Financial Statement California Superior Court Forms Page 2
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3Superior Court of California, County of San Luis Obispo
FOR COURT USE ONLY
□
San Luis Obispo Branch, County Government Center,
1050 Monterey Street, Room 220, San Luis Obispo, CA 93408
□
Grover Beach Branch, 214 South 16th Street, Grover Beach, CA 93433
□
Paso Robles Branch, 901 Park Street, Paso Robles, CA 93446
THE PEOPLE OF THE STATE OF CALIFORNIA
Plaintiff,
vs.
Defendant,
Case Number
FINANCIAL STATEMENT
Name: ____________________________________________________ Date of Birth: ____________________________
Address: __________________________________________________ City/Zip Code: ____________________________
Telephone # (Home): ________________________________________ Telephone # (Work): _______________________
Social Security #: ___________________________________________ Driver’s License #: _________________________
Defendant’s Occupation: _______________________________________________________________________________
Employer’s Name: ___________________________________________Address: _________________________________
If Defendant is not currently working:
Name of Last Employer: ____________________________________________Last Employment Date: _______________
Address of Employer: __________________________________________________________________________________
Marital Status: _____ Single
_____ Married
_____ Divorced
_____ Separated
Spouse’s Name: ________________________________________________Date of Birth: ________________________
Spouse’s Employer/Address: _____________________________________________________________________________
Spouse’s Social Security #: _________________________________________Driver’s License #: ____________________
Dependants:
Name
Age
Address
Relationship
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