CR-115 - Defendant's Statement of Assets

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Defendant's Statement of Assets

Text

Form ID: CR-115
Title: Defendant's Statement of Assets
Effective Date: 2020-01-01
Mandatory Form: yes
Languages: 汉语, 한국어, español, Tiếng Việt
Info Page: https://selfhelp.courts.ca.gov/jcc-form/CR-115
Primary Download URL: https://www.courts.ca.gov/documents/cr115.pdf
Alternate Download URLs: https://www.courts.ca.gov/documents/cr115c.pdf, https://www.courts.ca.gov/documents/cr115k.pdf, https://www.courts.ca.gov/documents/cr115s.pdf, https://www.courts.ca.gov/documents/cr115v.pdf
Form Detail Page:
Defendant's Statement of Assets
(CR-115)
Lists and describes a defendant's assets, income, and liabilities for the court to review when ordering payment of restitution to a crime victim in the defendant's case.
Get form CR-115
汉语
Get form CR-115 in Chinese Simplified
(Chinese Simplified)
한국어
Get form CR-115 in Korean
(Korean)
español
Get form CR-115 in Spanish
(Spanish)
Tiếng Việt
Get form CR-115 in Vietnamese
(Vietnamese)
Effective: January 1, 2020
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How-to instructions for Criminal
PDF Text:
CR-115
FOR COURT USE ONLYNAME OF VICTIM ON WHOSE BEHALF RESTITUTION IS ORDERED:
NAME OF COURT:
PEOPLE OF THE STATE OF CALIFORNIA
vs.
DEFENDANT'S STATEMENT OF ASSETS
It is a misdemeanor to make any willful misstatement of material fact in completing this form. (Pen. Code, § 1202.4(f)(4).)
(Attach additional sheets if the space provided below for any item is not sufficient.)
PERSONAL INFORMATION
1.   a. f. 
b. 
c. g. 
d. 
e. 
EMPLOYMENT
2.   
4.   
6.  
8.   Other sources of income (specify):
CASH, BANK DEPOSITS
9. 
10. How much other money do you have in banks, savings and loans, credit unions, and other financial institutions either in your own 
      name or jointly (list):
Name and address of financial institution Individual or joint?Account number Balance
a. $
b. $
c. $
PROPERTY
11. List all automobiles, other vehicles, and boats owned in your name or jointly. Legal owner if different 
Value   Amount owedMake and year
a.
b.
c.
(Continued on reverse)
DEFENDANT'S STATEMENT OF ASSETSAdopted for Mandatory Use 
Judicial Council of California 
CR-115 [Rev. Jan. 1, 2020]
Penal Code, § 1202.4(f)
5.  
h. 
i. 
$
$
$
$
$
$
DEFENDANT:
AKA:
What are your sources of income and occupation? (Provide job title and name of division or office in which you work.)
a. Name and address of your business or employer (include address of your payroll or human resources department, if different):
b. If not employed, names and addresses of all sources of income (specify):
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
Page 1 of 2
from registered owner
3.
Name:
Date of birth:
Social security number:
Marital status:
Driver license number:
State of issuance:
Home address (incl. city/zip):
Home telephone no.:
Employer's telephone no.:
What is your gross pay each pay period?   $
What is your take-home pay each pay period?   $
How often are you paid (for example, daily, weekly, biweekly, monthly)? (specify):
How much money do you have in cash?   $
7.  
CASE NUMBER:
If your spouse earns any income, give the name of your spouse, the name and address of the business or employer, job title, and 
division or office (specify):

PEOPLE OF THE STATE OF CALIFORNIA vs. 
12. List all real estate owned in your name or jointly: 
Fair market value Amount owed
a. $ $
b. $ $
OTHER PERSONAL PROPERTY (Do not list household furniture and furnishings, appliances, or clothing.)
13. List anything of value not listed above owned in your name or jointly (continue on attached sheet if necessary)
Description Value Address where property is located
a.
b.
c.
ASSETS
14. 
15. Is anyone holding assets for you? If yes, describe the assets and give the name and address of the
person or entity holding each asset (specify):
16. Except for attorney fees in this matter and ordinary and routine household expenses, have you disposed of or transferred any
assets since your arrest on this matter?
DEBTS
17.
18.
19. 
20. 
21. 
(TYPE OR PRINT NAME) (SIGNATURE)
DEFENDANT'S STATEMENT OF ASSETS
CR-115 [Rev. Jan. 1, 2020] Page 2 of 2
$
$
$
Address of real estate
List all other assets, including stocks, bonds, mutual funds, and other securities (specify):
Support arrearages (attach copies of orders and statements):
If yes, give the name and address of each person or entity who received any asset and describe each asset (specify):
Loans (give details):
Taxes (give details):
Credit cards (give creditor's name and address and the account number):
Other debts (specify):
INTERPRETER'S STATEMENT
I, having been duly sworn or having a written oath on file, certify that I truly translated this form to the defendant in the language noted 
below. 
Language:
(INTERPRETER'S SIGNATURE) DATE
(TYPE OR PRINT INTERPRETER'S NAME) (CERTIFICATION NUMBER)
DEFENDANT:
Date:
Yes No
Yes No
Spanish Other (specify):
CASE NUMBER:

Retrieval chunks

• #1

  Form ID: CR-115 Title: Defendant's Statement of Assets Effective Date: 2020-01-01 Mandatory Form: yes Languages: 汉语, 한국어, español, Tiếng Việt Info Page: https://selfhelp.courts.ca.gov/jcc-form/CR-115 Primary Download URL: https://www.courts.ca.gov/documents/cr115.pdf Alternate Download URLs: https://www.courts.…

• #2

  b. If not employed, names and addresses of all sources of income (specify): STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: Page 1 of 2 from registered owner 3. Name: Date of birth: Social security number: Marital status: Driver license number: State of issuance: Home address (incl. city…