Form FL-170, Declaration for Default or Uncontested Dissolution or Legal Separation (Family Law) Instructions

Check this box if the facts in support of the request for attorney fees are on the Request for Attorney's Fees and Costs Attachment (form FL-319).

Check this box if attorney fees should be ordered as set forth in the proposed Judgment (form FL-180).

Check this box if there are other facts to specify regarding attorney fees.

Specify any other facts related to the request for attorney fees.

Enter the name of the party the attorney is representing.

Enter the email address of the attorney or party.

Enter the fax number of the attorney or party.

Enter the telephone number of the attorney or party.

Enter the zip code of the attorney or party.

Enter the state of the attorney or party.

Enter the city of the attorney or party.

Enter the street address of the attorney or party.

Enter the name of the law firm.

Enter the full name of the attorney or party.

Enter the state bar number of the attorney or party.

Enter the full name of the respondent for this case.

Enter the full name of the petitioner for this case.

Enter the official case number for this matter.

Enter the full legal name of the respondent.

Enter the full legal name of the petitioner.

Provide the official case number associated with this legal matter.

Provide the court case number for this filing.

Enter the full name of the respondent.

Enter the full name of the petitioner.

Check this box if child custody and visitation (parenting time) should be ordered as specified in the proposed Judgment (form FL-180).

Check this box if the information in the child support calculation attached to the proposed judgment is correct based on your personal knowledge.

Check this box if child support for the minor children is currently being enforced in a different case in another county.

Enter the county where child support is being enforced for this case.

Enter the case number for the child support enforcement in the specified county.

Check this box if child support should be ordered as specified in the proposed Judgment (form FL-180).

Enter the name of the county where the superior court is located.

Enter the name of the court branch, if applicable.

Enter the city and zip code of the court.

Enter the street address of the court.

Enter the mailing address of the court.

Check this box if you are providing details for the current custody and visitation schedule, whether previously ordered or currently in effect.

Check this box if the current custody and visitation schedule details are included on Attachment 6c.

Provide the details of the current custody and visitation (parenting time) schedule previously ordered in this case, or the current schedule.

Enter the date the declaration is made.

Enter or print the full name of the person making the declaration.

Check this box if both parties have filed, or are filing concurrently, a Declaration Regarding Service of Declaration of Disclosure (form FL-141) and an Income and Expense Declaration (form FL-150).

Check this box if the matter is proceeding by default, you are the petitioner, service of summons was done by publication or posting under court order, preliminary Declaration of Disclosure (form FL-140) is not required, and you waive receipt of the final Declaration of Disclosure (form FL-140) from the respondent.

Check this box if the matter is proceeding by default, you are the petitioner, have filed a proof of service for the preliminary Declaration of Disclosure (form FL-140), and waive receipt of the final Declaration of Disclosure (form FL-140) from the respondent.

Check this box if the declaration pertains to a legal separation proceeding.

Check this box if the declaration pertains to a dissolution proceeding.

Check this box to request that the child support order be based on an estimate of earning ability, either the Petitioner's or the Respondent's.

Check this box if the child support order should be based on the Petitioner's earning ability.

Check this box if the child support order should be based on the Respondent's earning ability.

Provide the facts that support your estimate of the earning ability for child support.

Check this box if the facts in support of the estimate of earning ability for item 7.a.(3) are provided on an attached document.

Enter the county where the existing court order for custody or parenting time was issued.

Enter the case number for the existing court order.

Check this box if there is an existing court order for custody or parenting time in another case.

Check this box if family support should be ordered as set forth in the proposed Judgment (form FL-180).

Check this box if the information being declared as true and correct is from the Petition.

Check this box if the information being declared as true and correct is from the Response.

Check this box if the information being declared as true and correct is an amendment to a previous filing.

Check this box if the judgment should be entered nunc pro tunc for the specified reasons.

Provide the reasons why the judgment should be entered nunc pro tunc.

Check this box if you are making an 'Other' declaration that needs to be specified.

Enter the specific details of the other declaration being made.

Check this box if, to your knowledge, the other party is receiving public assistance.

Check this box if, to your knowledge, the other party is not receiving public assistance.

Check this box if the Petitioner is presently receiving public assistance.

Check this box if the Respondent is presently receiving public assistance.

Check this box if the spousal or family support order is not covered by the preceding options (8a-8e) and needs to be specified.

Enter the details of any other spousal or family support order.

Enter the county where parentage was previously established by the court.

Check this box if a voluntary declaration of parentage or paternity is attached to the form.

Check this box if a written agreement of the parties concerning parentage is attached to this form (Attachment 9b) or to the proposed Judgment (form FL-180).

Check this box if parentage was previously established by a court, and you will specify the county and case number.

Enter the case number if parentage was previously established by the court.

Check this box if parentage of children born prior to marriage or domestic partnership should be ordered as detailed in the proposed Judgment (form FL-180).

Check this box if you are currently receiving public assistance for the child or children listed in the proposed order.

Check this box if you are not currently receiving public assistance for the child or children listed in the proposed order.

Check this box if you intend to apply for public assistance for the child or children listed in the proposed order.

Check this box if you are asking the court to retain the authority to make decisions about spousal or partner support in the future.

Check this box if the court should reserve jurisdiction to award spousal or partner support to the Petitioner.

Check this box if the court should reserve jurisdiction to award spousal or partner support to the Respondent.

Check this box if the Petitioner requests restoration of their former name as set forth in the proposed Judgment (form FL-180).

Check this box if the Respondent requests restoration of their former name as set forth in the proposed Judgment (form FL-180).

Check this box if spousal or domestic partner support should be ordered as set forth in the proposed Judgment, based on one or more of the factors described below it.

Check this box if the spousal or partner support order is based on the Spousal or Partner Support Declaration Attachment, Form FL-157.

Check this box if the spousal or partner support order is based on an attached declaration, as specified in Attachment 8d.

Check this box if the spousal or partner support order is based on a written agreement.

Check this box if you are voluntarily and permanently waiving your right to receive spousal or partner support.

Check this box if there are no assets or debts to be disposed of by the court.

Check this box if community and quasi-community assets and debts are listed on a completed Property Declaration (form FL-160) and are proposed for division in the Judgment (form FL-180).

Check this box if this declaration is solely for the termination of marital or domestic partner status, and you want the court to reserve jurisdiction over all other issues not requested in this declaration for later determination.

Check this box if the facts that support the requested judgment are stated directly on this form.

Provide the facts that support the requested judgment, specifically stating reasons if this is a default case.

Check this box if the facts that support the requested judgment are provided on Attachment 6d.

Check this box to indicate that you are asking the court to terminate spousal or partner support permanently.

Check this box if you are asking the court to terminate spousal or partner support for the Petitioner.

Check this box if you are asking the court to terminate spousal or partner support for the Respondent.

Check this box if the information in the Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) has changed since it was last filed with the court.

Check this box if the information in the Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) has not changed since it was last filed with the court.

Check this box to indicate that the status of the Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) information is being specified.

Check this box if this matter is an uncontested action where both parties mutually waive service of the final Declaration of Disclosure, and a waiver provision is executed as described in the text.