SUPERIOR COURT OF CALIFORNIA, COUNTY OF HUMBOLDT STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE:	(Receive Stamp Only)
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
FAMILY LAW JUDGMENT CHECKLIST DISSOLUTION (DIVORCE), LEGAL SEPARATION AND DOMESTIC PARTNERSHIP	CASE NUMBER:

Attorney	Self-Represented Party

INSTRUCTIONS Use this checklist to show the Court that you have turned in all the forms needed to get a Judgment in your case. Default – no Response filed, no written agreement Default with written agreement – no Response filed. Uncontested – appearance by both parties and a written agreement. Check the box below for your type of case (one of the three listed above). Then complete all the items in that checklist. You only need to complete the checklist for your case type. All items must be completed either by checking each line to indicate you have filed that form or by marking “N/A” to say that an item is not applicable. So that we can return the judgment, please submit two envelopes addressed to each party that are of sufficient size and have sufficient postage.

DEFAULT CASE (no response filed and NO WRITTEN AGREEMENT between the parties)

Proof of Service of Summons [FL-115] (check one of the following):

Personal Service [FL-115]

Notice and Acknowledgment of Receipt attached [FL-117]

Service out-of state by certified mail with receipt attached [FL-115 or out-of state form]

Other, (please describe)___________________________________________________

Request to Enter Default [FL-165] with one (1) self-addressed envelope with postage prepaid

Income and Expense Declaration [FL-150]

(if you are requesting spousal support or attorney fees/costs)

Financial Statement (simplified) [FL-155]

(If you have a minor child, you are not requesting spousal support or attorney fees/costs, and you qualify for this form according to the instructions on page 2 of the form; if you have a minor child and you do not qualify, you must complete an Income and Expense Declaration)

Property Declaration [FL-160]

(if you have requested any property in your petition)

Declaration for Default or Uncontested Dissolution/Legal Separation [FL-170}

Declaration Regarding Service of Petitioner’s (Preliminary) Declaration of Disclosure [FL-141]

(submit endorsed-filed copy if previously filed)

Judgment [FL-180]

If you are requesting property division include Property Order Attachment [FL-345]

If there are minor children in the case attach a:

Child Custody and Visitation Attachment [FL-341]

Child Support Order Attachment [FL-342]

Guideline Child Support Calculation (California Guideline Support Calculator)

Non-guideline Child Support Findings Attachment [FL-342(A)]

Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order

[FL-192]

Child Support Case Registry Form [FL-191]

Order/Notice to Withhold Income [FL-195]

Children of Divorce Workshop Certificate of Completion, Petitioner

Children of Divorce Workshop Certificate of Completion, Respondent

Children of Divorce Workshop Waiver

Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for

each party)

DEFAULT CASE WITH WRITTEN AGREEMENT (no response filed)

Proof of Service of Summons [FL-115] (check one of the following):

Personal Service [FL-115]

Notice and Acknowledgement of receipt attached [FL-117]

Service out-of-state by certified mail with receipt attached [FL-115 or out-of-state form]

Other (please describe) _________________________________________________

Request to Enter Default [FL-165]

Income and Expense Declaration [FL-150]

(if you are requesting spousal support or attorney fees/costs)

Financial Statement (simplified) [FL-155]

(if you have a minor child, you are not requesting spousal support or attorney fees/costs, and you qualify for this form according to the instructions on page 2 of the form; if you have a minor child and you do not qualify, you must complete an Income and Expense Declaration)

Property Declaration [FL-160]

(if you have requested any property in your petition)

Written Agreement

Declaration for Default or Uncontested Dissolution/Legal Separation [FL-170]

Declaration Regarding Service of Petitioner’s and Respondent’s (Preliminary) Declaration of

Disclosure [FL-141]

Judgment [FL-180] with written agreement

(must address issues regarding spousal support and property division)

Signature is notarized for defaulted party. Family Code §2338.5

Attorney has signed and approved Judgment for represented parties.

5a. If there are minor children:

Child Support – State whether child support is at guideline amount or not and include

language required in Family Code §4065 If below guideline, attach guideline support calculation (California Guideline Support

Calculator)

Medical insurance and uninsured health care costs addressed

Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order

[FL-192]

Child Support Case Registry Form [FL-191]

Order/Notice to Withhold Income [FL-195]

Children of Divorce Workshop Certificate of Completion, Petitioner

Children of Divorce Workshop Certificate of Completion, Respondent

Children of Divorce Workshop Waiver

Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes

(one for each party)

UNCONTESTED CASE (Response or Appearance, Stipulation and Waivers filed by

Respondent and a written agreement)

Proof of Service of Summons [FL-115] (check one of the following):

Personal Service [FL-115]

Notice and Acknowledgment of Receipt attached [FL-117]

Service out-of state by certified mail with receipt attached [FL-115 or out-of state form]

Other, (please describe)___________________________________________________

Response [FL-120 or FL-123].

Appearance, Stipulations, and Waivers [FL-130] (along with Respondent’s first appearance fee

if not already paid)

Declaration for Default or Uncontested Dissolution/Legal Separation [FL-170]

Declaration Regarding Service of Petitioner’s and Respondent’s (Preliminary) Declaration of

Disclosure [FL-141]

Declaration regarding Service of Petitioner’s and Respondent’s (Final) Declaration of

Disclosure [FL-141] or Waiver of Final declaration of Disclosure [FL-144]

Judgment [FL-180] with written agreement

(Spousal support and property division issues are addressed)

Signature(s) are notarized for unrepresented parties

Attorney has signed and approved Judgment for represented parties

6a. If there are minor children:

Child custody/visitation and Family Code §3048 issues are addressed

Child Support – State whether child support is at guideline amount or not and include

language required in Family Code §4065

If below guideline, attach guideline support calculation (Dissomaster or X spouse)

Medical insurance and uninsured health care costs addressed

Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order

[FL-192]

Child Support Case Registry Form [FL-191]

Order/Notice to Withhold income [FL-195]

Children of Divorce Workshop Certificate of Completion, Petitioner

Children of Divorce Workshop Certificate of Completion, Respondent

Children of Divorce Workshop Waiver

Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for

each party)

I certify that all of the information indicated in this checklist has been provided to the court.

Date:______________________________	___________________________________________

Submitting party’s signature

DO NOT WRITE BELOW THIS LINE

Date of Service or Jurisdiction for Respondent	____________________________

Date Default may enter (if applicable)	____________________________

Date Check List compared with file	____________________________

Date Rejection Letter sent	____________________________

_____________________________________	____________________________

Reviewed by (Clerk’s Name)	Reviewed on (Date)