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Article Guide

The FL-155 form, also known as the Financial Statement (Simplified), serves a vital role in California's family law proceedings. Designed specifically for parents involved in child support cases, this form simplifies the financial disclosure process. It requires individuals to provide essential information about their income, expenses, and custody arrangements, ultimately to assess their financial obligations regarding child support. The form includes sections where users report their sources of income, such as TANF, SSI, or wages, delineate custody time-sharing with the other parent, and articulate monthly expenses related to the children. Further, it enables parties to highlight additional financial responsibilities, such as child care costs and health care expenses. Key to its usage is a clear set of eligibility criteria, ensuring that it is appropriate for specific cases and circumstances. Completing the FL-155 not only facilitates accurate financial assessments in court but also upholds the transparency necessary for fair child support determinations. Adhering to prescribed instructions throughout the completion process is essential to ensure compliance with court requirements and protection of personal information, thus preserving privacy while navigating family law matters.

Form Sample

FL-155

Your name and address or attorney's name and address:

TELEPHONE NO.:

FOR COURT USE ONLY

 

 

 

To keep other people from

 

 

 

 

 

 

seeing what you entered on

 

 

 

 

your form, please press the

 

ATTORNEY FOR (Name):

 

Clear This Form button at the

 

 

end of the form when finished.

 

 

 

 

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

 

 

 

 

STREET ADDRESS:

 

 

 

 

 

 

 

 

MAILING ADDRESS:

 

 

 

 

CITY AND ZIP CODE:

 

 

 

 

BRANCH NAME:

 

 

 

 

PETITIONER/PLAINTIFF:

 

 

 

 

RESPONDENT/DEFENDANT:

 

 

 

 

OTHER PARENT:

 

 

 

 

 

 

 

 

 

 

CASE NUMBER:

 

FINANCIAL STATEMENT (SIMPLIFIED)

 

 

 

NOTICE: Read page 2 to find out if you qualify to use this form and how to use it.

1.

a.

 

 

My only source of income is TANF, SSI, or GA/GR.

 

 

 

 

 

 

 

 

 

 

 

 

 

I have applied for TANF, SSI, or GA/GR.

 

 

 

 

 

 

 

 

 

 

 

 

b.

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

I am the parent of the following number of natural or adopted children from this relationship

 

3. a. The children from this relationship are with me this amount of time

. .

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

 

. . .

 

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

 

 

b. The children from this relationship are with the other parent this amount of time

 

 

c. Our arrangement for custody and visitation is (specify, using extra sheet if necessary):

 

 

4. My tax filing status is:

 

 

 

 

single

 

 

married filing jointly

 

 

head of household

 

 

 

married filing separately.

 

 

 

 

 

 

 

 

 

 

 

5.

My current gross income (before taxes) per month is . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

 

Attach 1

 

This income comes from the following:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary/wages: Amount before taxes per month

 

 

 

 

 

 

$

 

copy of pay

 

 

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

.

. . .

 

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

 

 

 

Retirement: Amount before taxes per month

 

 

 

 

 

 

$

 

stubs for

 

 

 

 

 

 

 

 

 

 

 

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

.

. . .

 

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

$

 

 

 

 

 

 

 

 

 

 

last 2

 

 

 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Unemployment compensation: Amount per month

 

months here

 

 

Workers' compensation: Amount per month

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

 

 

 

 

(cross out

 

 

Social security:

 

 

 

SSI

 

 

 

Other Amount per month

 

$

 

 

 

 

 

 

 

 

 

 

social

 

 

 

Disability: Amount per month . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

 

 

 

 

 

security

 

 

 

Interest income ( from bank accounts or other): Amount per month

 

$

 

 

 

 

 

 

numbers)

 

 

 

I have no income other than as stated in this paragraph.

 

 

 

 

 

 

 

 

 

 

 

6. I pay the following monthly expenses for the children in this case:

 

 

 

 

 

 

 

 

a.

 

 

 

Day care or preschool to allow me to work or go to school

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

 

 

 

 

 

 

 

 

 

Health care not paid for by insurance

 

 

 

 

 

 

 

 

 

 

$

 

b.

 

 

 

. . . .

. .. .

. . .

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

 

. . .

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

c.

 

 

 

. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .School, education, tuition, or other special needs of the child

 

 

 

 

 

Travel expenses for visitation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

d.

 

 

 

 

. . .

. . .

. . .

 

. . .

.

. .

. . .

. . . .

. . .

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

 

. . .

 

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

7.

 

 

 

There are (specify number)

 

 

 

 

other minor children of mine living with me. Their monthly expenses

 

 

 

 

 

 

 

 

 

 

 

 

that I pay are

$

 

 

 

 

8. I spend the following average monthly amounts (please attach proof):

 

 

 

 

 

 

 

 

a.

 

 

Job-related expenses that are not paid by my employer (specify reasons for expenses on separate sheet)

$

 

 

 

 

 

 

 

Required union dues

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

 

 

 

 

. .

.

. . . .

 

 

. . .

. . .

. . .

 

. . .

.

. .

. . .

. . . .

. . .

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

 

. . .

 

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

$

 

 

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

 

$

 

c.

 

 

 

 

 

d.

 

 

 

 

. . . . .Health insurance costs

 

. . .

. . .

. . .

 

. . .

.

. .

. . .

. . . .

.

. .

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

 

. . .

.

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

$

 

 

Child support I am paying for other minor children of mine who are not living with me

 

$

 

e.

 

 

 

 

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

 

f.

 

 

 

 

Spousal support I am paying because of a court order for another relationship. . . . . . . . . . . . . . . . . . . . . . . $

 

 

Monthly housing costs:

 

 

rent or

 

mortgage

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

 

g.

 

 

 

 

 

 

 

 

 

 

 

 

If mortgage: interest payments $____________ real property taxes $____________

 

 

9.

Information concerning

 

my current employment

 

 

my most recent employment:

 

 

 

 

 

 

 

 

Employer:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

My occupation:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date work started:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date work stopped (if applicable):

 

 

What was your gross income (before taxes) before work stopped?:

 

%

%

Page 1 of 2

Form Approved for Optional Use

Judicial Council of California FL-155 [Rev. January 1, 2004]

FINANCIAL STATEMENT (SIMPLIFIED)

Family Code, § 4068(b)

www.courtinfo.ca.gov

• Interest
• Workers' compensation
• Social security
• Retirement

PETITIONER/PLAINTIFF:

CASE NUMBER:

RESPONDENT/DEFENDANT:

OTHER PARENT:

10. My estimate of the other party's gross monthly income(before taxes) is . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . $ 11. My current spouse's monthly income(before taxes) is . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . $ 12. Other information I want the court to know concerning child support in my case (attach extra sheet with the information).

13.

I am attaching a copy of page 3 of form FL-150, Income and Expense Declaration showing my expenses.

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)

PETITIONER/PLAINTIFF

RESPONDENT/DEFENDANT

INSTRUCTIONS

Step 1: Are you eligible to use this form? If your answer is YES to any of the following questions, you may NOT use this form:

Are you asking for spousal support (alimony) or a change in spousal support?

Is your spouse or former spouse asking for spousal support (alimony) or a change in spousal support?

Are you asking the other party to pay your attorney fees?

Is the other party asking you to pay his or her attorney fees?

Do you receive money (income) from any source other than the following?

• Welfare (such as TANF, GR, or GA)

• Salary or wages

• Disability

• Unemployment

• Are you self-employed?

If you are eligible to use this form and choose to do so, you do not need to complete the Income and Expense Declaration (form FL-150). Even if you are eligible to use this form, you may choose instead to use the Income and Expense Declaration (form FL-150).

Step 2: Make 2 copies of each of your pay stubs for the last two months. If you received money from other than wages or salary, include copies of the pay stub received with that money.

Privacy notice: If you wish, you may cross out your social security number if it appears on the pay stub, other payment notice or your tax return

Step 3: Make 2 copies of your most recent federal income tax form.

Step 4: Complete this form with the required information. Type the form if possible or complete it neatly and clearly in black ink. If you need additional room, please use plain or lined paper, 8½-by-11", and staple to this form.

Step 5: Make 2 copies of each side of this completed form and any attached pages.

Step 6: Serve a copy on the other party. Have someone other than yourself mail to the attorney for the other party, the other party, and the local child support agency, if they are handling the case, 1 copy of this form, 1 copy of each of your stubs for the last two months, and 1 copy of your most recent federal income tax return.

Step 7: File the original with the court. Staple this form with 1 copy of each of your pay stubs for the last two months. Take this document and give it to the clerk of the court. Check with your local court about how to submit your return.

Step 8: Keep the remaining copies of the documents for your file.

Step 9: Take the copy of your latest federal income tax return to the court hearing.

It is very important that you attend the hearings scheduled for this case. If you do not attend a hearing, the court may make an order without considering the information you want the court to consider.

FL-155 [Rev. January 1, 2004]

FINANCIAL STATEMENT (SIMPLIFIED)

 

 

 

 

For your protection and privacy, please press the Clear This Form

 

 

 

Save This Form

button after you have printed the form.

 

 

 

 

 

Print This Form

Page 2 of 2

Clear This Form

Document Specifications

Fact Name Description
Purpose of the Form The FL-155 form is used to provide a simplified financial statement to the court in California family law cases.
Eligibility Individuals who receive TANF, SSI, or GA/GR benefits may use this form if specific criteria are met, mainly regarding income sources.
Governing Law California Family Code, § 4068(b) governs the use of the FL-155 form.
Income Declaration This form requires you to declare only your gross monthly income before taxes, helping facilitate child support and other financial obligations.
Custody Arrangements Users must specify their custody arrangements for children involved, providing a clear picture of living situations.
Monthly Expenses Detailed disclosure of monthly expenses related to children, such as childcare and education, is a requirement for accuracy.
Document Attachment You must attach necessary documentation, such as pay stubs and tax forms, to validate the financial information provided.
Service Requirement Copies of the completed FL-155 must be served to the other party, their attorney, and potentially the child support agency involved.
Filing Instructions After completing the form, it must be filed with the court along with required attachments, like pay stubs from the last two months.
Importance of Attendance Attending scheduled court hearings is crucial, as failure to do so could result in decisions made without considering your financial information.

Steps to Filling Out Fl 155

Filling out the FL-155 form is an important step in providing the court with your financial information. This financial statement aids the court in understanding your financial situation, which is necessary for cases concerning child support. Below are detailed steps to assist you in completing this form accurately and effectively.

  1. Determine your eligibility to use this form. If you answer YES to any of the following questions, you may NOT use this form: Are you asking for spousal support? Is your spouse or former spouse asking for spousal support? Are you asking the other party to pay your attorney fees? Are you self-employed? Do you receive income from sources outside of welfare, wages, or disability? If you are eligible, proceed to the next step.
  2. Make two copies of your pay stubs for the last two months. Ensure you include copies of any pay stubs received if you have income from other sources.
  3. Make two copies of your most recent federal income tax form.
  4. Carefully complete the FL-155 form. Use black ink and print clearly. It is advisable to type the form if possible. If you need more space, use plain or lined paper (8½ by 11 inches) and staple it to this form.
  5. Make two copies of each side of the completed form along with any attached pages.
  6. Serve a copy of the completed form. Have someone other than yourself mail copies to the other party, the attorney for the other party, and the local child support agency, if necessary. Include a copy of your pay stubs and your federal income tax return in the mailing.
  7. File the original form with the court. Staple it together with one copy of each of your pay stubs. Present this to the court clerk, checking with your local court for submission procedures.
  8. Retain the remaining copies of the documents for your records.
  9. Finally, take a copy of your most recent federal income tax return to the hearing. It is crucial to attend all scheduled hearings because if you do not, the court may make decisions without considering your information.

More About Fl 155

What is the FL-155 form used for?

The FL-155 form is a Financial Statement (Simplified) used in California to provide the court with essential financial information. It is particularly relevant for individuals who are involved in family law cases, especially those concerning child support and custody issues. The form helps by summarizing income, expenses, and other financial details required by the court to make informed decisions regarding child support obligations and related matters.

Who is eligible to use the FL-155 form?

You may use the FL-155 form if you meet specific criteria. If your only sources of income are welfare benefits like TANF, SSI, or GA/GR, or if you're receiving salary or wages, you may qualify. However, if you are requesting spousal support, or if the other party is requesting spousal support, you cannot use this simplified form. It is essential to review the eligibility criteria carefully before proceeding with the FL-155.

What information is required when filling out the FL-155?

The FL-155 requires various personal and financial details. You must provide your name and contact information, case number, and the names of all parties involved. Additionally, you will need to summarize your income, including salary, unemployment benefits, or other sources. Monthly expenses associated with children and any other dependents must also be reported. All provided information should be accurate to ensure the court has a full understanding of your financial situation.

How can I submit the FL-155 form?

After completing the FL-155 form, it's crucial to create copies for your records. The original form must be filed with the court clerk, accompanied by copies of your recent income documentation, such as pay stubs and tax returns. Additionally, you should serve the other party and any involved agencies with copies of the form and supporting documents. Ensure you keep copies for yourself and attend any scheduled hearings regarding your case, as your presence is important for addressing financial matters in court.

Are there specific instructions I should follow when filling out the FL-155?

Yes, several key instructions are provided to help ensure proper completion of the FL-155. Be sure to print or write clearly in black ink. If more space is needed for any section, you can use plain paper and attach it to the form. Moreover, double-check that all required information is included and that the form is signed and dated. Using the Clear This Form option after printing is also recommended for your privacy.

What should I do if I have questions about the FL-155 form?

If you have questions about the FL-155 form or the completion process, consider reaching out to legal aid organizations, family law assistance centers, or private attorneys who specialize in family law. They can offer guidance and support tailored to your situation. It's beneficial to seek help to ensure all aspects of your financial disclosures are correctly addressed, as this can significantly impact your court proceedings.

Common mistakes

  1. Inaccurate Personal Information: Filling out the form with incorrect or outdated personal details can prevent proper identification of the parties involved. Ensure that names, addresses, and contact information are current and accurate.

  2. Omitting Required Documentation: Failing to attach necessary documents, such as recent pay stubs or tax returns, may lead to delays. Always check the requirements and include all relevant paperwork.

  3. Forgetting to Update Income Sources: Not listing all sources of income, including side jobs or any benefits received, can misrepresent financial standings. Full disclosure is essential for an accurate assessment of the case.

  4. Inaccurate Expense Reporting: Underestimating or failing to list monthly expenses may lead to an unrealistic financial representation. Clearly itemize all expenses to accurately reflect your financial obligations.

  5. Skipping Signatures: Neglecting to sign the form can result in it being deemed incomplete. Ensure all necessary signatures are provided before submission.

  6. Not Reviewing Before Submission: Submitting the form without a thorough review may lead to errors. Take the time to carefully proofread entries to catch any mistakes before handing it in.

  7. Ignoring Court Instructions: Not adhering to the instructions for filing could result in the form not being accepted. Familiarize yourself with all filing requirements and follow them closely.

Documents used along the form

The FL-155 form, known as the Financial Statement (Simplified), is often accompanied by several other important forms and documents that facilitate financial disclosures in family law cases. Below is a list of additional documents commonly used alongside the FL-155 form, their descriptions, and the role they play in court proceedings.

  • FL-150 - Income and Expense Declaration: This form provides a detailed account of an individual's income, expenses, and financial circumstances. It is typically used when more comprehensive financial disclosure is required than what the FL-155 offers.
  • FL-141 - Declaration of Disclosure: This document formalizes the disclosures of income and expenses between parties during a dissolution of marriage or legal separation. It serves to ensure both parties have complete financial transparency.
  • FL-146 - Declaration Regarding Notice of Address Change: This form is used to notify the court of a change of address, which is crucial for ensuring that all parties receive timely updates regarding hearings and legal documents.
  • FL-155(A) - Financial Statement (Simplified) Attachment: This is an attachment that supports the FL-155 form, allowing for additional details on income or expenses that cannot fit within the confines of the simplified form.
  • FL-385 - Request for Order: Used to formally request the court for a specific order, such as child support or spousal support. This document also references financial disclosures made in the FL-155 form.
  • FL-190 - Notice of Hearing: This provides information regarding the time and place of upcoming court hearings related to the issues in the case, ensuring that all parties can be present.
  • DHS 64 - Child Support Information: This form gathers information regarding the children's needs, transport, and other related expenses that may influence support decisions.
  • W-2 Forms: These documents include summaries of an employee's annual wages and taxes withheld, which are essential for verifying income when evaluating support obligations.
  • Pay Stubs: Recent pay stubs provide evidence of income and should be included with the FL-155 to substantiate financial claims made on the form.

Each of these documents serves a crucial role in presenting a clear and complete financial picture to the court. Accurate and timely submission of all required forms can significantly impact the outcome of family law proceedings.

Similar forms

The FL-150, known as the Income and Expense Declaration, is a more detailed financial form used in California family law cases. Unlike the FL-155, which is a simplified version for certain qualifying individuals, the FL-150 captures a broader range of financial information. Individuals using the FL-150 must disclose various income sources, including self-employment earnings, spousal support, and other financial obligations. This document is often required when cases involve spousal support, while the FL-155 is designed for simpler situations without these complications.

The FL-140, or the Declaration of Disclosure, serves a similar purpose by requiring both parties in a divorce or legal separation to transparently disclose their financial circumstances. This document aims to ensure that both parties have access to comparable information when negotiating financial settlement terms. While the FL-140 focuses on full financial disclosure, the FL-155 is aimed at individuals who need to provide less comprehensive financial detail, making it more accessible for specific cases.

The FL-191 is another financial document focusing on child support matters. Similar to the FL-155, it is utilized to evaluate financial capabilities, but it specifically targets cases involving child support orders. The FL-191 collects information about both parents' income and expenses to determine fair child support obligations. It provides an additional mechanism for courts to assess financial situations when custody and support arrangements are contested.

Lastly, the FL-300, known as the Request for Order, can be associated with various types of relief, including financial matters such as child or spousal support. This form allows a party to request the court’s intervention regarding ongoing family law issues. While the FL-155 presents a simplified overview of one party’s finances, the FL-300 is often used as a procedural tool to initiate modifications to existing support orders based on the financial information provided in other documents like the FL-155 or the FL-150.

Dos and Don'ts

Things You Should Do:

  • Read the instructions carefully before starting.
  • Use black ink or type the form for clarity.
  • Attach necessary documents like pay stubs and tax returns.
  • Complete all required fields accurately.
  • Keep copies of everything you submit for your records.

Things You Shouldn't Do:

  • Don't leave any required fields blank.
  • Don't use unclear handwriting or non-black ink.
  • Refrain from including unnecessary information.
  • Never forget to attend the hearings scheduled for your case.
  • Do not submit a form that contains inaccuracies or omissions.

Misconceptions

1. The FL-155 form is only for high-income individuals. Many people believe that the FL-155 form is only applicable to those with high incomes. This is not true. In fact, it is designed for individuals with lower incomes who meet specific eligibility criteria, such as relying on public assistance programs like TANF or SSI.

2. You can't file FL-155 if you want spousal support. Another common misconception is that you cannot use the FL-155 form if you're requesting spousal support. The truth is that if you are asking for spousal support, you may need to fill out a different form, but that does not automatically disqualify you from using FL-155 for child support-related matters.

3. All income sources must be reported. Many believe they must list every possible income source on the FL-155 form. While you should report your monthly income accurately, the form is aimed at individuals who may have limited income sources. If your income solely comes from specific programs or wages, simply list those sources.

4. You don't need to provide proof of income. Some feel that completing the FL-155 form doesn't require support documentation. This is a misconception. You must attach necessary documents, such as pay stubs or tax returns, to verify your reported income.

5. Filing the FL-155 form is optional. There is a belief that completing the FL-155 form is merely optional. However, if you have child support obligations and are required to report your financial information, filling out the FL-155 form is often essential for the court to make informed decisions.

Key takeaways

  • When filling out the FL-155 form, ensure that all personal information is accurate and complete, as it is critical for the court’s understanding of your financial situation.

  • This form is designed for individuals who meet specific eligibility criteria, including not requesting spousal support or having other income sources beyond defined types such as TANF or wages.

  • After completing the form, make sure to serve copies of it along with necessary documents, like pay stubs and tax returns, to the other party involved in the case.

  • Finally, retain copies of all submitted materials for your records and ensure attendance at court hearings, as failure to appear could result in the court making decisions without your input.