1. Parties Attorney for: Petitioner Respondent Joined Party Self-Represented: Petitioner Respondent Joined Party Other (explain): 2. General Information a) Date of Marriage/Partnership: Date of Separation: b) Minor Child/ren and ages: 1. 4. 2. 5. 3. 6. c) Service of Declarations of Disclosure: Preliminary Final Petitioner Yes No Yes No Respondent Yes No Yes No 3. Issues in Agreement (Check all applicable boxes) Yes Date of Stipulation and /or Order (if applicable): (a) Child Custody (b) Child Support (c) Spousal Support (d) (e) Paternity Optional Use (f) Property Division FL 105 Rev 12/16 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (NAME, ADDRESS & PHONE) ATTORNEY FOR: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: CITY & ZIP CODE: PETITIONER: RESPONDENT: S ettlement Conference Statement FOR COURT USE ONLY CASE NO.: Court Date: American LegalNet, Inc. www.FormsWorkFlow.com 2 If there is a property agreement, please specify issues agreed upon (e.g.: personal property, residence/real property, debts): 4. Issues in Dispute (Check applicable boxes and briefly state position) Yes Your position: (a) Child Custody (b) Child Support (c) Spousal Support (d) (e) Paternity of Minor Children 5. Division of Community Property Assets (If yes, you must file an FL-160.) (a) Residence: Do the parties have an Agreement? Yes No If the parties do not have an Agreement, describe your proposal: American LegalNet, Inc. www.FormsWorkFlow.com 3 (b) Vehicles: Do the parties have an Agreement? Yes No If the parties do not have an Agreement, describe your proposal: (c) Retirement/Pension: Do the parties have an Agreement? Yes No If the parties do not have an Agreement, describe your proposal: (d) Money/Investments: Do the parties have an Agreement? Yes No If the parties do not have an agreement, describe your proposal: (e) Other Assets: Do the parties have an Agreement? Yes No If the parties do not have an Agreement, describe your proposal: American LegalNet, Inc. www.FormsWorkFlow.com 4 6. Division of Community Debts (a) Credit Cards: Do the parties have an Agreement? Yes No If the parties do not have an Agreement, describe your proposal: (b) Other Debts/Credits: Do the parties have an Agreement? Yes No If the parties do not have an Agreement, describe your proposal: 7. Separate Property Do the parties have an Agreement? Yes No If the parties do not have an Agreement, describe your proposal: 8. Other Issues in Dispute Specify: American LegalNet, Inc. www.FormsWorkFlow.com 5 9. Attachments Attachment No. : Income and Expense Declaration (FL-150) Attachment No. : Schedule of Assets and Debts (FL-142) Attachment No. : Property Declaration(s) (FL-160) Attachment No. : Spousal/Partner Support Declaration (FL-157) 10. Trial Estimate Hour(s) or Day(s) Dated: Attorney for or Self-represented Petitioner Respondent Joined Party Proof of Service by Mail I declare I am over 18 years of age, not a party to this action. I am a resident of or employed in the county where the mailing took place. My residence or business address is: On the date below, I served a completed copy of this document by: Depositing the sealed envelope with the United States postal Service with the postage fully prepaid or Placing the envelope for collection and mailing following our ordinary business practices. I am readily familiar with practice for collecting and processing correspondence for mailing. On the same day that correspondence is placed for collection and mailing, it is deposited in the ordinary course of business with the United States Postal Service in a sealed envelope with postage fully prepaid. The envelope was addressed and mailed as follows: Name of person served: Address of person served: I declare, under penalty of perjury, under the laws of the State of California, that the foregoing is true and correct. DATE: Signature of Person Mailing: Print Name of Person Mailing: American LegalNet, Inc. www.FormsWorkFlow.com