ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) Telephone Number FOR COURT USE ONLY BAR NUMBER: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LAKE 255 North Forbes Street, Lakeport, CA 95453 PETITIONER RESPONDENT MANDATORY SETTLEMENT CONFERENCE STATEMENT 1. Party or Parties (answer one): This statement is submitted jointly by parties. This statement is submitted by only one party. CASE NUMBER: 2. Meeting to discuss case. Local Rules require you to meet and discuss the case. Did you meet and discuss the case? Yes Date:_________________ No Explain why you did not meet: ________________________________________________________ ______________________________________________________________________________________________ 3. 4. Expert Reports. Are Expert Reports involved in this case? Yes No Are these reports completed? Yes No If no, date all will be completed:___________ Were the Declarations of Disclosure served? Filed Declaration re Service (FL-141) Yes No Yes No Exchange of Information: Petitioner Respondent Preliminary Yes No Yes No Filed and Served current Income and Expense forms? Petitioner Respondent 5. Yes Yes No No If yes, date filed: _________________ If yes, date filed: _________________ If there are issues in your case, do you have an Agreement or Court order? a. Child Custody b. Child Visitation c. Child Support d. Spousal Support e. Attorney Fees f. Paternity Agreement? Yes No Yes No Yes No Yes No Yes No Yes No If Yes Written Written Written Written Written Written Written OR Court Order Court Order Court Order Court Order Court Order Court Order Court Order Mandatory Form LK-101 New 01/12 MANDATORY SETTLEMENT CONFERENCE STATEMENT Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 6. If you do not agree on these issues, what do you want? a. Child Custody LK-101 Petitioner _______________________________________________________________ ________________________________________________________________________ Respondent______________________________________________________________ ________________________________________________________________________ Petitioner _______________________________________________________________ ________________________________________________________________________ Respondent______________________________________________________________ ________________________________________________________________________ Petitioner _______________________________________________________________ ________________________________________________________________________ Respondent______________________________________________________________ ________________________________________________________________________ Petitioner _______________________________________________________________ ________________________________________________________________________ Respondent______________________________________________________________ ________________________________________________________________________ Petitioner _______________________________________________________________ ________________________________________________________________________ Respondent______________________________________________________________ ________________________________________________________________________ Attach a Property Declaration (FL-160), Propertizer or other equivalent spreadsheet. If the parties are unable to agree on the contents of the attachments, each party may complete and attach separate forms. b. Child Support c. Spousal Support d. Attorney Fees e. Paternity 7. Property and Debts: 8. Dates you are not available to come to court: _______________________________________________________ ______________________________________________ Signature of Petitioner or Attorney ____________________________ Date __________________________________________ Signature of Petitioner or Attorney _________________________ Date Mandatory Form LK-101 New 01/12 MANDATORY SETTLEMENT CONFERENCE STATEMENT Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com