Attorney or Party Without An Attorney (Name, Address, Telephone Number) Attorney for (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SONOMA Civil & Family Law Courthouse/Family Law Division 3055 Cleveland Avenue Santa Rosa, Ca 95403 Telephone: (707) 521-6500 Petitioner/Plaintiff: Respondent/Defendant: Other Parent/Claimant: Statement of Issues for Settlement Conference or Trial Petitioner222s Respondent222s Third Party Claimant222s Case Number: Settlement Conference Date: Time: Department: NOTE: BOTH PARTIES MUST FILE JUDICIAL COUNCIL FORM FL141 DECLARATION REGARDING SERVICE OF DECLARATION OF DISCLOSURE (PRELIMINARY) PRIOR TO THE DATE SET FOR SETTLEMENT CONFERENCE. BOTH PARTIES MUST COMPLETE THE FINAL DECLARATION OF DISCLOSURE NO LATER THAN 45 DAYS BEFORE THE FIRST TRIAL DATE. PARTIES SHALL SERVE A COPY OF THE SAME AND A CURRENT INCOME AND EXPENSE DECLARATION, UNLESS PARTIES MUTUALLY WAIVE THE FINAL DECLARATION OF DISCLOSURE (FC247 2105). Local rule 9.13.C requires the attorneys, if any, for the parties or the parties themselves, if self-represented, to meet and confer in a good faith effort to resolve all issues prior to settlement conference and trial. Self-represented parties should not confer with one another if any restraining order prohibits contact between the parties. This coversheet must be submitted to the Family Law Clerk, 3055 Cleveland Avenue, Santa Rosa, California 95403; ten (10) calendar days before the settlement conference or, if no settlement conference, ten (10) calendar days before the trial date. A copy of this coversheet and of all attachments must be mailed to all parties and a Proof of Service must be filed with the original of this form. DISPUTED ISSUES *** Check items you and the other party do not (or may not) agree on *** Custody/Visitation Property Valuation Attorney222s Fees/Costs Child Support Property Characterization Set Asides/Validity of Orders Spousal Support Property Valuation Date Contempt Back Support (Arrears) Reimbursement Bifurcation (specify Issue): Property Division Date of Separation Other: YOU ARE REQUIRED TO PROVIDE THE FOLLOWING INFORMATION (TYPE OR CLEARLY PRINT ANSWERS TO ALL APPLICABLE QUESTIONS ON SEPARATE PAPER AND ATTACH IT TO THIS COVERSHEET): 1. State the following statistical information: A. Date of marriage or domestic partnership and date of separation; age and occupation of the petitioner and the respondent; the names and ages of minor children of this relationship. B. List by date and describe any temporary orders or stipulations that are in effect; C. If there is any dispute regarding the date of separation, provide the factual and legal basis for your contention regarding the date of separation. Sonoma County Local Form FL - 002 Form Adopted for Mandatory Use (Rev. 4/08; 1/10; 7/10; 7/11; 7/13; 5/18) Statement of Issues for Settlement Conference or Trial P age 1 of 3 Sonoma County Local Rules 9.21(D); 9.23(C)&(D) American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: 2. Summarize issues that you believe have been settled. Briefly describe the terms of settlement of each issue that you believe has been settled. 3. If child support, spousal support, partner support, or attorney222s fee are in dispute, please do the following: A. Prepare and file a current INCOME AND EXPENSE DECLARATION on Judicial Council form FL-150 if one has not been filed in the last 90 days or if there have been significant changes in your income or expenses within the last 90 days. B. If child support is in dispute: i. Attach a support calculation printed from a court approved computer support program; ii. State your proposal for child support. Include your proposal for which parent will be entitled to claim the dependency exemption for each child. State each party222s expenses; iii. State your proposal for how the cost of uninsured health care and of any day care costs will be shared and who will pay for the cost of health insurance; iv. State the factual and legal basis for your proposal. C. If spousal or partner support is in dispute: i. Address each of the applicable factual and legal factors regarding spousal support (Family Code Section 4320); ii. State your proposal for spousal or partner support, including duration of support. D. If attorney222s fees are in dispute: i. State your proposal for an order for attorney222s fees; ii. State the factual and legal basis for your proposal. 4. If there are disputed issues concerning real property, personal property, debts, credits, reimbursements, and/or charges for the exclusive use of community property, do the following: A. For all assets in dispute, including real property: i. State when the asset was acquired (before marriage or domestic partnership, during marriage or domestic partnership, after separation); ii. State the manner in which title to the asset is held (for example: joint tenants, tenants in common, community property, in the name of one of the parties, etc.); iii. State the character of the asset as community, separate, quasi-community, or mixed; iv. State the current fair market value of each asset; v. List any loans or outstanding balances against each asset; vi. State the nature of any tracing issue. State the facts upon which you rely in support of your position regarding any tracing; vii. State your proposal for division of assets in dispute; viii. State the factual and legal basis for your proposal. B. For all debts in dispute: i. State all debts in dispute, name of creditors and balance due on the date of separation; ii. State your proposal for division of debts in dispute; iii. State the factual and legal basis for your proposal. Sonoma County Local Form FL - 002 Form Adopted for Mandatory Use (Rev. 4/08; 1/10; 7/10; 7/11; 7/13; 5/18) Statement of Issues for Settlement Conference or Trial Page 2 of 3 Sonoma County Local Rule 9. 21(D); 9.23( C)&(D ) American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: C. For all disputed claims to credits, rights to reimbursement, charges for exclusive use of community property: i. For any claim to credit for post-separation use of separate funds to pay community debts, state the basis for the claim; ii. For any claim that a party should be charged for the exclusive post-separation use of a community property asset, state the basis for the claim; iii. For any claim to the right to reimbursement for separate property paid toward acquisition of a community property asset or toward the acquisition of the other party222s separate property under Family Code Section 2640, state the basis for the claim; iv. For other claimed credits, state the basis. 5. Describe any significant disputed issues in your case not addressed above. 6. Attach copies of documents that may help settle disputes. 7. State your efforts to settle the issues outlined above and the dates that you met and conferred as required by Local Rules 9.13.C and 9.23.D. DATED: Signature of Petitioner/Plaintiff or Attorney of Record DATED: Signature of Respondent/Defendant or Attorney of Record DATED: Signature of Other Parent or Child Support Agency, Other Third Party Claimant or Attorney of Record Sonoma County Local Form FL - 002 Form Adopted for Mandatory Use (Rev. 4/08; 1/10; 7/10; 7/11; 7/13; 5/18) Statement of Issues for Settlement Conference and Trial Page 3 of 3 Sonoma County Local Rules 9. 21(D); 9.23( C)&(D) American LegalNet, Inc. www.FormsWorkFlow.com