FL-150 PDF Details

Here's a concise summary of what you should be aware of regarding Form FL-150:

Accuracy is Critical: Because this form is submitted under penalty of perjury, ensure that all information provided is accurate to the best of your knowledge. Submitting false information can have legal consequences.

Documentation: You might be required to provide documentation to back up your declared income and expenses. This can include pay stubs, bank statements, tax returns, receipts, or other relevant documentation.

Changes in Circumstances: If there are significant changes in your financial situation after submitting this form, you may need to submit an updated form.

Legal Assistance: Given the form's significance and the potential complexity of some sections, consider seeking advice from a family law attorney or legal aid clinic when filling it out.

QuestionAnswer
Form NameFL-150 Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesfl 150 california form, income and expense forms, form fl 150 fill out, form fl 150 kern county

Form Preview Example

FL-150

PARTY WITHOUT ATTORNEY OR ATTORNEY

STATE BAR NUMBER:

NAME:

 

 

FIRM NAME:

 

 

STREET ADDRESS:

 

 

CITY:

STATE:

ZIP CODE:

TELEPHONE NO.:

FAX NO.:

 

E-MAIL ADDRESS:

 

 

ATTORNEY FOR (name):

 

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

OTHER PARTY/PARENT/CLAIMANT:

INCOME AND EXPENSE DECLARATION

FOR COURT USE ONLY

CASE NUMBER:

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

Attach copies of your pay stubs for last two months (black out Social Security numbers).

a.Employer:

b. Employer's address:

c.Employer's phone number: d. Occupation:

e. Date job started:

f. If unemployed, date job ended:

g.

I work about

hours per week.

h.

I get paid $

gross (before taxes)

per month

per week

per hour.

(If you have more than one job, attach an 8 1/2-by-11-inch sheet of paper and list the same information as above for your other jobs. Write "Question 1—Other Jobs" at the top.)

2.Age and education

a.My age is (specify):

b.

I have completed high school or the equivalent:

 

 

Yes

 

 

c. Number of years of college completed (specify):

 

 

 

 

d. Number of years of graduate school completed (specify):

 

 

e.

I have:

 

professional/occupational license(s) (specify):

 

 

 

 

vocational training (specify):

 

 

 

 

 

 

 

No If no, highest grade completed (specify): Degree(s) obtained (specify):

Degree(s) obtained (specify):

3.Tax information

a.

 

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

 

 

 

b.

My tax filing status is

 

 

single

 

 

head of household

 

married, filing separately

 

 

 

 

 

 

married, filing jointly with (specify name):

 

 

 

 

 

 

 

 

 

 

c.

I file state tax returns in

 

 

 

California

 

other (specify state):

 

 

 

 

 

 

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

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

(If you need more space to answer any questions on this form, attach an 8 1/2-by-11-inch sheet of paper and write the question number before your answer.) Number of pages attached:

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

Date:

(TYPE OR PRINT NAME)

 

(SIGNATURE OF DECLARANT)

Page 1 of 4

Form Adopted for Mandatory Use Judicial Council of California FL-150 [Rev. January 1, 2019]

INCOME AND EXPENSE DECLARATION

Family Code, §§ 2030–2032, 2100–2113, 3552, 3620–3634, 4050–4076, 4300–4339 www.courts.ca.gov

FL-150

PETITIONER:

RESPONDENT:

OTHER PARTY/PARENT/CLAIMANT:

CASE NUMBER:

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. Income (For average monthly, add up all the income you received in each category in the last 12 months

 

 

Average

and divide the total by 12.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last month monthly

a. Salary or wages (gross, before taxes)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

c.

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

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

d.

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

 

 

currently receiving

 

$

 

 

 

 

 

e.

Spousal support

 

 

from this marriage

 

 

 

from a different marriage

 

federally taxable*

$

 

 

 

 

 

 

 

 

 

 

 

 

f.

Partner support

 

 

from this domestic partnership

 

 

from a different domestic partnership

$

 

 

 

 

 

 

 

g.

Pension/retirement fund payments

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

.........................................................................................................h. Social Security retirement (not SSI)

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

i.

Disability:

 

 

Social Security (not SSI)

 

 

 

 

State disability (SDI)

 

Private insurance

$

 

 

 

 

 

 

 

 

 

j.

Unemployment compensation

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

k.

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

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

l.

Other (military allowances, royalty payments) (specify):

 

 

 

 

 

$

 

 

 

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

a.

Dividends/interest

$

b.

Rental property income

$

c.

Trust income

$

d.

Other (specify):

$

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

$

I am the

 

owner/sole proprietor

 

business partner

 

other (specify):

 

 

 

 

 

Number of years in this business (specify):

Name of business (specify):

Type of business (specify):

Attach a profit and loss statement for the last two years or a Schedule C from your last federal tax return. Black out your Social Security number. If you have more than one business, provide the information above for each of your businesses.

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

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

10.Deductions

a.

Required union dues

$

b. Required retirement payments (not Social Security, FICA, 401(k), or IRA)

..................................................................

$

c. 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

 

 

federally tax deductible*

$

 

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

$

g.

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

$

11.Assets

a.

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

$

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

$

c.

All other property,

 

real and

 

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

$

 

 

Last month

Total

*Check the box if the spousal support order or judgment was executed by the parties and the court before January 1, 2019, or if a court-ordered change maintains the spousal support payments as taxable income to the recipient and tax deductible to the payor.

FL-150 [Rev. January 1, 2019]

INCOME AND EXPENSE DECLARATION

Page 2 of 4

FL-150

PETITIONER:

RESPONDENT: OTHER PARTY/PARENT/CLAIMANT:

CASE NUMBER:

12.The following people live with me:

Name

Age

How the person is

That person's gross

Pays some of the

 

related to me (ex: son)

monthly income

household expenses?

a.

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

b.

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

c.

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

d.

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

e.

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13.Average monthly expenses

a. Home:

(1) Rent or

If mortgage:

(a)average principal:

(b)average interest:

Estimated expenses

mortgage.......... $

$

$

 

Actual expenses

 

Proposed needs

 

 

 

 

 

h.

Laundry and cleaning

$

 

i.

Clothes

$

 

j.

Education

$

 

k.

Entertainment, gifts, and vacation

$

 

l.

Auto expenses and transportation

 

 

(2)

Real property taxes

$

 

(3)

Homeowner's or renter's insurance

$

 

 

(if not included above)

 

(4)

Maintenance and repair

$

b. Health-care costs not paid by insurance

$

c.

Child care

$

d. Groceries and household supplies

$

e.

Eating out

$

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

$

g.

Telephone, cell phone, and e-mail

$

14.Installment payments and debts not listed above

 

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

$

m. Insurance (life, accident, etc.; do not include

$

 

auto, home, or health insurance)

n.

Savings and investments

$

o.

Charitable contributions

$

p. Monthly payments listed in item 14

$

 

(itemize below in 14 and insert total here)

q.

Other (specify):

$

r.TOTAL EXPENSES (a–q) (do not add in

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

$

 

 

 

 

s. Amount of expenses paid by others

$

 

Paid to

For

Amount

Balance

Date of last payment

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

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

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

b.The source of this money was (specify):

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

d.My attorney's hourly rate is (specify):

I confirm this fee arrangement.

Date:

 

(TYPE OR PRINT NAME)

 

 

(SIGNATURE OF DECLARANT)

 

 

 

 

 

FL-150 [Rev. January 1, 2019]

INCOME AND EXPENSE DECLARATION

Page 3 of 4

FL-150

PETITIONER:

RESPONDENT:

OTHER PARTY/PARENT/CLAIMANT:

CASE NUMBER:

CHILD SUPPORT INFORMATION

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

16.Number of children

a.

I have (specify number):

children under the age of 18 with the other parent in this case.

b.

The children spend

percent of their time with me and

percent of their time with the other parent.

 

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

17.Children's health-care expenses

a.

 

I do

 

I do not

have health insurance available to me for the children through my job.

 

 

b.Name of insurance company:

c.Address of insurance company:

d.The monthly cost for the children's health insurance is or would be (specify): $ (Do not include the amount your employer pays.)

18. Additional expense for the children in this....................................................................case

Amount per month

a. Childcare so I can work or get job training

$

 

 

 

b. Children's health care not covered by insurance

$

 

 

 

c. Travel expenses for visitation

$

 

 

 

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

$

 

 

 

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

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

$

Amount per month For how many months?

a. Extraordinary health expenses not included in 18b

 

 

 

 

b. Major losses not covered by insurance (examples: fire, theft, other

$

insured loss)

 

c. (1) Expenses for my minor children who are from other relationships and

$

are living with me

 

(2) Names and ages of those children (specify):

 

(3) Child support I receive for those children............................................... $

The expenses listed in a, b, and c create an extreme financial hardship because (explain):

20.Other information I want the court to know concerning support in my case (specify):

FL-150 [Rev. January 1, 2019]

INCOME AND EXPENSE DECLARATION

 

 

 

 

 

For your protection and privacy, please press the Clear

 

Print this form

 

Save this form

This Form button after you have printed the form.

 

 

 

 

 

 

 

 

Page 4 of 4

Clear this form

How to Edit FL-150 Form Online for Free

We have used the efforts of the best developers to design the PDF editor you are about to take advantage of. The software will help you create the income expense form with ease and don’t waste precious time. All you should do is follow the next easy-to-follow steps.

Step 1: At first, choose the orange "Get form now" button.

Step 2: As soon as you have accessed the income expense edit page, you'll see all functions you can take with regards to your document at the top menu.

The next sections will compose the PDF template that you will be creating:

form fl 150 ca empty spaces to consider

Jot down the details in the Attach copies of your pay stubs, a b c d e f g h, Employer Employers address, hours per week gross before taxes, per month, per week, per hour, If you have more than one job, Age and education, My age is specify I have completed, Yes, If no highest grade completed, Number of years of college, Degrees obtained specify, and Number of years of graduate school field.

form fl 150 ca Attach copies of your pay stubs, a b c d e f g h, Employer Employers address, hours per week gross before taxes, per month, per week, per hour, If you have more than one job, Age and education, My age is specify I have completed, Yes, If no highest grade completed, Number of years of college, Degrees obtained specify, and Number of years of graduate school fields to insert

Note down all information you may need inside the box If you need more space to answer, Number of pages attached, I declare under penalty of perjury, Date, TYPE OR PRINT NAME, SIGNATURE OF DECLARANT, Form Adopted for Mandatory Use, INCOME AND EXPENSE DECLARATION, Page of, and Family Code wwwcourtscagov.

part 3 to finishing form fl 150 ca

The area PETITIONER, RESPONDENT, OTHER PARTYPARENTCLAIMANT, CASE NUMBER, Attach copies of your pay stubs, Income For average monthly add up, Salary or wages gross before taxes, a b c d e f g h i j k l Other, from this marriage from this, Social Security not SSI, from a different marriage, State disability SDI, currently receiving, federally taxable, and Average monthly will be where you include both parties' rights and obligations.

Completing form fl 150 ca stage 4

Terminate by reviewing the next fields and completing them accordingly: ownersole proprietor, Income from selfemployment after, business partner, other specify, Attach a profit and loss statement, Additional income I received, Change in income My financial, Deductions, a b c d e f g, Required union dues Required, federally tax deductible, Assets a b c, Cash and checking accounts savings, real and, and personal.

form fl 150 ca ownersole proprietor, Income from selfemployment after, business partner, other specify, Attach a profit and loss statement, Additional income I received, Change in income My financial, Deductions, a b c d e f g, Required union dues Required, federally tax deductible, Assets a b c, Cash and checking accounts savings, real and, and personal blanks to fill out

Step 3: In case you are done, press the "Done" button to transfer the PDF file.

Step 4: Generate duplicates of the document. This should save you from forthcoming issues. We cannot view or distribute the information you have, for that reason feel comfortable knowing it will be safe.

Watch FL-150 Form Video Instruction

FL-150 Form isn’t the one you’re looking for?

Related Documents

  • Form Fl 160

    "... Attorney for Name Mail Address fax No Telephone City Street Address Firm name Respondent Other Parent Party Case Number Superior Court of California County of Branch name Zip Code Street address Peter Respondent Real Estate ..."

  • Fl Provider Application

    "... For fiscal agent assistance, please contact acs provider enrollment by calling 800 377 8216. Co-treating provider application August 2006 page. Provider name must not be the same as the provider listed above. Enter your business ..."

  • Form Con 160

    "... Not activated as per child proxy sheet con 160 11 11 consent to my child's chart. To sign up to my child's chart, please fill out the form. If you are a patient at Everett ..."

  • Form Fl 100

    "... An amended petition to dissolve a domestic marriage nullity of the domestic partner domestic relationship domestic partnership domestic separation of marital partnership domestic relationship for court use only attorney, or party without attorney name and ..."

Please rate Form Fl 150

1 Votes

Related Resources

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .