Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 1 of 7 Form No. PL-FL008 Effective 10-01-2018 Name: Address: Telephone: In Pro Per THE SUPERIOR COURT OF CALIFORNIA IN AND FOR THE COUNTY OF PLACER In Re Matter/Marriage of: ) Case No. ) ) PETITIONER222S Petitioner: ) RESPONDENT222S ) STATEMENT OF ISSUES AND ) CONTENTIONS and ) CHILD SUPPORT AND VISITATION ) ) Settlement Conference Respondent: ) Date: ) ) Trial or Long Cause ) Date: PRELIMINARY INFORMATION 1) Petitioner : Name D.O.B. Present Employer Gross Monthly Income $ 2) Respondent : Name D.O.B. Present Employer Gross Monthly Income $ American LegalNet, Inc. www.FormsWorkFlow.com Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 2 of 7 Form No. PL-FL008 Effective 10-01-2018 3) Issues to be Considered by the Court (check those that apply): Child Custody Child Support Child Visitation CHILDREN OF THE RELATIONSHIP 4) Provide the following information regarding minor children of the relationship: Name Date of Birth Age 5) In Present Custody of (Petitioner / Respondent / Other) EXISTING ORDERS FOR CUSTODY AND SUPPORT 6) Is there presently an order for child custody in effect? a) Yes No 7) If yes, list existing child custody orders: Name of Child Date of Order Party Having Custody Party Having Visitation 8) Is there presently an order for payment of child support? a) Yes No American LegalNet, Inc. www.FormsWorkFlow.com Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 3 of 7 Form No. PL-FL008 Effective 10-01-2018 9) If yes, list existing child support orders: Date of Order Type of Order/Amount Party to Whom Payable AGREEMENTS BETWEEN THE PARTIES 10) Do you and the other party have any agreements concerning child custody? a) Yes No b) If yes, list and describe each agreement: CHILD CUSTODY 11) Describe the child custody/visitation arrangements presently being followed by you and the other parent: 12) Have the parents been to custody mediation? Yes No 13) If yes, has the report been completed? Yes No If the report has not been completed, when do you think it will be completed? (date) What is the date of the completed report and recommendation? (date) American LegalNet, Inc. www.FormsWorkFlow.com Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 4 of 7 Form No. PL-FL008 Effective 10-01-2018 What custody/visitation arrangement is recommended by the Mediator222s Report? (Briefly describe): 14) Describe the custody arrangement you want the court to order at the present time (check the appropriate box): a) Remain the same. b) Adopt Mediation report dated: c) Other (describe): CURRENT INCOME AND EXPENSES (Complete in all cases) 15) Attach a completed Income and Expense Declaration or Financial Statement (simplified) which has current income and expense information for you. CHILD SUPPORT (Complete in all cases where child custody or child support is in issue) 16) Is there presently an order for payment of child support? a) Yes (complete b, c and d) No (go on to 17) b) Payable by which party? to which party? (party name, or district attorney) c) How much per month? (amount) d) Date the order was issued: American LegalNet, Inc. www.FormsWorkFlow.com Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 5 of 7 Form No. PL-FL008 Effective 10-01-2018 e) Is current or past due support being collected by the Department of Child Support Services or the District Attorney222s Family Support Division for any county? No Yes, for the following county/ies: 17) Does either party presently pay for day care for work? a) Yes No b) If yes, what is the monthly cost of day care? $ 18) Future Child Support: a) Should one Party pay Child Support to the other Party? Yes No b) If no, why not? c) Amount of time the child(ren) spend with each parent: Father percent Mother percent ATTORNEY222S FEES AND COSTS 19) Fees: $ Explanation Costs: $ Explanation American LegalNet, Inc. www.FormsWorkFlow.com Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 6 of 7 Form No. PL-FL008 Effective 10-01-2018 OTHER ISSUES (Complete if there are additional issues before the court) 20) If there are other issues the Court is to consider, identify each and describe the circumstances: 21) Witness List: Name of Witness Topic of anticipated testimony Date: (Date Signed) (Signature) Petitioner Respondent American LegalNet, Inc. www.FormsWorkFlow.com Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 7 of 7 Form No. PL-FL008 Effective 10-01-2018 INSTRUCTIONS FOR FAMILY LAW STATEMENTS OF ISSUES AND CONTENTIONS (Child Custody, Visitation, Child Support) The following is required before your Settlement Conference and Trial Dates : 1. Complete all sections of the Statement of Issues and Contentions that apply to you. 2. Write in the dates you have been scheduled for Settlement Conference and Trial on the top page (to the right) 3. You may attach any additional sheets or documentation that is pertinent to your Statement of Issues and Contentions 4. Make three copies of the Statement of Issues and Contentions and any attached documents. 5. Have another adult serve one copy of your Statement to the other party. Service can be done in person or by mail. Your server must complete a Proof of Personal Service (FL- 330, if done in person) or Proof of Service by Mail (FL-335, if done by mail) for you. 6. File the original plus two copies of the Statement of Issues and Contentions along with the original Proof of Service plus one copy with the family law filing window. Deadline: The deadline for filing the Statement of Issues and Contentions is twenty-four (24) calendar days prior to your trial date (Placer Court Local Rule 30.9). Income and Expense Declaration: If you are going to trial on child support or attorney222s fees, you must also submit an updated Income and Expense Declaration (form FL-150) to the court within the same deadline listed above. Accessing the Forms: The Statement of Issues and Contentions CVCS is located on our court homepage, www.placer.courts.ca.gov. Click the link for 223Local Forms224, then 223Family Forms224, then scroll down to 223Statement of Issues and Contentions CVCS224 The Income and Expense Declaration is located at www.courts.ca.gov/forms/documents/fl150.pdf Proof of Personal Service is located at: www.courts.ca.gov/forms/documents/fl330.pdf Proof of Service by Mail is located at: www.courts.ca.gov/forms/documents/fl335.pdf American LegalNet, Inc. www.FormsWorkFlow.com