in this matter.

Petitioner’s2. respondent’s Preliminary Declaration of Disclosure (form FL-140) and current* Income and Expense

mail

the other party

by: personal service other (specify):

on (date):

4.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:


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.

Page 1 of 1

DECLARATION REGARDING SERVICE OF DECLARATION OFDISCLOSURE AND INCOME AND EXPENSE DECLARATION

(Family Law)

Family Code, §§ 2104, 2105, 2106,

2107 211


a. The parties agreed to waive final declaration of disclosure requirements under Family Code section 2105(d). The

Petitioner’s3. respondent’s Final Declaration of Disclosure (form FL-140) and current Income and Expense

Declaration (form FL-150) were served on attorney for the other party

other (specify):

on (date):

petitioner's respondent's preliminary final declaration of disclosure





Service of

* "Current" is defined as completed within the past three months providing no facts have changed. (Cal. Rules of Court, rule 5.128.)

current income and expense declaration has been waived as follows:

The party has failed to comply with disclosure requirements and the court granted the request for voluntary waiverb.

of receipt under Family Code section 2107 on (date):

waiver was filed on (date):

c. This is a default proceeding. Petitioner waives the final declaration disclosure requirements under Family Code

section 2110.

mailby: personal service

www.courts.ca.gov2107, 2112

Declaration (form FL-150) were served on attorney for



Orange, 92868

John Doe

Jane Doe

Jane Doe

Glendale, CA 91203

123 Main Street

ORANGE

(323) 962-8600

X

Jane Doe

X

X

X

X

X

In Pro Per

X X

X

SAMPLE

Jane Doe

John Doe

X

John Doe

321 Elm Street

Glendale, CA 91203

(323) 962-8600

ORANGE

In Pro Per

House hold Funiture 120.00 0.00

9876 Mum Street, Glendale, CA 91203 1/01/2001 265,000.00 261,000.00

SAMPLE

The 2006 Harley Davidson Sportster Motorcycle 05/05/2006 4,500.00 0.00

SAMPLE

SAMPLE

John Doe

The Auto Lease P 17,385.00 10/15/2012

The Auto Loan account P 18,349.48 03/06/2013

SAMPLE

Jane Doe

John Doe

X

Jane Doe

123 Main Street

Glendale, CA 91203

(323) 962-8600

ORANGE

In Pro Per

House hold Funiture 120.00 0.00

9876 Mum Street, Glendale, CA 91203 1/01/2001 265,000.00 261,000.00

SAMPLE

The 2006 Harley Davidson Sportster Motorcycle 05/05/2006 4,500.00 0.00

SAMPLE

SAMPLE

Jane Doe

The Auto Lease P 17,385.00 10/15/2012

The Auto Loan account P 18,349.48 03/06/2013

SAMPLE

FOR COURT USE ONLY

CASE NUMBER:

b.

Date:

Form Approved for Optional UseJudicial Council of California

FL-144 [Rev. January 1, 2007]

FL-144ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):



E MAIL ADDRESS (Optional):

Page 1 of 1

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PLAINTIFF/ PETITIONER:

DEFENDANT/ RESPONDENT:


STIPULATION AND WAIVER OF FINAL DECLARATION OF DISCLOSURE

STIPULATION AND WAIVER OF FINALDECLARATION OF DISCLOSURE

Under Family Code section 2105(d), the parties agree to waive the requirements of Family Code section 2105(a) concerning thefinal declaration of disclosure.

a. We have complied with Family Code section 2104, and the preliminary declarations of disclosure have been completed andexchanged.

We have completed and exchanged a current Income and Expense Declaration (form FL-150) that includes all material facts andinformation on each party's earnings, accumulations, and expenses.

c. We have fully complied with Family Law section 2102 and have fully augmented the preliminary declarations of disclosure,including disclosure of all material facts and information on

(1) the characterization of all assets and liabilities,

(2) the valuation of all assets that are community property or in which the community has an interest, and

(3) the amounts of all community debts and obligations.

d. Each of the parties enters into this waiver knowingly, intelligently, and voluntarily.

e. Each party understands that this waiver does not limit the legal disclosure obligations of the parties but rather is astatement under penalty of perjury that those obligations have been fulfilled.

f. The parties also understand that if they do not comply with these obligations, the court will set aside the judgment.

The petitioner and respondent declare under penalty of perjury under the laws of the State of California that the foregoing is true andcorrect.

(TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT)

Family Code, §§ 2102, 2104, 2105(d)www.courtinfo.ca.gov

OTHER:

(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)

1.

The parties agree as follows:2.

American LegalNet, Inc.www.FormsWorkflow.com

John Doe

321 Elm Street

Glendale, CA 91203

(323) [email protected] Pro Per

Orange, 92868



Jane DoeJohn Doe

ORANGE

John Doe

Jane Doe

SAMPLE


ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY


STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

CASE NUMBER:INCOME AND EXPENSE DECLARATION

Date:

(SIGNATURE OF DECLARANT)

Page 1 of 4

INCOME AND EXPENSE DECLARATIONForm Adopted for Mandatory UseJudicial Council of California


FL-150

Family Code, §§ 2030 2032,2100 2113, 3552, 3620 3634,

4050 4076, 4300 4339www.courtinfo.ca.gov

Employment1.

Employer:

Employer's address:

Occupation:

Employer's phone number:

Number of years of college completed (specify):

I have completed high school or the equivalent:

Date job started:

If unemployed, date job ended:

I get paid $ gross (before taxes)

I work about hours per week.

(If you have more than one job, attach an 8½-by-11-inch sheet of paper and list the same information as above for your otherjobs. Write "Question 1 Other Jobs" at the top.)

Number of years of graduate school completed (specify):

Degree(s) obtained (specify):

3. Tax information

I last filed taxes for tax year (specify year):

single head of household married, filing separately

married, filing jointly with (specify name):

I file state tax returns in

I claim the following number of exemptions (including myself) on my taxes (specify):

This estimate is based on (explain):

I declare under penalty of perjury under the laws of the State of California that the information contained on all pages of this form andany attachments is true and correct.

OTHER PARENT/CLAIMANT:

per month per week

California

4. Other party's income. I estimate the gross monthly income (before taxes) of the other party in this case at (specify): $

(Give information on your current job or, if you're unemployed, your most recent job.)

Age and education2.

I have:

a.

c.

d.

My tax filing status is

other (specify state):

(If you need more space to answer any questions on this form, attach an 8½-by-11-inch sheet of paper and write the

question number before your answer.)

b.

Yes Nob.

c.

d.

e.


My age is (specify):a.

professional/occupational license(s) (specify):

vocational training (specify):

If no, highest grade completed (specify):

a.

b.

c.

d.

e.

f.

g.

h.

Attach copiesof your paystubs for lasttwo months(black outsocialsecuritynumbers).

per hour.

Number of pages attached:

(TYPE OR PRINT NAME)

TELEPHONE NO.:



John Doe

Glendale, CA 91203321 Elm Street

(323) 962-8600


ORANGE

Orange, 92868Lamoreaux Justice Center

John DoeJane Doe

[email protected]

In Pro Per

X

ABC LLC456 Circle Ave, Los Angeles, CA 91203

(323) 962-8600

General Contractor

August 20, 2003

3,504.58

40

34X

1,628.91

X

X

2012

Jane Doe

2

X

John Doe

SAMPLE

Disability: Social security (not SSI) State disability (SDI) Private insurance .

All other property,

CASE NUMBER:PETITIONER/PLAINTIFF:



Income (For average monthly, add up all the income you received in each category in the last 12 monthsand divide the total by 12.)

Page 2 of 4INCOME AND EXPENSE DECLARATIONFL-150 [Rev. January 1, 2007]

Salary or wages (gross, before taxes). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.)

5.

a.

c.

Last month

$

$Commissions or bonuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

My financial situation has changed significantly over the last 12 months because (specify):9.

Assets11.

a.

b.

Total

$

$

$

Cash and checking accounts, savings, credit union, money market, and other deposit accounts . . . . . . . . . . . . . . . .

c.

Stocks, bonds, and other assets I could easily sell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Averagemonthly

Change in income.

Investment income (Attach a schedule showing gross receipts less cash expenses for each piece of property.)

I received one-time money (lottery winnings, inheritance, etc.) in the last 12 months (specify source and

6.

7.

Rental property income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other (specify): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dividends/interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$

$

8.

$

Trust income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Additional income.

Pension/retirement fund payments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Social security retirement (not SSI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Workers' compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other (military BAQ, royalty payments, etc.) (specify): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g.

h.

i.

j.

k.

l.

d.

e.

$

$

Public assistance (for example: TANF, SSI, GA/GR) currently receiving . . . . . . . . . . . . . . . . .

Spousal support from this marriage from a different marriage . . . . . . . . . . . . . . . . . .

$

$

$

$

$

$

$b. Overtime (gross, before taxes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

a.

c.

d.

b.

I am the owner/sole proprietor business partner other (specify):

Number of years in this 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.

Name of business (specify):

Type of business (specify):

Income from self-employment, after business expenses for all businesses. . . . . . . . . . . . . . . . . . . . . $

Deductions10.

a.

Last month

$

$

$

$

$

Required union dues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b. Required retirement payments (not social security, FICA, 401(k), or IRA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medical, hospital, dental, and other health insurance premiums (total monthly amount). . . . . . . . . . . . . . . . . . . . . . . .

d. Child support that I pay for children from other relationships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e. Spousal support that I pay by court order from a different marriage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g. $Necessary job-related expenses not reimbursed by my employer (attach explanation labeled "Question 10g") . . . . .

Partner support from this domestic partnership from a different domestic partnershipf. $

$f. Partner support that I pay by court order from a different domestic partnership . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

amount):

c.

real and personal (estimate fair market value minus the debts you owe) . . . .

FL-150

John DoeJane Doe

SAMPLE

CASE NUMBER:

Name AgeHow the person isrelated to me? (ex: son)

That person's grossmonthly income

Pays some of thehousehold expenses?

The following people live with me:

Average monthly expenses

Groceries and household supplies. . . . . . .

Rent or mortgage. . . $(1)

Eating out. . . . . . . . . . . . . . . . . . . . . . . . . .

If mortgage:

average principal:

Utilities (gas, electric, water, trash) . . . . . .

$

Telephone, cell phone, and e-mail . . . . . . .

average interest:

$

$

Laundry and cleaning . . . . . . . . . . . . . . . . . $

Clothes . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Education . . . . . . . . . . . . . . . . . . . . . . . . . .

Real property taxes . . . . . . . . . . . . . . $

Entertainment, gifts, and vacation. . . . . . . . $

Homeowner's or renter's insurance

(if not included above) . . . . . . . . . . . .

Auto expenses and transportation

$

$

Monthly payments listed in item 14(itemize below in 14 and insert total here). .

Maintenance and repair . . . . . . . . . . .

$

$Savings and investments. . . . . . . . . . . . . . . $

$

Other (specify): . . . . . . . . . . . . . . . . . . . . . . $

Child care . . . . . . . .. . . . . . . . . . . . . . . . . . $

TOTAL EXPENSES (a q) (do not add in

$the amounts in a(1)(a) and (b))


$

$

$

$

Yes No

Yes No

Yes No

Yes No

a.

b.

c.

d.

Estimated expenses Actual expenses Proposed needs

Installment payments and debts not listed above

(insurance, gas, repairs, bus, etc.) . . . . . . .

Charitable contributions. . . . . . . . . . . . . . . . $

Date of last paymentAmountForPaid to

$

$

$

$

Home:

Balance

The source of this money was (specify):

I still owe the following fees and costs to my attorney (specify total owed): $

I confirm this fee arrangement.

(SIGNATURE OF ATTORNEY)(TYPE OR PRINT NAME OF ATTORNEY)

Attorney fees (This is required if either party is requesting attorney fees.):

To date, I have paid my attorney this amount for fees and costs (specify): $

Insurance (life, accident, etc.; do notinclude auto, home, or health insurance). . . $

My attorney's hourly rate is (specify): $

12.

13.

14.

15.

a.

b.

c.

(2)

(3)

(4)

d.

e.

f.

g.

h.

i.

j.

k.

l.

m.

n.

o.

p.

q.

r.

e. Yes No

$

$

$

$

Amount of expenses paid by others $s.

a.

b.

c.d.

Date:

Health-care costs not paid by insurance. . .

(a)

(b)




FL-150

$ $

$ $

John DoeJane Doe

SAMPLE




CHILD SUPPORT INFORMATION

I do not have health insurance available to me for the children through my job.

Children's health-care expenses

I doa.

The monthly cost for the children's health insurance is or would be (specify): $

Additional expenses for the children in this case

Children's health care not covered by insurance . . . . . . . . . . . . . . . . . . . .

Travel expenses for visitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Children's educational or other special needs (specify below): . . . . . . . .


Child care so I can work or get job training. . . . . . . . . . . . . . . . . . . . . . . . .

Name of insurance company:

Address of insurance company:

I have (specify number): children under the age of 18 with the other parent in this case.

The children spend percent of their time with me and percent of their time with the other parent.

(Do not include the amount your employer pays.)

Amount per month

$

Special hardships. I ask the court to consider the following special financial circumstances

Major losses not covered by insurance (examples: fire, theft, otherinsured loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Expenses for my minor children who are from other relationships andare living with me . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Extraordinary health expenses not included in 18b. . . . . . . . . . . . . . . . . .

(attach documentation of any item listed here, including court orders):

$

$

$

$

$

$

Amount per month For how many months?

(NOTE: Fill out this page only if your case involves child support.)

(If you're not sure about percentage or it has not been agreed on, please describe your parenting schedule here.)

b.

a.

c.

d.

16.

17.

18.

19.

a.

b.

b.

c.

d.

a.

b.

c.

Names and ages of those children (specify):

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.

Number of children

Child support I receive for those children. . . . . . . . . . . . . . . . . . . . . . . $

(1)

(3)

(2)

FL-150

John DoeJane Doe

2

Zxy Insurance

X

Los Angeles, CA 91203

456 Circle Ave

50.149.9

50.00

SAMPLE


ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY


STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:



CASE NUMBER:INCOME AND EXPENSE DECLARATION

Date:

(SIGNATURE OF DECLARANT)

Page 1 of 4

INCOME AND EXPENSE DECLARATIONForm Adopted for Mandatory UseJudicial Council of California


FL-150

Family Code, §§ 2030 2032,2100 2113, 3552, 3620 3634,

4050 4076, 4300 4339www.courtinfo.ca.gov

Employment1.

Employer:

Employer's address:

Occupation:

Employer's phone number:

Number of years of college completed (specify):

I have completed high school or the equivalent:

Date job started:

If unemployed, date job ended:

I get paid $ gross (before taxes)

I work about hours per week.

(If you have more than one job, attach an 8½-by-11-inch sheet of paper and list the same information as above for your otherjobs. Write "Question 1 Other Jobs" at the top.)

Number of years of graduate school completed (specify):


3. Tax information

I last filed taxes for tax year (specify year):

single head of household married, filing separately

married, filing jointly with (specify name):

I file state tax returns in

I claim the following number of exemptions (including myself) on my taxes (specify):

This estimate is based on (explain):

I declare under penalty of perjury under the laws of the State of California that the information contained on all pages of this form andany attachments is true and correct.


per month per week

California

4. Other party's income. I estimate the gross monthly income (before taxes) of the other party in this case at (specify): $

(Give information on your current job or, if you're unemployed, your most recent job.)

Age and education2.

I have:

a.

c.

d.

My tax filing status is

other (specify state):

(If you need more space to answer any questions on this form, attach an 8½-by-11-inch sheet of paper and write the

question number before your answer.)

b.

Yes Nob.

c.

d.

e.


My age is (specify):a.

professional/occupational license(s) (specify):

vocational training (specify):

If no, highest grade completed (specify):

a.

b.

c.

d.

e.

f.

g.

h.

Attach copiesof your paystubs for lasttwo months(black outsocialsecuritynumbers).

per hour.

Number of pages attached:

(TYPE OR PRINT NAME)

TELEPHONE NO.:



Jane Doe

Glendale, CA 91203123 Main Street

(323) 962-8600


ORANGE


John DoeJane Doe

In Pro Per

X

XYZ , LLC.321 Elm Street, Irvine, CA 92618

(323) 962-8600

Teacher

January 8, 2007

1,628.91

40

33X

3,504.58

X

X

2012

John Doe

0

X

Jane Doe

SAMPLE

Disability: Social security (not SSI) State disability (SDI) Private insurance .

All other property,




Income (For average monthly, add up all the income you received in each category in the last 12 monthsand divide the total by 12.)


Salary or wages (gross, before taxes). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.)

5.

a.

c.

Last month

$

$Commissions or bonuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

My financial situation has changed significantly over the last 12 months because (specify):9.

Assets11.

a.

b.

Total

$

$

$

Cash and checking accounts, savings, credit union, money market, and other deposit accounts . . . . . . . . . . . . . . . .

c.

Stocks, bonds, and other assets I could easily sell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Averagemonthly

Change in income.

Investment income (Attach a schedule showing gross receipts less cash expenses for each piece of property.)

I received one-time money (lottery winnings, inheritance, etc.) in the last 12 months (specify source and

6.

7.

Rental property income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other (specify): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dividends/interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$

$

8.

$

Trust income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Additional income.

Pension/retirement fund payments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Social security retirement (not SSI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Workers' compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other (military BAQ, royalty payments, etc.) (specify): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g.

h.

i.

j.

k.

l.

d.

e.

$

$

Public assistance (for example: TANF, SSI, GA/GR) currently receiving . . . . . . . . . . . . . . . . .

Spousal support from this marriage from a different marriage . . . . . . . . . . . . . . . . . .

$

$

$

$

$

$

$b. Overtime (gross, before taxes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

a.

c.

d.

b.

I am the owner/sole proprietor business partner other (specify):

Number of years in this 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.

Name of business (specify):

Type of business (specify):

Income from self-employment, after business expenses for all businesses. . . . . . . . . . . . . . . . . . . . . $

Deductions10.

a.

Last month

$

$

$

$

$

Required union dues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b. Required retirement payments (not social security, FICA, 401(k), or IRA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medical, hospital, dental, and other health insurance premiums (total monthly amount). . . . . . . . . . . . . . . . . . . . . . . .

d. Child support that I pay for children from other relationships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e. Spousal support that I pay by court order from a different marriage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g. $Necessary job-related expenses not reimbursed by my employer (attach explanation labeled "Question 10g") . . . . .

Partner support from this domestic partnership from a different domestic partnershipf. $

$f. Partner support that I pay by court order from a different domestic partnership . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

amount):

c.

real and personal (estimate fair market value minus the debts you owe) . . . .

FL-150

John DoeJane Doe

SAMPLE

CASE NUMBER:

Name AgeHow the person isrelated to me? (ex: son)

That person's grossmonthly income

Pays some of thehousehold expenses?

The following people live with me:

Average monthly expenses

Groceries and household supplies. . . . . . .

Rent or mortgage. . . $(1)

Eating out. . . . . . . . . . . . . . . . . . . . . . . . . .

If mortgage:

average principal:

Utilities (gas, electric, water, trash) . . . . . .

$

Telephone, cell phone, and e-mail . . . . . . .

average interest:

$

$

Laundry and cleaning . . . . . . . . . . . . . . . . . $

Clothes . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Education . . . . . . . . . . . . . . . . . . . . . . . . . .

Real property taxes . . . . . . . . . . . . . . $

Entertainment, gifts, and vacation. . . . . . . . $

Homeowner's or renter's insurance

(if not included above) . . . . . . . . . . . .

Auto expenses and transportation

$

$

Monthly payments listed in item 14(itemize below in 14 and insert total here). .

Maintenance and repair . . . . . . . . . . .

$

$Savings and investments. . . . . . . . . . . . . . . $

$

Other (specify): . . . . . . . . . . . . . . . . . . . . . . $

Child care . . . . . . . .. . . . . . . . . . . . . . . . . . $

TOTAL EXPENSES (a q) (do not add in

$the amounts in a(1)(a) and (b))


$

$

$

$

Yes No

Yes No

Yes No

Yes No

a.

b.

c.

d.

Estimated expenses Actual expenses Proposed needs

Installment payments and debts not listed above

(insurance, gas, repairs, bus, etc.) . . . . . . .

Charitable contributions. . . . . . . . . . . . . . . . $

Date of last paymentAmountForPaid to

$

$

$

$

Home:

Balance

The source of this money was (specify):

I still owe the following fees and costs to my attorney (specify total owed): $

I confirm this fee arrangement.

(SIGNATURE OF ATTORNEY)(TYPE OR PRINT NAME OF ATTORNEY)

Attorney fees (This is required if either party is requesting attorney fees.):

To date, I have paid my attorney this amount for fees and costs (specify): $

Insurance (life, accident, etc.; do notinclude auto, home, or health insurance). . . $

My attorney's hourly rate is (specify): $

12.

13.

14.

15.

a.

b.

c.

(2)

(3)

(4)

d.

e.

f.

g.

h.

i.

j.

k.

l.

m.

n.

o.

p.

q.

r.

e. Yes No

$

$

$

$

Amount of expenses paid by others $s.

a.

b.

c.d.

Date:

Health-care costs not paid by insurance. . .

(a)

(b)




FL-150

$ $

$ $

John DoeJane Doe

SAMPLE




CHILD SUPPORT INFORMATION

I do not have health insurance available to me for the children through my job.

Children's health-care expenses

I doa.

The monthly cost for the children's health insurance is or would be (specify): $

Additional expenses for the children in this case

Children's health care not covered by insurance . . . . . . . . . . . . . . . . . . . .

Travel expenses for visitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Children's educational or other special needs (specify below): . . . . . . . .


Child care so I can work or get job training. . . . . . . . . . . . . . . . . . . . . . . . .

Name of insurance company:

Address of insurance company:

I have (specify number): children under the age of 18 with the other parent in this case.

The children spend percent of their time with me and percent of their time with the other parent.

(Do not include the amount your employer pays.)

Amount per month

$

Special hardships. I ask the court to consider the following special financial circumstances

Major losses not covered by insurance (examples: fire, theft, otherinsured loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Expenses for my minor children who are from other relationships andare living with me . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Extraordinary health expenses not included in 18b. . . . . . . . . . . . . . . . . .

(attach documentation of any item listed here, including court orders):

$

$

$

$

$

$

Amount per month For how many months?

(NOTE: Fill out this page only if your case involves child support.)

(If you're not sure about percentage or it has not been agreed on, please describe your parenting schedule here.)

b.

a.

c.

d.

16.

17.

18.

19.

a.

b.

b.

c.

d.

a.

b.

c.

Names and ages of those children (specify):

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.

Number of children

Child support I receive for those children. . . . . . . . . . . . . . . . . . . . . . . $

(1)

(3)

(2)

FL-150

John DoeJane Doe

2

49.950.1

SAMPLE


FL-160FOR COURT USE ONLYATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):


STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

PETITIONER'S RESPONDENT'S CASE NUMBER:

COMMUNITY AND QUASI-COMMUNITY PROPERTY DECLARATION

SEPARATE PROPERTY DECLARATION

INSTRUCTIONS

When this form is attached to the Petition or Response, values and your proposal regarding division need not be completed. Do not list

community, including quasi-community, property with separate property on the same form. Quasi-community property must be so

identified. For additional space, use Continuation of Property Declaration (form FL-161).

GROSS FAIRMARKETVALUE

AMOUNT OFDEBT

NET FAIRMARKETVALUE

PROPOSAL FOR DIVISIONITEMNO. BRIEF DESCRIPTION

Award to:PETITIONER RESPONDENT

$ $ $ $ $1. REAL ESTATE

2. HOUSEHOLD FURNITURE,

FURNISHINGS, APPLIANCES

3. JEWELRY, ANTIQUES, ART,

COIN COLLECTIONS, etc.

4. VEHICLES, BOATS,

TRAILERS

Page 1 of 2

Family Code, §§ 115, 2500 2660www.courtinfo.ca.gov

Form Adopted for Mandatory UseJudicial Council of California


PROPERTY DECLARATION(Family Law)

TELEPHONE NO.:


FAX NO. (Optional):


Orange, 92868

John Doe


Jane Doe


John Doe321 Elm StreetGlendale, CA 91203

(323) [email protected]

ORANGE

In Pro Per

X

X

The 2006 Harley Davidson Sportster Motorcycle 4,500.00 0.00 4,500.00 4,500.00 0.00

House hold Funiture 120.00 0.00 120.00 0.00 120.00

SAMPLE

15. A Continuation of Property Declaration (form FL-161) is attached and incorporated by reference.

I declare under penalty of perjury under the laws of the State of California that, to the best of my knowledge, the foregoing isa true and correct listing of assets and obligations and the amounts shown are correct.

Date:


FL-160 [Rev. January 1, 2007] Page 2 of 2PROPERTY DECLARATION(Family Law)

$ $ $ $ $

6. LIFE INSURANCE (CASH

VALUE)

7. EQUIPMENT, MACHINERY,

LIVESTOCK

8. STOCKS, BONDS, SECURED

NOTES

9. RETIREMENT, PENSION,

PROFIT-SHARING,ANNUITIES

10. ACCOUNTS RECEIVABLE,

UNSECURED NOTES,

TAX REFUNDS

11. PARTNERSHIPS, OTHER

BUSINESS INTERESTS

12. OTHER ASSETS AND DEBTS

13. TOTAL FROM

CONTINUATION SHEET

14. TOTALS

5. SAVINGS, CHECKING,

CREDIT UNION,

CASH


AMOUNT OFDEBT

NET FAIRMARKETVALUE



FL-160

John Doe

SAMPLE


FL-160FOR COURT USE ONLYATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):


STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

PETITIONER'S RESPONDENT'S CASE NUMBER:

COMMUNITY AND QUASI-COMMUNITY PROPERTY DECLARATION

SEPARATE PROPERTY DECLARATION

INSTRUCTIONS

When this form is attached to the Petition or Response, values and your proposal regarding division need not be completed. Do not list

community, including quasi-community, property with separate property on the same form. Quasi-community property must be so

identified. For additional space, use Continuation of Property Declaration (form FL-161).


AMOUNT OFDEBT

NET FAIRMARKETVALUE



$ $ $ $ $1. REAL ESTATE

2. HOUSEHOLD FURNITURE,

FURNISHINGS, APPLIANCES

3. JEWELRY, ANTIQUES, ART,

COIN COLLECTIONS, etc.

4. VEHICLES, BOATS,

TRAILERS

Page 1 of 2

Family Code, §§ 115, 2500 2660www.courtinfo.ca.gov

Form Adopted for Mandatory UseJudicial Council of California


PROPERTY DECLARATION(Family Law)

TELEPHONE NO.:


FAX NO. (Optional):


Orange, 92868

John Doe


Jane Doe


Jane Doe123 Main StreetGlendale, CA 91203

(323) 962-8600

ORANGE

In Pro Per

X

X

The 2006 Harley Davidson Sportster Motorcycle 4,500.00 0.00 4,500.00 4,500.00 0.00

House hold Funiture 120.00 0.00 120.00 0.00 120.00

SAMPLE

15. A Continuation of Property Declaration (form FL-161) is attached and incorporated by reference.

I declare under penalty of perjury under the laws of the State of California that, to the best of my knowledge, the foregoing isa true and correct listing of assets and obligations and the amounts shown are correct.

Date:


FL-160 [Rev. January 1, 2007] Page 2 of 2PROPERTY DECLARATION(Family Law)

$ $ $ $ $

6. LIFE INSURANCE (CASH

VALUE)

7. EQUIPMENT, MACHINERY,

LIVESTOCK

8. STOCKS, BONDS, SECURED

NOTES

9. RETIREMENT, PENSION,

PROFIT-SHARING,ANNUITIES

10. ACCOUNTS RECEIVABLE,

UNSECURED NOTES,

TAX REFUNDS

11. PARTNERSHIPS, OTHER

BUSINESS INTERESTS

12. OTHER ASSETS AND DEBTS

13. TOTAL FROM

CONTINUATION SHEET

14. TOTALS

5. SAVINGS, CHECKING,

CREDIT UNION,

CASH


AMOUNT OFDEBT

NET FAIRMARKETVALUE



FL-160

Jane Doe

SAMPLE



Orange, 92868

John Doe

Jane Doe

John Doe

Glendale, CA 91203

321 Elm Street

ORANGE

(323) 962-8600

XX

X

John Doe

FatherJane Doe

Mother

X 300.00

X

In Pro Per

[email protected]

SAMPLE

John Doe

Jane Doe

Mary Megen DoePeter Ryan Doe April 10, 2005

August 3, 2008

John Doe Jane Doe

May 29, 1980

123 Main Street

April 17, 1980

321 Elm Street

Glendale, CA 91203Glendale, CA 91203

B5555555

CA

(323) 962-8600

B1111111

CA

(323) 962-8600

ABC LLC

321 Elm Street

Irvine, CA 92618

(323) 962-8600

456 Circle Ave


(323) 962-8600

John Doe

XYZ , LLC.

XX

321 Elm Street

Glendale, CA 91203

123 Main Street

Glendale, CA 91203

SAMPLE

SAMPLE

SAMPLE

X

Jane Doe

Glendale, CA 91203123 Main Street



Orange, 92868

John Doe

Jane Doe

ORANGE

X

John Doe

FatherJane Doe

Mother

X 300.00

(323) 962-8600

X

In Pro Per

SAMPLE

John Doe

Jane Doe

Mary Megen DoePeter Ryan Doe April 10, 2005

August 3, 2008

John Doe Jane Doe

May 29, 1980

123 Main Street

April 17, 1980

321 Elm Street

Glendale, CA 91203Glendale, CA 91203

B5555555

CA

(323) 962-8600

B1111111

CA

(323) 962-8600

ABC LLC

321 Elm Street

Irvine, CA 92618

(323) 962-8600

456 Circle Ave


(323) 962-8600

Jane Doe

XYZ , LLC.

XX

321 Elm Street

Glendale, CA 91203 Glendale, CA 91203

123 Main Street

SAMPLE

SAMPLE

SAMPLE

NOTICE OF RIGHTS AND RESPONSIBILITIES

Health-Care Costs and Reimbursement Procedures

IF YOU HAVE A CHILD SUPPORT ORDER THAT INCLUDES A PROVISION FOR THEREIMBURSEMENT OF A PORTION OF THE CHILD S OR CHILDREN S HEALTH-CARE COSTS

AND THOSE COSTS ARE NOT PAID BY INSURANCE, THE LAW SAYS:

If you claim that the other party has failed toreimburse you for a payment, or the other partyhas failed to make a payment to the providerafter proper notice has been given, you may filea motion in court to resolve the dispute. Thecourt will presume that if uninsured costs havebeen paid, those costs were reasonable. Thecourt may award attorney fees and costsagainst a party who has been unreasonable.

1. Notice. You must give the other parent anitemized statement of the charges that havebeen billed for any health-care costs not paidby insurance. You must give this statement tothe other parent within a reasonable time, butno more than 30 days after those costs weregiven to you.

2. Proof of full payment. If you have alreadypaid all of the uninsured costs, you must(1) give the other parent proof that you paidthem and (2) ask for reimbursement for theother parent s court-ordered share of thosecosts.

6. Court-ordered insurance coverage. If aparent provides health-care insurance asordered by the court, that insurance must beused at all times to the extent that it is availablefor health-care costs.

3. Proof of partial payment. If you have paidonly your share of the uninsured costs, youmust (1) give the other parent proof that youpaid your share, (2) ask that the other parentpay his or her share of the costs directly to thehealth-care provider, and (3) give the otherparent the information necessary for thatparent to be able to pay the bill.

a. Burden to prove. The party claimingthat the coverage is inadequate to meet thechild's needs has the burden of proving thatto the court.

b. Cost of additional coverage. If a parentpurchases health-care insurance in additionto that ordered by the court, that parent mustpay all the costs of the additional coverage.In addition, if a parent uses alternativecoverage that costs more than the coverageprovided by court order, that parent must paythe difference.

4. Payment by notified parent. If you receivenotice from a parent that an uninsuredhealth-care cost has been incurred, you mustpay your share of that cost within the time thecourt orders; or if the court has not specified aperiod of time, you must make payment(1) within 30 days from the time you were givennotice of the amount due, (2) according to anypayment schedule set by the health-care provider, (3) according to a scheduleagreed to in writing by you and the otherparent, or (4) according to a schedule adoptedby the court.

7. Preferred health providers. If thecourt-ordered coverage designates a preferredhealth-care provider, that provider must beused at all times consistent with the terms ofthe health insurance policy. When any partyuses a health-care provider other than thepreferred provider, any health-care costs thatwould have been paid by the preferred healthprovider if that provider had been used must bethe sole responsibility of the party incurringthose costs.

5. Disputed charges. If you dispute a charge,you may file a motion in court to resolve thedispute, but only if you pay that charge beforefiling your motion.

FL-192

Form Approved for Optional UseJudicial Council of CaliforniaFL-192 [Rev. July 1, 2007]

Family Code, §§ 4062, 4063www.courtinfo.ca.gov

NOTICE OF RIGHTS AND RESPONSIBILITIESHealth-Care Costs and Reimbursement Procedures

Page 1 of 2

SAMPLE

FL-192 [Rev. July 1, 2007] NOTICE OF RIGHTS AND RESPONSIBILITESHealth-Care Costs and Reimbursement Procedures

INFORMATION SHEET ON CHANGING A CHILD SUPPORT ORDERGeneral InformationThe court has just made a child support order in your case. This order will remain the same unless a party to the action requests that thesupport be changed (modified). An order for child support can be modified only by filing a motion to change child support and servingeach party involved in your case. If both parents and the local child support agency (if it is involved) agree on a new child supportamount, you can complete, have all parties sign, and file with the court a Stipulation to Establish or Modify Child Support and Order(form FL-350) or Stipulation and Order (Governmental) (form FL-625).

When a Child Support Order May Be ModifiedThe court takes several things into account when ordering the payment of child support. First, the number of children is considered.Next, the net incomes of both parents are determined, along with the percentage of time each parent has physical custody of thechildren. The court considers both parties tax filing status and may consider hardships, such as a child of another relationship. Anexisting order for child support may be modified when the net income of one of the parents changes significantly, the parenting schedulechanges significantly, or a new child is born.

ExamplesYou have been ordered to pay $500 per month in child support. You lose your job. You will continue to owe $500 per month, plus10 percent interest on any unpaid support, unless you file a motion to modify your child support to a lower amount and the courtorders a reduction.You are currently receiving $300 per month in child support from the other parent, whose net income has just increasedsubstantially. You will continue to receive $300 per month unless you file a motion to modify your child support to a higher amountand the court orders an increase.You are paying child support based upon having physical custody of your children 30 percent of the time. After several months itturns out that you actually have physical custody of the children 50 percent of the time. You may file a motion to modify child supportto a lower amount.

How to Change a Child Support Order

To change a child support order, you must file papers with the court. Remember: You must follow the order you have now.

What forms do I need?If you are asking to change a child support order open with the local child support agency, you must fill out one of these forms:

FL-680, Notice of Motion (Governmental) or FL-683 Order to Show Cause (Governmental) andFL-684, Request for Order and Supporting Declaration (Governmental)

If you are asking to change a child support order that is not open with the local child support agency, you must fill out one of theseforms:

FL-301, Notice of Motion or FL-300, Order to Show Cause andFL-310, Application for Order and Supporting Declaration orFL-390, Notice of Motion and Motion for Simplified Modification of Order for Child, Spousal, or Family Support

You must also fill out one of these forms:FL-150, Income and Expense Declaration or FL-155, Financial Statement (Simplified)

What if I am not sure which forms to fill out?Talk to the family law facilitator at your court.

You must serve the other parent. If the local child support agency is involved, serve it too.This means someone 18 or over not you must serve the other parent copies of your filed court forms at least 16 court days beforethe hearing. Add 5 calendar days if you serve by mail within California (see Code of Civil Procedure section 1005 for other situations).Court days are weekdays when the court is open for business (Monday through Friday except court holidays). Calendar days includeall days of the month, including weekends and holidays. To determine court and calendar days, go towww.courtinfo.ca.gov/selfhelp/courtcalendars/.

Go to your hearing and ask the judge to change the support. Bring your tax returns from the last two years and your last twomonths pay stubs. The judge will look at your information, listen to both parents, and make an order. After the hearing, fill out:

FL-340, Findings and Order After Hearing andFL-342, Child Support Information and Order Attachment

Need help?Contact the family law facilitator in your county or call your county's bar association and ask for an experienced family lawyer.

The server must also serve blank copies of these forms:FL-320, Responsive Declaration to Order to Show Cause or Notice of Motion and FL-150, Income and Expense Declaration, orFL-155, Financial Statement (Simplified)

Then the server fills out and signs a Proof of Service (form FL-330 or FL-335). Take this form to the clerk and file it.

Page 2 of 2

FL-192

After you fill out the forms, file them with the court clerk and ask for a hearing date. Write the hearing date on the form.The clerk will ask you to pay a filing fee. If you cannot afford the fee, fill out these forms, too:

Form FW-001, Application for Waiver of Court Fees and CostsForm FW-003, Order on Application for Waiver of Court Fees and CostsSAMPLE

NOTICE OF RIGHTS AND RESPONSIBILITIES

Health-Care Costs and Reimbursement Procedures

IF YOU HAVE A CHILD SUPPORT ORDER THAT INCLUDES A PROVISION FOR THEREIMBURSEMENT OF A PORTION OF THE CHILD S OR CHILDREN S HEALTH-CARE COSTS

AND THOSE COSTS ARE NOT PAID BY INSURANCE, THE LAW SAYS:

If you claim that the other party has failed toreimburse you for a payment, or the other partyhas failed to make a payment to the providerafter proper notice has been given, you may filea motion in court to resolve the dispute. Thecourt will presume that if uninsured costs havebeen paid, those costs were reasonable. Thecourt may award attorney fees and costsagainst a party who has been unreasonable.

1. Notice. You must give the other parent anitemized statement of the charges that havebeen billed for any health-care costs not paidby insurance. You must give this statement tothe other parent within a reasonable time, butno more than 30 days after those costs weregiven to you.

2. Proof of full payment. If you have alreadypaid all of the uninsured costs, you must(1) give the other parent proof that you paidthem and (2) ask for reimbursement for theother parent s court-ordered share of thosecosts.

6. Court-ordered insurance coverage. If aparent provides health-care insurance asordered by the court, that insurance must beused at all times to the extent that it is availablefor health-care costs.

3. Proof of partial payment. If you have paidonly your share of the uninsured costs, youmust (1) give the other parent proof that youpaid your share, (2) ask that the other parentpay his or her share of the costs directly to thehealth-care provider, and (3) give the otherparent the information necessary for thatparent to be able to pay the bill.

a. Burden to prove. The party claimingthat the coverage is inadequate to meet thechild's needs has the burden of proving thatto the court.

b. Cost of additional coverage. If a parentpurchases health-care insurance in additionto that ordered by the court, that parent mustpay all the costs of the additional coverage.In addition, if a parent uses alternativecoverage that costs more than the coverageprovided by court order, that parent must paythe difference.

4. Payment by notified parent. If you receivenotice from a parent that an uninsuredhealth-care cost has been incurred, you mustpay your share of that cost within the time thecourt orders; or if the court has not specified aperiod of time, you must make payment(1) within 30 days from the time you were givennotice of the amount due, (2) according to anypayment schedule set by the health-care provider, (3) according to a scheduleagreed to in writing by you and the otherparent, or (4) according to a schedule adoptedby the court.

7. Preferred health providers. If thecourt-ordered coverage designates a preferredhealth-care provider, that provider must beused at all times consistent with the terms ofthe health insurance policy. When any partyuses a health-care provider other than thepreferred provider, any health-care costs thatwould have been paid by the preferred healthprovider if that provider had been used must bethe sole responsibility of the party incurringthose costs.

5. Disputed charges. If you dispute a charge,you may file a motion in court to resolve thedispute, but only if you pay that charge beforefiling your motion.

FL-192

Form Approved for Optional UseJudicial Council of CaliforniaFL-192 [Rev. July 1, 2007]

Family Code, §§ 4062, 4063www.courtinfo.ca.gov

NOTICE OF RIGHTS AND RESPONSIBILITIESHealth-Care Costs and Reimbursement Procedures

Page 1 of 2

SAMPLE

FL-192 [Rev. July 1, 2007] NOTICE OF RIGHTS AND RESPONSIBILITESHealth-Care Costs and Reimbursement Procedures

INFORMATION SHEET ON CHANGING A CHILD SUPPORT ORDERGeneral InformationThe court has just made a child support order in your case. This order will remain the same unless a party to the action requests that thesupport be changed (modified). An order for child support can be modified only by filing a motion to change child support and servingeach party involved in your case. If both parents and the local child support agency (if it is involved) agree on a new child supportamount, you can complete, have all parties sign, and file with the court a Stipulation to Establish or Modify Child Support and Order(form FL-350) or Stipulation and Order (Governmental) (form FL-625).

When a Child Support Order May Be ModifiedThe court takes several things into account when ordering the payment of child support. First, the number of children is considered.Next, the net incomes of both parents are determined, along with the percentage of time each parent has physical custody of thechildren. The court considers both parties tax filing status and may consider hardships, such as a child of another relationship. Anexisting order for child support may be modified when the net income of one of the parents changes significantly, the parenting schedulechanges significantly, or a new child is born.

ExamplesYou have been ordered to pay $500 per month in child support. You lose your job. You will continue to owe $500 per month, plus10 percent interest on any unpaid support, unless you file a motion to modify your child support to a lower amount and the courtorders a reduction.You are currently receiving $300 per month in child support from the other parent, whose net income has just increasedsubstantially. You will continue to receive $300 per month unless you file a motion to modify your child support to a higher amountand the court orders an increase.You are paying child support based upon having physical custody of your children 30 percent of the time. After several months itturns out that you actually have physical custody of the children 50 percent of the time. You may file a motion to modify child supportto a lower amount.

How to Change a Child Support Order

To change a child support order, you must file papers with the court. Remember: You must follow the order you have now.

What forms do I need?If you are asking to change a child support order open with the local child support agency, you must fill out one of these forms:

FL-680, Notice of Motion (Governmental) or FL-683 Order to Show Cause (Governmental) andFL-684, Request for Order and Supporting Declaration (Governmental)

If you are asking to change a child support order that is not open with the local child support agency, you must fill out one of theseforms:

FL-301, Notice of Motion or FL-300, Order to Show Cause andFL-310, Application for Order and Supporting Declaration orFL-390, Notice of Motion and Motion for Simplified Modification of Order for Child, Spousal, or Family Support

You must also fill out one of these forms:FL-150, Income and Expense Declaration or FL-155, Financial Statement (Simplified)

What if I am not sure which forms to fill out?Talk to the family law facilitator at your court.

You must serve the other parent. If the local child support agency is involved, serve it too.This means someone 18 or over not you must serve the other parent copies of your filed court forms at least 16 court days beforethe hearing. Add 5 calendar days if you serve by mail within California (see Code of Civil Procedure section 1005 for other situations).Court days are weekdays when the court is open for business (Monday through Friday except court holidays). Calendar days includeall days of the month, including weekends and holidays. To determine court and calendar days, go towww.courtinfo.ca.gov/selfhelp/courtcalendars/.

Go to your hearing and ask the judge to change the support. Bring your tax returns from the last two years and your last twomonths pay stubs. The judge will look at your information, listen to both parents, and make an order. After the hearing, fill out:

FL-340, Findings and Order After Hearing andFL-342, Child Support Information and Order Attachment

Need help?Contact the family law facilitator in your county or call your county's bar association and ask for an experienced family lawyer.

The server must also serve blank copies of these forms:FL-320, Responsive Declaration to Order to Show Cause or Notice of Motion and FL-150, Income and Expense Declaration, orFL-155, Financial Statement (Simplified)

Then the server fills out and signs a Proof of Service (form FL-330 or FL-335). Take this form to the clerk and file it.

Page 2 of 2

FL-192

After you fill out the forms, file them with the court clerk and ask for a hearing date. Write the hearing date on the form.The clerk will ask you to pay a filing fee. If you cannot afford the fee, fill out these forms, too:

Form FW-001, Application for Waiver of Court Fees and CostsForm FW-003, Order on Application for Waiver of Court Fees and CostsSAMPLE

John Doe

Jane Doe

X

X

X

X

X

Peter Ryan Doe 4/10/2005 John Doe and Jane Doe

Mary Megen Doe 8/03/2008 John Doe and Jane Doe

SAMPLE

John Doe

Jane Doe

X

XX SAMPLE



ORANGE



John Doe

Jane Doe

X

X 50 49

John Doe

300.00X

300.00 X see 7.c.

X Monthly

300.00

Peter Ryan Doe $150.00 Jane Doe

Mary Megen Doe $150.00 Jane DoeSAMPLE

John Doe

Jane Doe

John Doe and Jane Doe

X

50 50

X

John Doe

Jane Doe SAMPLE

X

X X

X

X

X

X

John Doe

321 Elm Street

Glendale, CA 91203

John Doe

Jane Doe

ORANGE



Lamoreaux Justice CenterOrange, 92868

SAMPLE

John Doe

Jane Doe

X

SAMPLE

John Doe

321 Elm Street

Glendale, CA 91203(323) 962-8600

ORANGE


Orange, 92868


John Doe

Jane Doe

Jane Doe

[email protected]

Jane Doe

In Pro Per

X

SAMPLE

John Doe

321 Elm Street

Glendale, CA 91203

John Doe

Jane Doe



Jane Doe

(323) 962-8600


ORANGE

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(323) [email protected]

ORANGE

X

In Pro Per



Orange, 92868

John Doe

Jane Doe

John Doe

321 Elm Street

Glendale, CA 91203

X

X

X

SAMPLE

X

X

John Doe

Jane Doe

X

X

X

X

X

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John Doe

Jane Doe

John Doe

X

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X

John Doe

Jane Doe

X

X

X

X

X Jane Eod

ORANGE

X

SAMPLE


X

X

Peter Ryan Doe

Mary Megen Doe

April 10, 2005

August 3, 2008

X

X

X

X

X

X

X

X

25

X

X

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John Doe

321 Elm Street

Glendale, CA 91203

(323) 962-8600

ORANGE



John Doe

Jane Doe

X

John Doe

321 Elm Street

Glendale, CA 91203

Jane Doe

123 Main Street

Glendale, CA 91203

[email protected] Pro Per

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Xspouse 2013-1-CA

Time: 11:22:41 Date: 01/14/14Legalzoom.com

2013 Formal Report Monthly figures

Figures on this page exclude effects of guideline support.

Father Mother

CHILDREN

Supported children of this relationship 0 2

Husband's visitation of children with wife 20.00%

Wife's visitation of children with husband 0.00%

INCOME

Tax filing status <-MFJ MFJ->

Number of federal exemptions 4 0

Wage and salary income 4500 200

Self-employment income 0 0

Other federally taxable income 0 0

Other non-taxable income 0 0

TOTAL GUIDELINE INCOME 4500 200

TANF and child support received from other relationships 0 0

New spouse income on joint return 0 0

EXPENSES

Deductible support paid re other relationships B 0 0

Non-deductible support paid re other relationships G 0 0

Health insurance premiums B 0 10

Recurring other medical, dental and drug expenses T 0 40

Recurring property taxes paid T 0 690

Recurring interest expense T 0 0

Recurring charitable contribution deductions T 0 0

Recurring miscellaneous expenses T 0 2500

Union dues required for employment B 0 0

Mandatory retirement/pension contributions B 0 0

Hardship deductions G 0 0

Other discretionary guideline deductions G 0 0

Child care expenses, this relationship B 0 400

Total guideline deductions, excluding taxes 0 10

COMPUTATIONS (BEFORE SUPPORT)

State income tax (prorated in the case of MFJ) 0 0

Federal income tax (prorated in the case of MFJ) 86 -81

FICA 344 15

Federal self-employment tax 0 0

State employment taxes 45 2

Total taxes 476 -64

TOTAL GUIDELINE DEDUCTIONS 476 -54

NET GUIDELINE INCOME BEFORE SUPPORT 4024 254

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Xspouse 2013-1-CA



Guideline spousal support is based on adjusted nets

Guideline Proposed

COMBINED CASH FLOW

Combined net spendable income 4278 4495

Percent change 0% 5%

Father'S CASH FLOW

After-tax cost (-) or benefit (+) of payment -1721 -1604

Net spendable income after support 2303 2420

Percent of combined net spendable income 54% 54%

Percent of total tax savings 0% 54%

Total taxes after credits 476 259

Value of dependency exemptions 86 0

Number of withholding allowances 9 11

Net wage paycheck 4008 4087

State marginal bracket 4% 2%

Federal marginal bracket 15% 10%

Combined marginal bracket 18% 12%

Mother'S CASH FLOW

After-tax cost (-) or benefit (+) of payment 1721 1821

Net spendable income after support 1975 2075

Percent of combined net spendable income 46% 46%

Percent of total tax savings 0% 46%

Total taxes after credits -64 -64

Value of dependency exemptions 0 0

Number of withholding allowances 0 0

Net wage paycheck 183 183

State marginal bracket 0% 0%

Federal marginal bracket 0% 0%

Combined marginal bracket 0% 0%

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Xspouse 2013-1-CA



Guideline spousal support is based on adjusted nets

Support Summary

Addons

Child support

Spousal support

Total support

200

1521

0

1721

father pays

father pays

father pays

GUIDELINE SUPPORT

Child support

Spousal support

Total support

Saving

0

1821

1821

217

father pays

father pays

PROPOSED SETTLEMENT

Comments

On page 1, the lines marked G affect guideline directly, lines marked T affect taxes directly and guideline indirectly through

changes in tax, and lines marked B affect both guideline and taxes directly.

Proposed column minimizes taxes, then splits the enlarged net spendable income in the same proportion as the guideline allocation.

Proposed column assumes that Mother releases 0 exemptions via IRS Form 8332.

Spousal Support formula: Formula SS

Tax year: 2013

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MARRIAGE OF: CASE NUMBER


Husband Initials: Wife Initials:

MARITAL SETTLEMENT AGREEMENT Page 1 of 8

MARITAL SETTLEMENT AGREEMENT

THIS AGREEMENT is made on ____________________ by John Doe (Petitioner) and JaneDoe (Respondent). This agreement shall become effective on the date it is approved by the court in thepending dissolution proceeding; or on the date final judgment is entered.

Purpose. The purpose of this agreement is to settle the parties' rights and obligations as to childcustody, child support, property, debts, and spousal support.

RECITALS

This agreement is made in light of the facts stated below.

1. Marriage. The parties were married to each other on September 30, 2006, and ever since havebeen, and now are, Husband and Wife.

2. Separation. Irreconcilable differences have arisen between the parties, which have led to theirremediable breakdown of their marriage. The parties agree that no further waiting period, marriagecounseling, or conciliation efforts would save the marriage, and the parties have filed for dissolution oftheir marriage.

3. Legal Proceedings. An action for dissolution of marriage has been filed by Petitioner and isnow pending in the Superior Court of the State of California, County of Orange, Case No:____________________.

4. Children of the Marriage. Two (2) children were born of this marriage, Peter Ryan Doe, bornApril 10, 2005 and Mary Megan Doe, born August 3, 2008 No children have been adopted by theseparties, and Respondent is not now pregnant.

5. Employment. Respondent is presently employed by XYZ, LLC, and her gross monthlyearnings are $1,628.91. Petitioner is presently employed by ABC LLC, and his gross monthly earningsare $3,504.58.

6. Voluntariness. The parties acknowledge that they enter into this agreement voluntarily, freefrom duress, fraud, undue influence, coercion, or misrepresentation of any kind.

7. Waiver. The parties waive their rights to notice of trial, findings of fact and conclusions oflaw, motion for new trial, and the right to appeal.

Petitioner and Respondent each agree that this matter may be granted by declaration under Fam.Code § 2336. Neither desires to be heard in Court.

Petitioner and Respondent further agree that this matter may proceed as an uncontested matterand may be submitted before a Pro Tem Judge.

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The parties agree as follows:

WARRANTIES

8. Warranty of Values of Property. The parties intend the transfers of property in thisagreement to be consistent with their agreement. Respondent and Petitioner each agree that they havehad sufficient opportunity to investigate the values of the property and that each warrants to the otherthat each has no knowledge of any fact which would affect the distribution of any property listed in thisagreement.

9. Transfers for Adequate Consideration. Each party promises that he or she has not gifted ortransferred any community property without the other's knowledge and consent. Each party signs thisagreement relying on these representations.

DIVISION OF PROPERTY

10. Petitioner's Share of Community Property. Petitioner is awarded as his sole and separateproperty, and Respondent shall have no further rights or responsibilities regarding the followingproperty:

A. The 2006 Harley Davidson Sportster Motorcycle, estimated value 4,500.00;B. Any and all personal property, tangible and intangible, in his possession.

11. Confirmation of Petitioner's Separate Property. Respondent hereby confirms that thefollowing property owned by Petitioner prior to this marriage or received by Petitioner by gift ofinheritance during the marriage shall remain the sole and separate property of Petitioner:

A. Various items of personal property and personal effects.

12. Respondent's Share of Community Property. Respondent is awarded as her sole and separateproperty, and Petitioner shall have no further rights or responsibilities regarding the following property:

A. House hold Funiture, estimated value $120.00;B. Any and all personal property, tangible and intangible, in her possession.

13. Confirmation of Respondent's Separate Property. Petitioner hereby confirms that thefollowing property owned by Respondent prior to this marriage or received by Respondent by gift ofinheritance during the marriage shall remain the sole and separate property of Respondent:

A. Various items of personal property and personal effects.

The division shall be effected when necessary by a transfer of title. All property is transferredsubject to any debt attached to it.

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REAL PROPERTY

14. Community Real Property.

A. The parties agree that they do not jointly own any real property.

15. Separate Real Property

A. The parties agree that the real property located at 9876 Mum Street, Glendale, CA 91203with a legal description as follows (from Deed): Multi-Family three (3) bed, two(2), Bath and ModularHomeSaid property shall be sold and Petitioner shall receive fifty percent (50%) of the net porceeds andRespondent shall receive fifty percent (50%) of the net proceeds from the sale.

OBLIGATIONS TO THIRD PARTIES & DIVISION OF DEBTS

16. The parties agree not to incur any further debts or obligations for which the other may beliable. The parties agree that any debt incurred by either after the effective date of this agreement shallbe the sole responsibility of that party, and each agrees to hold the other harmless against any such debtand agrees to indemnify the other against any liability in connection with it, including court costs andattorney's fees. The Court shall retain jurisdiction over this issue.

17. Distribution of Debt to Petitioner. The Petitioner shall be solely responsible for and shallhold the Respondent harmless from the following debts:

A. The Auto Lease, estimated amount owed $17,385.00;B. The Auto Loan account, estimated amount owed $18,349.48;C. Any and all debts held in his name alone.

If a creditor makes an attempt to obtain satisfaction from the Respondent for any obligationlisted above, the Petitioner shall defend and fully indemnify the Respondent with regard to such attempt.

18. Distribution of Debt to Respondent. The Respondent shall be solely responsible for and shallhold the Petitioner harmless from the following debts:

A. Any and all debts held in her name alone.

If a creditor makes an attempt to obtain satisfaction from the Petitioner for any obligation listedabove, the Respondent shall defend and fully indemnify the Petitioner with regard to such attempt.

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WAIVER

19. Waiver of Rights and Respective Estates: Respondent and Petitioner agree that each partywaives all right, title, claim, lien or interest in the other's separate property, separate property income,and separate property estate, including the following:

1. All community property, quasi-community property, and quasi-marital property rights.2. The right to probate family allowance.3. The right to probate homestead.4. The right or claims of dower, curtesy, or any statutory substitute now or hereafter

provided under the laws of the State of California. The court shall retain jurisdiction overthis issue indefinitely.

5. The right to inherit separate property from the other by intestate succession.6. The right to receive separate property which would pass from the decedent party by

testamentary disposition in a Will executed before this agreement.7. The right of election to take against the Will of the other.8. The right to take the statutory share of an omitted spouse.9. The right to be appointed as administrator of the deceased party's estate, or as executor of

the deceased party's Will, unless appointed pursuant to a Will executed after the date ofthis agreement.

10. The right to have exempt property set aside in probate.11. Any right created under federal law, including without limitation, the Retirement Equity

Act of 1984.12. Any right, title, claim or interest in or to the separate property, separate income or

separate estate of the other by reason of the parties’ marriage.

20. Confirmation of Personal Belongings. Certain items of personal wearing apparel, jewelry,furniture, furnishings, and other miscellaneous items have previously been divided between the parties,and the parties agree that the distribution was an equitable division of such property and each confirmsto the other all such property now in that party's possession.

SPOUSAL SUPPORT, CHILD SUPPORT, CUSTODY

21. Spousal Support. The parties terminate their right to receive spousal support now or atanytime in the future. This termination shall not be modifiable by the parties or the court for any reasonwhatsoever. By executing this agreement, the parties agree and acknowledge that they understand thatby terminating their ability to receive spousal support, they will be forever barred from seeking spousalsupport at any time in the future regardless of the circumstances.

22. Child Support. The parties acknowledge that the State of California Child Support Guidelinesstate that Petitioner’s child support obligation is $300.00 per month. The parties agree that Petitionershall pay child support to Respondent in the amount of $300.00 per month, payable monthly. Childsupport payments shall commence on 01/02/2014, and shall continue as to an unmarried child who hasattained the age of eighteen years, is a full-time high school student, and who is not self-supporting, until

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the time the child completes the twelfth grade or attains the age of nineteen years, whichever occursfirst. Said support shall be paid directly to Respondent. No wage assignment is required or requested.The Court shall retain jurisdiction over this issue.

We are aware that the child support agreed to herein may not conform to the guideline amountand we therefore state:

1. We agree that we are fully informed of our rights concerning child support;2. We make this agreement freely without coercion or duress;3. This agreement is in the best interests of the children involved;4. The needs of the children will be adequately met by the stipulated amount;5. The right to support has not been assigned to the county pursuant to Section 11477 of the

Welfare and Institutions Code and no public assistance application is pending.

In the event that there is a contract between a party receiving support and a private child supportcollector, the party ordered to pay support must pay the fee charged by the private child supportcollector. This fee must not exceed thirty three and one third percent (33⅓ %) of the total amount of past due support nor may it exceed 50 percent of any fee charged by the private child support collector. Themoney judgment created by this provision is in favor of the private child support collector and the partyreceiving support, jointly.

The parties agree that both parties shall be responsible for obtaining health insurance coveragefor the minor children, and the parties shall be equally responsible for the uninsured medical expensesincurred by or on behalf of the minor children.

The parties agree that they shall be equally responsible for the extracurricular activity expensesincurred by or on behalf of the minor children.

The parties agree that they alternate the tax exemptions for the minor children on a yearly basis.

The parties agree that they shall be equally responsible for the educational expenses incurred byor on behalf of the minor children.

NAME CHANGE

23. Name Change. The Respondent desires to be restored to her maiden name, Jane Eod.

MISCELLANEOUS

24. Miscellaneous. The parties agree that the Petitioner’s to make the following payments onbehalf of the Respondent for a maximum of three (3) years from the date of separation. Rent, AutoLease Installments, Cell Phone Bill, Car Insurance, and Toll Road Expenses. The both parties’ do notwish to have the courts involvement with debts and or assets as both parties have come to an agreementand will handle this on their own.

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GENERAL PROVISIONS

25. Freedom From Interference. Each party may lawfully continue to live apart from the other asthough he or she were unmarried and free from the other's direct and indirect control. Each party mayengage in any employment or business of his/her choosing, entirely free of the other party's interference.

26. Freedom From Harassment. Each party agrees not to annoy, harass, embarrass, or interferewith the other in any way and agrees not to interfere with property that the other now owns or will lateracquire.

27. Further Acts to Implement Agreement. On the demand of the other party, each party willpromptly execute any document or perform any other act reasonably necessary to implement the termsof this agreement. A party who fails to comply with this provision will pay all attorneys’ fees and otherexpenses resulting from noncompliance.

28. Release of All Claims. Except as provided in this agreement, each party releases the otherfrom all claims, liabilities, debts, obligations, actions, and causes of action that have been or will beasserted or incurred. This release does not apply to any obligation incurred under this agreement, underany document executed pursuant to the agreement, or under any order issued incident to the agreement.The release is binding on each party's heirs, executors, administrators, and assigns.

29. Effect of Reconciliation. Any reconciliation between the parties after they execute thisagreement will have no effect on the agreement unless the parties modify or cancel it in writing, signedby both parties.

30. Breach. If any provision of this agreement is breached, the non-breaching party has a right toremedy the breach. If the breach involves an amount of money that is due, the non-breaching party hasthe right to collect the money as well as legal interest on it. Should an action for breach be brought andproved, the breaching party will pay all reasonable attorneys’ fees and other expenses that the non-breaching party has incurred in bringing the action. Either party's failure to insist upon the strictperformance of any provision of this agreement will not be construed as a waiver of the provision, whichwill continue in full force. No breach or claimed breach will impair any rights or obligations that theparties have under the agreement.

31. Governing Law. This agreement shall be interpreted according to the laws of the State ofCalifornia.

32. Parties and Persons Bound. This agreement shall bind the parties to the agreement and theirrespective heirs, assigns, representatives, executors and administrators and any other successors ininterest.

33. Costs of Enforcement. If either party were required to bring any action to enforce thisagreement or any court order made after merger of any provision of this agreement in the judgment, theprevailing party shall be entitled to recover costs and reasonable attorney fees.

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34. Execution of Instruments. The parties agree that each will execute and deliver to the otherupon request any legal instrument or title document which may be necessary to carry out this agreementincluding, but not limited to, the division of property or confirmation of property set forth in thisagreement.

35. Execution Formalities. The parties agree that upon their signing of this agreement, theirsignatures shall be acknowledged by a notary public. This agreement, or final judgment of dissolutioninto which this agreement has been merged, may be recorded at any time by either party in any place.

36. Modification, Revocation or Termination. This agreement may be amended or revoked onlyby a writing expressly referring to this agreement and signed by both Respondent and Petitioner. Each ofthe parties waives the right to claim in the future that this agreement was modified, canceled, orsuperseded by oral agreement or conduct.

37. Invalidity; Severability. If any provision or condition of this agreement is held by a court asinvalid, void or unenforceable, the remainder of the provisions shall remain in full force and effect.

38. Entire Agreement. The parties intend this agreement to be a final and complete settlement ofall of their rights and obligations arising out of their marriage.

39. Merger of Agreement. If either party obtains a judgment of dissolution of marriage, thisagreement shall be incorporated into the judgment and be a part of it, or otherwise filed with courtpursuant to local court procedure. The parties shall ask the court to approve the agreement as fair and toorder each of them to comply with all of its provisions.

Date: __________________________________John Doe, Petitioner

Date: __________________________________Jane Doe, RespondentSAMPLE





State of California )County of ) s.s.

On ______________________ before me, _________________________________, personallyappeared John Doe who proved to me on the basis of satisfactory evidence to be the person(s) whosename(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executedthe same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrumentthe person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoingparagraph is true and correct.

WITNESS my hand and official seal.

Signature __________________________________ (Seal)

State of California )County of ) s.s.

On ______________________ before me, _________________________________, personallyappeared Jane Doe who proved to me on the basis of satisfactory evidence to be the person(s) whosename(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executedthe same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrumentthe person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoingparagraph is true and correct.

WITNESS my hand and official seal.

Signature _________________________________ (Seal)SAMPLE

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SUMMONS (Family Law) CITACIÓN (Derecho familiar) · PDF fileSUMMONS (Family Law) NOTICE TO RESPONDENT ... las partes de este caso llega a fallecer antes de que se divida la propiedad