EM-115 - Emancipation of Minor Income and Expense Declaration

Summary

Emancipation of Minor Income and Expense Declaration

Text

Form ID: EM-115
Title: Emancipation of Minor Income and Expense Declaration
Effective Date: 2018-09-01
Mandatory Form: yes
Info Page: https://selfhelp.courts.ca.gov/jcc-form/EM-115
Primary Download URL: https://www.courts.ca.gov/documents/em115.pdf
Form Detail Page:
Emancipation of Minor Income and Expense Declaration
(EM-115)
Gives the court information about your finances to decide if you're able to support yourself.
Get form EM-115
Effective: September 1, 2018
PDF Text:
a.
b.
EMANCIPATION OF MINOR INCOME 
AND EXPENSE DECLARATION
Form Adopted for Mandatory Use 
Judicial Council of California 
EM-115 [Rev. September 1, 2018]
Family Code, § 7000, et seq. 
www.courts.ca.gov
Page 1 of 2
I am attending school (name of school and grade):
1.   My name and address are:
My telephone number is:
I have been living at this address since:
I live there with (name and relationship of all persons, including children):
2.   My date of birth is:
3.   
I am not attending school. The highest year of education I have completed is:
4.   
a.
b.
5.   I am employed. My place of employment is (name and address):
I started work there on (date): 
I am not employed at the present time. I last worked from (starting month and year):
to (ending month and year): My gross monthly earnings were: $
a.
b.
6.   
c.
d.
I am not receiving welfare or AFDC and I do not intend to apply for welfare or AFDC.
I am receiving welfare or AFDC. Monthly amount received: $ 
I have applied for welfare or AFDC.
I intend to apply for welfare or AFDC.
My occupation is:
ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER:
NAME:
FIRM NAME:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
Petitioner, a minor
IN THE MATTER OF (name):
EMANCIPATION OF MINOR INCOME AND 
EXPENSE DECLARATION
FOR COURT USE ONLY
CASE NUMBER:
EM-115

AmountThe average of my gross monthly earnings is:
a.
b.
c.
ValueI have the following assets:
a.
b.
c.
d.
e.
f.
AmountMy monthly expenses are:9.
b.
c.
d.
e.
Loan payments
Rent or
Mortgage
Food
Clothing
Phone and utilities
Vehicle
(1)
(2) Maintenance
I declare under penalty of perjury that the foregoing is true and correct.
(SIGNATURE OF PETITIONER)
EM-115
CASE NUMBER:IN THE MATTER OF (name):
8.
7.
 $Salary and wages, including bonuses and overtime
Money received from parents or other adults assisting me  
(name and relationship):
Other 
 $
 $
Cash
Checking account
Savings account
Stocks, bonds
Vehicle
Other
 $
 $
 $
 $
 $
 $
a.  $
 $
 $
 $
 $
 $
 $
(TYPE OR PRINT NAME)
Date:
EMANCIPATION OF MINOR INCOME 
AND EXPENSE DECLARATION
 EM-115 [Rev. September 1, 2018] Page 2 of 2
(specify):
(year, make, model):
(specify source and amount):

Retrieval chunks

• #1

  Form ID: EM-115 Title: Emancipation of Minor Income and Expense Declaration Effective Date: 2018-09-01 Mandatory Form: yes Info Page: https://selfhelp.courts.ca.gov/jcc-form/EM-115 Primary Download URL: https://www.courts.ca.gov/documents/em115.pdf Form Detail Page: Emancipation of Minor Income and Expense Decl…

• #2

  Money received from parents or other adults assisting me (name and relationship): Other $ $ Cash Checking account Savings account Stocks, bonds Vehicle Other $ $ $ $ $ $ a. $ $ $ $ $ $ $ (TYPE OR PRINT NAME) Date: EMANCIPATION OF MINOR INCOME AND EXPENSE DECLARATION EM-115 [Rev. September …