Form FL-150 "Income and Expense Declaration" - California

What Is Form FL-150?

Form FL-150, Income and Expense Declaration, is a document that should be reported by spouses seeking a divorce in the state of California. This form includes information about their financial situation: the income of the declarants from all sources, and their expenses as well. This information is used by California's divorce courts in order to make a fair resolution.

Alternate Name:

  • California Income and Expense Declaration.

The California Income and Expense Declaration should be filed by each party in legal cases involving requests for money such as a child support order or attorney fees. It is also used in true default divorce cases. This form was released by the Judicial Council of California and the latest version was issued on January 1, 2007. A Form FL-150 fillable version is available for download below.

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Form FL-150 Instructions

Form FL-150 must be filled in as follows:

  1. Information about the attorney, superior court, and the case number should be indicated in the table.
  2. Employment. The declarant should provide information on their current or recent job, including the address and phone number of the employer, wages, and the number of working hours.
  3. Age and education. The declarant should specify their age, the number of years of college and school completed, degree(s) obtained, and information about their occupational licenses.
  4. Tax information should be entered.
  5. Other party's income. The declarant should estimate the gross monthly income of the other spouse and explain the basis of this statement.
  6. Income. All the income received in each category listed in the last 12 months must be indicated. The declarant must specify separately the income for the last month, and the average monthly income.
  7. Investment income, including dividends, rental property income, and trust income should be indicated.
  8. Income from self-employment. The declarant must specify information about their business, including their position (owner or business partner), number of years in this business, and its type. A profit or loss statement for the last two years should be attached. If the declarant has several businesses, information for each of them should be provided.
  9. Additional income. This section contains information about one-time money received in the last 12 months.
  10. Change in income. It is necessary to explain changes in the financial situation of the declarant over the last 12 months if there were any.
  11. Deductions. Enter information about retirement payments, medical fees, and child support payments from other relationships.
  12. Assets. Specify information about deposit accounts, savings, stocks, bonds, and property.
  13. People who live with a spouse should be indicated in this section, including their names, ages, their relationship to the spouse, and their gross monthly income.
  14. Average monthly expenses such as health-care costs, child care, education, auto expenses should be outlined separately and in total.
  15. Installment payments and debts should be indicated in the table.
  16. Attorney fees should be specified.
  17. Signature and date.
  18. Child support information should be completed only if the case involves child support.
  19. The declarant must enter the number of their children under the age of 18, information about children's health care, travel and educational expenses, special hardships, and financial circumstances of the spouse.
  20. Other information for the court which can support the case.

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Download Form FL-150 "Income and Expense Declaration" - California

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FL-150
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
TELEPHONE NO.:
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
OTHER PARENT/CLAIMANT:
CASE NUMBER:
INCOME AND EXPENSE DECLARATION
1.
Employment
(Give information on your current job or, if you're unemployed, your most recent job.)
a.
Employer:
Attach copies
b.
Employer's address:
of your pay
c.
Employer's phone number:
stubs for last
d.
Occupation:
two months
(black out
e.
Date job started:
social
f.
If unemployed, date job ended:
security
g.
I work about
hours per week.
numbers).
h.
I get paid
gross (before taxes)
per month
per week
per hour.
$
(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 other
jobs. Write "Question 1—Other Jobs" at the top.)
2.
Age and education
a.
My age is (specify):
If no, highest grade completed (specify):
b.
I have completed high school or the equivalent:
Yes
No
c.
Number of years of college completed (specify):
Degree(s) obtained (specify):
d.
Degree(s) obtained (specify):
Number of years of graduate school completed (specify):
e.
I have:
professional/occupational license(s) (specify):
vocational training (specify):
3. Tax information
a.
I last filed taxes for tax year (specify year):
My tax filing status is
single
head of household
b.
married, filing separately
married, filing jointly with (specify name):
c.
I file state tax returns in
California
other (specify state):
I claim the following number of exemptions (including myself) on my taxes (specify):
d.
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 8½-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
Family Code, §§ 2030–2032,
Form Adopted for Mandatory Use
INCOME AND EXPENSE DECLARATION
2100–2113, 3552, 3620–3634,
Judicial Council of California
4050–4076, 4300–4339
FL-150 [Rev. January 1, 2007]
www.courtinfo.ca.gov
American LegalNet, Inc.
www.FormsWorkflow.com
FL-150
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
TELEPHONE NO.:
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
OTHER PARENT/CLAIMANT:
CASE NUMBER:
INCOME AND EXPENSE DECLARATION
1.
Employment
(Give information on your current job or, if you're unemployed, your most recent job.)
a.
Employer:
Attach copies
b.
Employer's address:
of your pay
c.
Employer's phone number:
stubs for last
d.
Occupation:
two months
(black out
e.
Date job started:
social
f.
If unemployed, date job ended:
security
g.
I work about
hours per week.
numbers).
h.
I get paid
gross (before taxes)
per month
per week
per hour.
$
(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 other
jobs. Write "Question 1—Other Jobs" at the top.)
2.
Age and education
a.
My age is (specify):
If no, highest grade completed (specify):
b.
I have completed high school or the equivalent:
Yes
No
c.
Number of years of college completed (specify):
Degree(s) obtained (specify):
d.
Degree(s) obtained (specify):
Number of years of graduate school completed (specify):
e.
I have:
professional/occupational license(s) (specify):
vocational training (specify):
3. Tax information
a.
I last filed taxes for tax year (specify year):
My tax filing status is
single
head of household
b.
married, filing separately
married, filing jointly with (specify name):
c.
I file state tax returns in
California
other (specify state):
I claim the following number of exemptions (including myself) on my taxes (specify):
d.
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 8½-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
Family Code, §§ 2030–2032,
Form Adopted for Mandatory Use
INCOME AND EXPENSE DECLARATION
2100–2113, 3552, 3620–3634,
Judicial Council of California
4050–4076, 4300–4339
FL-150 [Rev. January 1, 2007]
www.courtinfo.ca.gov
American LegalNet, Inc.
www.FormsWorkflow.com
FL-150
PETITIONER/PLAINTIFF:
CASE NUMBER:
RESPONDENT/DEFENDANT:
OTHER PARENT/CLAIMANT:
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.)
monthly
Last month
Salary or wages (gross, before taxes). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
a.
$
b. Overtime (gross, before taxes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Commissions or bonuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c.
$
d.
Public assistance (for example: TANF, SSI, GA/GR)
currently receiving . . . . . . . . . . . . . . . . .
$
Spousal support
from this marriage
from a different marriage . . . . . . . . . . . . . . . . . .
e.
$
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 BAQ, royalty payments, etc.) (specify): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Investment income (Attach a schedule showing gross receipts less cash expenses for each piece of property.)
6.
a.
Dividends/interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Rental property income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b.
$
c.
Trust income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
d.
Other (specify): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Income from self-employment, after business expenses for all businesses. . . . . . . . . . . . . . . . . . . . . $
7.
I am the
owner/sole proprietor
business partner
other (specify):
Number of years in this business (specify):
Name of business (specify):
Type of business (specify):
Attach a profit and loss statement for the last two years or a Schedule C from your last federal tax return. Black out your
social security number. If you have more than one business, provide the information above for each of your businesses.
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
Last month
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
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
Total
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) . . . .
$
FL-150 [Rev. January 1, 2007]
Page 2 of 4
INCOME AND EXPENSE DECLARATION
FL-150
CASE NUMBER:
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
OTHER PARENT/CLAIMANT:
The following people live with me:
12.
How the person is
That person's gross
Pays some of the
Name
Age
related to me? (ex: son)
monthly income
household expenses?
a.
Yes
No
Yes
No
b.
c.
Yes
No
Yes
No
d.
e.
Yes
No
Average monthly expenses
Proposed needs
13.
Estimated expenses
Actual expenses
Home:
a.
Laundry and cleaning . . . . . . . . . . . . . . . . . $
h.
i.
Clothes . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
(1)
Rent or
mortgage. . . $
j.
Education . . . . . . . . . . . . . . . . . . . . . . . . . .
$
If mortgage:
k.
Entertainment, gifts, and vacation. . . . . . . . $
(a)
average principal:
$
average interest:
(b)
$
Auto expenses and transportation
l.
(insurance, gas, repairs, bus, etc.) . . . . . . .
$
Real property taxes . . . . . . . . . . . . . . $
(2)
Insurance (life, accident, etc.; do not
m.
(3)
Homeowner's or renter's insurance
include auto, home, or health insurance). . . $
$
(if not included above) . . . . . . . . . . . .
n.
Savings and investments. . . . . . . . . . . . . . . $
(4)
Maintenance and repair . . . . . . . . . . .
$
o.
Charitable contributions. . . . . . . . . . . . . . . . $
Health-care costs not paid by insurance. . .
b.
$
p.
Monthly payments listed in item 14
Child care . . . . . . . .. . . . . . . . . . . . . . . . . . $
c.
(itemize below in 14 and insert total here). .
$
q.
Other (specify): . . . . . . . . . . . . . . . . . . . . . . $
d.
Groceries and household supplies. . . . . . .
$
Eating out. . . . . . . . . . . . . . . . . . . . . . . . . .
e.
$
TOTAL EXPENSES (a–q) (do not add in
r.
f.
Utilities (gas, electric, water, trash) . . . . . .
the amounts in a(1)(a) and (b))
$
$
Telephone, cell phone, and e-mail . . . . . . .
g.
$
s.
Amount of expenses paid by others
$
14.
Installment payments and debts not listed above
Date of last payment
Paid to
For
Amount
Balance
$
$
$
$
$
$
$
$
$
$
$
$
15.
Attorney fees (This 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 OF ATTORNEY)
(SIGNATURE OF ATTORNEY)
FL-150 [Rev. January 1, 2007]
INCOME AND EXPENSE DECLARATION
Page 3 of 4
FL-150
CASE NUMBER:
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
OTHER PARENT/CLAIMANT:
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
I do not
have health insurance available to me for the children through my job.
I do
a.
Name of insurance company:
b.
Address of insurance company:
c.
d.
The monthly cost for the children's health insurance is or would be (specify): $
(Do not include the amount your employer pays.)
Additional expenses for the children in this case
Amount per month
18.
a.
Child care so I can work or get job training. . . . . . . . . . . . . . . . . . . . . . . . .
$
Children's health care not covered by insurance . . . . . . . . . . . . . . . . . . . .
b.
$
$
c.
Travel expenses for visitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
d.
Children's educational or other special needs (specify below): . . . . . . . .
Special hardships. I ask the court to consider the following special financial circumstances
19.
(attach documentation of any item listed here, including court orders):
Amount per month
For how many months?
Extraordinary health expenses not included in 18b. . . . . . . . . . . . . . . . . .
a.
$
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):
Other information I want the court to know concerning support in my case (specify):
20.
FL-150 [Rev. January 1, 2007]
Page 4 of 4
INCOME AND EXPENSE DECLARATION
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