FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA FAMILY LAW DIVISION 99 Notre Dame San Jose, California 95113 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: CASE NUMBER: FAMILY COURT SETTLEMENT OFFICER WORKSHEET (Settlement Officer Conference) FL APJ: Hon. USE APPROXIMATIONS Date of Marriage __________ Length of Marriage __________ Support started __________________ Date of Separation ________ Time since separation __________ Age Occupation / Job / Skill Income Mnth / Yr CS ___________ SS ___________ | Attorney Fees & Costs Husb - yrs - __________________ - $ | Total fees ______________ Wife - yrs - __________________ - $ | Total fees ______________ W / H DoB Age Timeshare K1 __________ _______ House value ____________ _____________ _____________ K2 __________ _______ Encumbrance ____________ _____________ _____________ K3 __________ _______ ____________ _____________ _____________ K4 __________ _______ ____________ _____________ _____________ Tot H/W H/W H/W _______ Purchase, ReFi, Change of Title Moore/Marsden Purchase Price Principle Reduction C/P contrib/improv Current Value __________ __________ __________ __________ Date Value Loan Cash out __________ __________ __________ __________ _________ _________ _________ _________ Current House Payment Principle Interest Taxes Insurance __________ __________ __________ __________ REIMBURSEMENTS Watts (FRVxMnths) ___________ X ___________ H to W or W to H Epstein (PITI x Mnths) ___________ X ___________ H to W or W to H Credit Accts DoS Bal. ______ _________ _______ CCCards DoS Bal. _______ _______ ______ CCC Payments post-Sep ______ _________ _______ Payments post-Sep _______ _______ ______ CCC Current Balance _______ _______ ______ FM-1031 REV 7/28/06 ______ _________ _______ Current Balance FAMILY COURT SETTLEMENT OFFICER WORKSHEET (Settlement Officer Conference) (SOCWorkShtFrm) American LegalNet, Inc. www.FormsWorkflow.com Significant Assets/Liabilities - Pension /IRA/401k VALUE WIFE HUSBAND ____________ ___________ ____________ ___________ ___________ __________________________________________________ Attorney for Petitioner/Plaintiff FM-1031 REV 7/28/06 Attorney for Respondent/Defendant FAMILY COURT SETTLEMENT OFFICER WORKSHEET (Settlement Officer Conference) (SOCWorkShtFrm) American LegalNet, Inc. www.FormsWorkflow.com