Declaration For Default Or Uncontested Dissolution / Legal Separation
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3FL-170
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
TELEPHONE NO.:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PETITIONER:
RESPONDENT:
DECLARATION FOR DEFAULT OR UNCONTESTED
CASE NUMBER:
DISSOLUTION
LEGAL SEPARATION
(NOTE: Items 1 through 12 apply to both dissolution and legal separation proceedings.)
1.
I declare that if I appeared in court and were sworn, I would testify to the truth of the facts in this declaration.
2.
I agree that my case will be proven by this declaration and that I will not appear before the court unless I am ordered by the court to
do so.
3.
All the information in the
amended
Petition
Response
is true and correct.
4.
Type of case (check a, b, or c):
Default without agreement
a.
(1)
No response has been filed and there is no written agreement or stipulated judgment between the parties;
(2)
The default of the respondent was entered or is being requested, and I am not seeking any relief not requested in the
petition; and
(3)
The following statement is true (check one):
(A)
There are no assets or debts to be disposed of by the court.
(B)
The community and quasi-community assets and debts are listed on the completed current Property
Declaration (form FL-160), which includes an estimate of the value of the assets and debts that I propose
to be distributed to each party. The division in the proposed Judgment (form FL-180) is a fair and equal
division of the property and debts, or if there is a negative estate, the debts are assigned fairly and equitably.
b.
Default with agreement
(1)
No response has been filed and the parties have agreed that the matter may proceed as a default matter without
notice; and
(2)
The parties have entered into a written agreement regarding their property and their marriage or domestic partnership
rights, including support, the original of which is being or has been submitted to the court. I request that the court
approve the agreement.
c.
Uncontested
(1)
Both parties have appeared in the case; and
The parties have entered into a written agreement regarding their property and their marriage or domestic partnership
(2)
rights, including support, the original of which is being or has been submitted to the court. I request that the court
approve the agreement.
5.
Declaration of disclosure (check a, b, or c):
a.
Both the petitioner and respondent have filed, or are filing concurrently, a Declaration Regarding Service of Declaration
of Disclosure (form FL-141) and an Income and Expense Declaration (form FL-150).
b.
This matter is proceeding by default. I am the petitioner in this action and have filed a proof of service of the preliminary
Declaration of Disclosure (form FL-140) with the court. I hereby waive receipt of the final Declaration of Disclosure (form
FL-140) from the respondent.
This matter is proceeding as an uncontested action. Service of the final Declaration of Disclosure (form FL-140) is mutually
c.
waived by both parties. A waiver provision executed by both parties under penalty of perjury is contained on the Stipulation
and Waiver of Final Declaration of Disclosure (form FL-144), in the settlement agreement or proposed judgment or
another, separate stipulation.
Page 1 of 3
Form Adopted for Mandatory Use
DECLARATION FOR DEFAULT OR UNCONTESTED
Family Code, § 2336
Judicial Council of California
DISSOLUTION OR LEGAL SEPARATION
FL-170 [Rev. July 1, 2012]
(Family Law)
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