Judicial Council of California Form FL-150, Income and Expense Declaration Completed Form Examples and Samples
Find clear, completed examples of the Judicial Council of California Form FL-150, Income and Expense Declaration. Our detailed samples guide you through filling out the form correctly for your divorce or family law case, covering income, expenses, assets, and debts.
FL-150 Income and Expense Declaration Example - Employed Parent
How this form was filled:
This is an example of a completed Judicial Council of California Form FL-150 for a petitioner, Maria Garcia, who is a salaried W-2 employee (a teacher). The form details her monthly income, payroll deductions, estimated living expenses, and information about her child. It's a common scenario in a divorce or legal separation case where child and spousal support are at issue.
Information used to fill out the document:
- Petitioner's Name: Maria Garcia
- Occupation: High School Teacher
- Employer: San Diego Unified School District
- Case Type: Divorce with one child
- Filing Date: February 10, 2026
- Last Month's Gross Income (Salary): $6,500
- Total Gross Monthly Income: $6,500
- Payroll Deductions (Monthly): $1,988
- - Federal Income Tax: $750
- - State Income Tax: $350
- - Social Security/FICA: $403
- - Health Insurance Premium: $150
- - Mandatory Union Dues: $85
- - Mandatory Retirement (CalSTRS): $300
- Net Monthly Disposable Income: $4,512
- Liquid Assets (Cash & Checking): $5,000
- Monthly Expenses (Total): $4,280
- - Rent: $2,200
- - Utilities, Phone, Internet: $300
- - Food & Household Supplies: $600
- - Clothing: $150
- - Transportation (Payment, Insurance, Fuel): $730
- - Child's Extracurriculars: $200
- - Credit Card Payment: $150
- Attorney's Fees Paid: $2,500
What this filled form sample shows:
- Demonstrates how to report W-2 salary income based on recent pay stubs.
- Provides a clear breakdown of both mandatory and voluntary payroll deductions.
- Includes a realistic itemization of estimated monthly living expenses for one adult and one child.
- Accurately reports child-related costs, such as health insurance premiums and extracurricular activities.
- Shows how to declare assets and disclose information about attorney's fees.
Form specifications and details:
| Form Name: | Judicial Council of California Form FL-150, Income and Expense Declaration |
| Use Case: | Divorce/Separation with one child, filed by a W-2 salaried employee. |
| Filing Party: | Petitioner |
| Key Financials: | Based on 2025 year-end information for a 2026 court filing. |
Created: January 27, 2026 02:40 AM
