ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

MIL-015

FAX NO.:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF 

TELEPHONE NO.:

 E-MAIL ADDRESS:

ATTORNEY FOR (Name):

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITION OF (Name of petitioner):

DECLARATION IN SUPPORT OF PETITION FOR RELIEF FROM 
FINANCIAL OBLIGATIONS DURING MILITARY SERVICE   

CASE NUMBER:

I (name):

declare as follows:

1.

I am or was a member of the National Guard or a reservist of the United States military reserves, and I (check the applicable boxes):

have been called or ordered into  

am currently serving 

am within six months of having completed

full-time active duty service in the state or federal armed services or reserves. (Mil. & Vet. Code, § 400(b).)

The effective date of the orders for my most current period of military service is: 

2.

3.

My expected dates and location of full-time active service are as follows (describe dates [including beginning and release dates] 
and location in service, with rank, branch, and unit of service):

4.

a certificate attesting to
I have attached as Exhibit A a true and correct copy of (check one):
information in item 3  signed by an appropriately authorized officer of my military department branch or unit                   other 
documents as evidence of my military service, listed below. (Bring original of documents to hearing if available.)

 my military orders

5. 

The financial obligation or liability from which I am seeking relief is (identify and describe in detail what obligation or liability to 
respondent you are seeking relief from, including when they were incurred):

Continued on form MC-025 (attach that form if you need more space). 

6.

I have attached as Exhibit B true and correct copies of evidence of the above obligation as follows (Attach copy of mortgage 
statement, loan statement, bill, tax bill, or other evidence of your financial obligations or liabilities and list the documents below.)

Form Adopted for Mandatory Use 
Judicial Council of California 
MIL-015 [New January 1, 2012]

DECLARATION IN SUPPORT OF PETITION FOR RELIEF FROM 
FINANCIAL OBLIGATIONS DURING MILITARY SERVICE

Page 1 of 2

Military and Veterans Code § 409.3
www.courts.ca.gov

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

CASE NUMBER: 

MIL-015

7. 

The following facts show why my ability to pay the financial obligation or liability to respondent has been materially affected by 
my most current period of military service:
6

Continued on form MC-025 (attach that form if you need more space). 

8. 

I have attached as Exhibit C copies of documents that support the above facts. (List any documents you have attached to 
support the facts described above):

9. 

Number of pages attached to this declaration:

I declare under penalty of perjury under the laws of the State of California that the foregoing, including statements on all 
attachments, is true and correct.

Date:

(TYPE OR PRINT NAME OF DECLARANT)

(SIGNATURE OF DECLARANT)

 MIL-015 [New January 1, 2012]

DECLARATION IN SUPPORT OF PETITION FOR RELIEF FROM 
FINANCIAL OBLIGATIONS DURING MILITARY SERVICE

Page 2 of 2