LOCAL FORM FL-104 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PLACER 10820 JUSTICE CENTER DRIVE P.O. BOX 619072 ROSEVILLE, CA 95661-9072 BILL SANTUCCI JUSTICE CENTER PETITIONER: RESPONDENT: FAMILY LAW CASE MANAGEMENT CONFERENCE STATEMENT CASE MANAGEMENT CONFERENCE: DATE: __________ 1. PARTIES AND ATTORNEYS. I am a. I am am not is b. The other party is not Petitioner CASE NUMBER: TIME: __________ DEPT: __________ Respondent Other: _______________________ represented by an attorney. represented by an attorney. c. The address of the other party/party's attorney is: Name: ______________________________________________________________________________________ Address: ______________________________________________________________________________________ City/State/Zip Code: Telephone Number: 2. NATURE OF CASE. a. Have the parties reconciled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Has the Respondent been served with the Summons and Petition . . . . . . . . . c. Do the parties expect to make an agreement . . . . . . . . . . . . . . . . . . . . . . . . . . d. Has this case settled . . . . . . . . . . . . . . . . . . . Yes No Yes Yes Yes No No No _____________________________________________________________________________ _____________________________________________________________________________ Judgment will be filed on/before: ____________ Yes Yes Yes Yes Yes No No No No No e. Parties working on an agreement and request the CMC be continued . . . . . . f. Has the Petitioner served Respondent with Disclosure Documents . . . . . . . . . g. Has the Respondent served Petitioner with Disclosure Documents . . . . . . . . . h. Have the parties had a meeting to try and settle all issues . . . . . . . . . . . . . . . . i. Are the parties involved in any private mediation . . . . . . . . . . . . . . . . . . . . . . . NOTICE: You must file this document at least fifteen (15) calendar days before the hearing date listed above. LOCAL FORM FL-104 [Rev. Aug 20, 2008] FAMILY LAW CASE MANAGEMENT CONFERENCE STATEMENT PAGE 1 OF 2 LOCAL RULE 30.13 American LegalNet, Inc. www.FormsWorkflow.com PETITIONER: RESPONDENT: CASE NUMBER: 3. ISSUES. This case involves the following issues (check all that apply): a. CHILD CUSTODY/VISITATION has been resolved by agreement resolved by Court Order still pending and there is no hearing date set. resolved by Court Order still pending and there is no hearing date set. resolved by Court Order still pending and there is no hearing date set. resolved by Court Order still pending and there is no hearing date set. resolved by Court Order still pending and there is no hearing date set. resolved by Court Order still pending and the next hearing date is _____________ b. CHILD SUPPORT has been resolved by agreement still pending and the next hearing date is _____________ c. SPOUSAL SUPPORT has been resolved by agreement still pending and the next hearing date is _____________ d. DIVISION OF ASSETS has been resolved by agreement still pending and the next hearing date is _____________ e. DIVISION OF DEBTS has been resolved by agreement still pending and the next hearing date is _____________ f. ATTORNEY'S FEES & COSTS have been resolved by agreement still pending and the next hearing date is _____________ 4. TRIAL READINESS. I am am not ready for trial. days hours still pending and there is no hearing date set. a. If not ready for trial, when will you be ready (date): __________________________ b. If ready for trial, this case will take _____ to complete. c. If ready for trial, what dates are you unavailable for trial: ___________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ 5. ADDITIONAL INFORMATION: ________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ NOTICE: You must file this document at least fifteen (15) calendar days before the hearing date listed on the first page. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) SIGNATURE PETITIONER ATTORNEY FOR RESPONDENT OTHER LOCAL FORM FL-104 [Rev. Aug 20, 2008] FAMILY LAW CASE MANAGEMENT CONFERENCE STATEMENT PAGE 2 OF 2 LOCAL RULE 30.13 American LegalNet, Inc. www.FormsWorkflow.com