ORANGE COUNTY SUPERIOR COURT

489697cb3f9ed9f8b6c15b76859329b382b0a887

California Superior Local Rules

s) Personal Information Name: Date of Birth: Address: Apt #/Unit # City: State: Zip Code: Home Phone #: Cell Phone #: Social Security Number: Driver’s License or I.D.: E-Mail: Name of Relative/Friend Not Living With You: Relative Phone #: Family Name of Spouse/Partner: Phone #: # of Dependents Living With You: Employment Employer: Phone#: Length of Employment: Income and Expenses Monthly Take Home Income $ Other Income Source: Other Income Amount: $ Monthly Basic Expenses: Rent or Mortgage Payment……………………………. $_________ Gas/Fuel………………………………………………………. $_________ Utilities (gas, electric, water, phone)……………… $_________ Child Care/Support………………………………………. $_________ Food………………………………………………………………. $_________ Other Monthly Expenses (please list below): Loan Payments (i.e. car, student, credit card)… $_________ __________________________________ $_________ Insurance Costs……………………………………………… $_________ __________________________________ $_________ I certify under penalty of perjury under the laws of the State of California that the information given by me in this affidavit is true and correct, and reflects my current financial situation.

Further, the Court has my expressed permission to, as needed, verify the information furnished through credit bureaus, and other tools, including references. I acknowledge that I have provided a cellular phone number, and I authorize the Orange County Superior Court to make automated cellular phone calls or to send SMS text messages reminders, as needed, regarding my case or payments I owe. Yes  No  I authorize the court to send me electronic notices, as needed, regarding my case under this agreement.

Yes  No  Signature:___________________________________________________________ Date:_______________________________________ Rev. 02/05/2026 Office Use Only: Time In: Processed By: Pro

Document details

Collection	California Superior Local Rules
Citation	489697cb3f9ed9f8b6c15b76859329b382b0a887
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	489697cb3f9ed9f8b6c15b76859329b382b0a887

Source file is stored in the law ingest library (pdf).