GROSS WEEKLY INCOME - ATTACH LAST THREE (3) PAYROLL STUBS
|
|
|
- Victoria Quinn
- 5 years ago
- Views:
Transcription
1 FILL OUT AND RETURN TO JENNIFER AUGER S OFFICE IN ONE WEEK, Petitioner, Cause No. vs. VERIFIED FINANCIAL DECLARATION OF, Respondent. HUSBAND/FATHER: Name: Address: Social Security Number: Occupation: Employer: Date of Birth: ATTORNEY WIFE/MOTHER: Name: Address: Social Security Number: Occupation: Employer: Date of Birth: SPACE BELOW FOR USE OF COURT CLERK ONLY: WEEKLY INCOME - ATTACH LAST THREE (3) PAYROLL STUBS AMOUNTS 1. Gross Weekly SALARY, WAGES AND COMMISSIONS 2. Gross Weekly PENSIONS/RETIREMENT/SOCIAL SECURITY/DISABILITY/UNEMPLOYMENT/WORKMAN'S COMP 3. Gross Weekly CHILD SUPPORT received from any prior marriage (not this marriage) 4. Gross Weekly DIVIDENDS and INTEREST 5. Gross Weekly RENTS/ROYALTIES less ordinary and necessary expenses (Attach calculations) 6. Gross Weekly BUSINESS/SELF-EMPLOYMENT INCOME less ordinary and necessary expenses (Attach calculations 7. ALL OTHER SOURCES (Specify) *** 8. TOTAL WEEKLY INCOME (Total of Lines 1 through 7) 9. Minus Weekly COURT ORDERED CHILD SUPPORT for Prior Children - amounts actually paid 10. Minus Weekly LEGAL DUTY CHILD SUPPORT for Prior Children 11. Minus Weekly HEALTH INSURANCE PREMIUMS for Children of This Marriage Only 12. Minus Weekly ALIMONY/SUPPORT/MAINTENANCE Paid to Prior Spouses - amounts actually paid 13. WEEKLY AVAILABLE INCOME (Line 8 less Lines 9 through 12) 14. Weekly WORK RELATED CHILD CARE COSTS for Custodial Parent to work for Children of this Marriage Only 15. Weekly EXTRAORDINARY HEALTHCARE EXPENSES (Children of This Marriage Only - Uninsured Only) 16. Weekly EXTRAORDINARY EDUCATION EXPENSES (Children of This Marriage Only) *** Includes Bonuses; Alimony and Maintenance Received from Prior Marriages; Capital Gains, Trust Income, Gifts, Prizes, In-kind Benefits from Employment such as Company Car, Free Housing, Reimbursed Meals. DO NOT include ADC, SSI, General Assistance, Food Stamps PAGE 1
2 Names and Relationship of all members of household whose expenses are included: MONTHLY EXPENSES AND DEDUCTIONS FROM INCOME 1. FEDERAL INCOME TAXES (weekly deductions times 4.3) 2. STATE INCOME TAXES (weekly deductions times 4.3) 3. LOCAL INCOME TAXES (weekly deductions times 4.3) 4. SOCIAL SECURITY TAXES (weekly deductions time 4.3) 5. RETIREMENT/PENSION FUND [ Mandatory] [ Optional] (Weekly deductions times 4.3) 6. RENT/MORTGAGE PAYMENTS (Residence) 7. RESIDENCE/PROPERTY TAXES/INSURANCE if not included in Mortgage Payment (Total year 12) 8. MAINTENANCE ON RESIDENCE 9. FOOD/HOUSEHOLD SUPPLIES/LAUNDRY/CLEANING 10. ELECTRICITY (Total for year 12) 11. GAS (Total for year 12 or Monthly Budget Amount) 12. WATER/SEWER/SOLID WASTE/TRASH COLLECTION (Total for Year 12) 13. TELEPHONE (including Long Distance Charges) 14. CLOTHING 15. MEDICAL/DENTAL EXPENSES (Not reimbursed by Insurance) 16. AUTOMOBILE - LOAN PAYMENT 17. AUTOMOBILE - GAS/OIL 18. AUTOMOBILE REPAIRS 19. AUTOMOBILE - INSURANCE (Total for year 12) 20. LIFE INSURANCE 21. HEALTH INSURANCE (exclude payments for children shown on Page 1, line 11) 22. DISABILITY/ACCIDENT/OTHER INSURANCE (Please specify) 23. ENTERTAINMENT (Clubs, Social Obligations, Travel, Recreation, Cable Television) 24. CHARITABLE/CHURCH CONTRIBUTIONS 25. PERSONAL EXPENSES (Haircuts, cosmetics, grooming, tobacco, alcohol, etc.) 26. BOOKS/MAGAZINES/NEWSPAPERS 27. EDUCATION/SCHOOL EXPENSES (Self and children you have custody of) PAGE 2
3 28. DAYCARE/WORK RELATED CHILD CARE COSTS (weekly amount times 4.3) 29. OTHER EXPENSES (Please specify) MONTHLY LOAN/CHARGE CARD EXPENSES (Do not include monthly payments shown above) FOR BALANCE Total Monthly Expenses And Deductions From Income (Total of Lines 1 thru 33) Average Weekly Expenses And Deductions (Total monthly expenses 4.3) ASSETS Disclose all assets known to you, even if you do not know the value. Under ownership, H=Husband; W=Wife; J=Joint. Lien amount includes only those debts secured by an item, such as a mortgage against a house, debts shown on title to vehicle, loans against life insurance policies or loans where an item is pledged as collateral. Value assets as of date Petition for Dissolution was filed. Show valuation date here A. HOUSEHOLD FURNISHINGS, FURNITURE, APPLIANCES 1. In possession of Husband 2. In possession of Wife B. AUTOMOBILES, TRUCKS, RECREATIONAL VEHICLES (Include, Make, Model and Year) C. SECURITIES, STOCKS, BONDS, AND STOCK OPTIONS PAGE 3
4 10. D. CASH, CHECKING, SAVINGS, DEPOSIT ACCOUNTS, CD (Include name of Bank/Credit Union and type of acct.) E. REAL ESTATE (including Land Sales Contracts) 13. Marital Residence (Show Address) Basis of Valuation: Name of lender of 1st mortgage: Name of lender of 2nd mortgage: 14. Other (Show Address) Basis of Valuation: Name of lender of 1st mortgage: Name of lender of 2nd mortgage: 15. Other (Show Address) Basis of Valuation: Name of lender of 1st mortgage: Name of lender of 2nd mortgage: F. CASH RETIREMENT ACCOUNTS (IRA's, SEPS, KEOUGHS, 401K) Employee Savings Plans, stock ownership/profit sharing plans, etc.) PAGE 4
5 G. RETIREMENT BENEFITS, DEFERRED COMPENSATION PLANS AND PENSIONS (Include Information available on benefits, whether benefits are vested or in pay status) H. BUSINESS INTERESTS I. LIFE INSURANCE (Show Company Name and death benefit) Term and Group 26. Named Beneficiary: 27. Named Beneficiary: 28. Named Beneficiary: Whole Life and Others (Show Cash value under Gross Value) 29. Named Beneficiary: 30. Named Beneficiary: 31. Named Beneficiary: J. OTHER ASSETS (Include any type of assets having value, including jewelry, personal property, assets located in safety deposit boxes, accrued bonuses, etc.) PAGE 5
6 ASSETS ACQUIRED BY YOU PRIOR TO THE MARRIAGE OR THROUGH INHERITANCE OR GIFT (Whether now owned or not) SHOW SIGNIFICANT ASSETS ONLY VALUATION DATE A. ASSETS OWNED BY YOU PRIOR TO MARRIAGE (Value as of date of marriage) B. ASSETS ACQUIRED BY YOU DURING THE MARRIAGE THROUGH INHERITANCE OR GIFTS (value as of date of acquisition) 3. Acquired from whom: 4. Acquired from whom: 5. Acquired from whom: I declare under penalty of perjury that the foregoing, including any attachments, is true and correct, that this declaration was executed on the day of You are under a duty to supplement or amend this Financial Declaration prior to trial if you learn the information provided is no longer true. PAGE 6
7 CERTIFICATE OF SERVICE I hereby certify that a true, exact and authentic copy of the foregoing, has been served upon either personally or by United States mail, first class postage prepaid, this day of,2015. Jennifer Auger, # Attorney at Law 26 E. Jefferson Street Suite 100 Franklin, IN (317) Jennifer Auger PAGE 7
CAUSE NO: DATED: VERIFIED FINANCIAL DECLARATION OF
STATE OF INDIANA: CIRCUIT COURT: SUPERIOR COURT: MARION COUNTY Petitioner -vs- CAUSE NO: DATED: Respondent VERIFIED FINANCIAL DECLARATION OF Name: Address: Social Security Number: Occupation: Employer:
STATE OF INDIANA: XXX COURT: XXX COUNTY VERIFIED FINANCIAL DECLARATION. Respondent
STATE OF INDIANA: XXX COURT: XXX COUNTY VERIFIED FINANCIAL DECLARATION vs. Petitioner Respondent Cause No. Date: HUSBAND/FATHER NAME: ADDRESS: SSN: OCCUPATION: EMPLOYER: BIRTH DATE: WIFE/MOTHER NAME: ADDRESS:
VERIFIED FINANCIAL DISCLOSURE STATEMENT
VERIFIED FINANCIAL DISCLOSURE STATEMENT This form is required, even if your case is believed to be uncontested, and must be completed, signed and returned to our office within seven (7) days after your
and Financial Disclosure Statement of:
PRINT in BLACK ink Enter the name of the county in which this case is filed. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY For Official Use Enter the name of the petitioner. If joint petitioners, enter the
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
IN THE SUPERIOR COURT OF CLAYTON COUNTY STATE OF GEORGIA vs. Plaintiff,,, Defendant. Civil Action Case Number DOMESTIC RELATIONS FINANCIAL AFFIDAVIT (1) Your Name: Your Age: Spouse s Name: Spouse s Age:
FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM)
IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: Division: and, Petitioner,, Respondent. FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (Under $50,000 Individual Gross Annual
Case No.: Division:, Petitioner,, Respondent. FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (Under $50,000 Individual Gross Annual Income)
IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: Division: and, Petitioner,, Respondent. FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (Under $50,000 Individual Gross Annual
COUNTY SUPERIOR COURT STATE OF GEORGIA DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
COUNTY SUPERIOR COURT STATE OF GEORGIA vs. Plaintiff, Defendant.,, Civil Action Case Number DOMESTIC RELATIONS FINANCIAL AFFIDAVIT (1) Your Name: Your Age: Spouse s Name: Spouse s Age: Date of Marriage:
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
IN THE SUPERIOR COURT OF COUNTY STATE OF GEORGIA vs. Plaintiff, CIVIL ACTION FILE NO. Defendant. DOMESTIC RELATIONS FINANCIAL AFFIDAVIT You are required to make to the Court, under oath, a FULL DISCLOSURE
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT At the time of filing any action for temporary or permanent child support, alimony, equitable division of property, modification of child support or alimony or attorneys
Case No.: Division: FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (Under $50,000 Individual Gross Annual Income)
IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA and, Petitioner,, Respondent. Case No.: Division: FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (Under 50,000 Individual Gross Annual
STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS OF LAKE COUNTY
FINANCIAL DECLARATION FORM STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS OF LAKE COUNTY IN RE THE MARRIAGE OF: CAUSE NO. and Petitioner, Respondent.,, FINANCIAL DECLARATION OF I. PERSONAL INFORMATION HUSBAND*
Financial Disclosure Statement of Plaintiff Defendant
TYPE or PRINT in ink STATE OF MICHIGAN, 44th CIRCUIT COURT Note: File with FOC only! For Official Use Enter the name of the plaintiff. Plaintiff: First name Middle name Last name Enter the name of the
IN THE CHANCERY COURT OF COUNTY, MISSISSIPPI PLAINTIFF CAUSE NO. DEFENDANT FINANCIAL DECLARATION OF NAME: ADDRESS: DATE OF BIRTH:
IN THE CHANCERY COURT OF COUNTY, MISSISSIPPI _, PLAINTIFF VS. _, CAUSE NO. DEFENDANT _ FINANCIAL DECLARATION OF I. GENERAL INFORMATION: NAME: ADDRESS: DATE OF BIRTH: SOCIAL SECURITY NUMBER: OCCUPATION:
UNIFORM SUPERIOR COURT RULE 24.2 DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
UNIFORM SUPERIOR COURT RULE 24.2 DOMESTIC RELATIONS FINANCIAL AFFIDAVIT Except as noted below, at the time of filing any action for temporary or permanent child support, alimony, equitable division of
FINANCIAL DECLARATION OF STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS OF PORTER COUNTY
FINANCIAL DECLARATION FORM STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS OF PORTER COUNTY IN RE THE MARRIAGE OF: Cause Number: Petitioner, And Respondent In accordance with Local Rule 18 of the Porter
EXHIBIT A IN THE CHANCERY COURT OF COUNTY STATE OF MISSISSIPPI
EXHIBIT A IN THE CHANCERY COURT OF COUNTY STATE OF MISSISSIPPI PLAINTIFF VS. CIVIL ACTION NUMBER DEFENDANT ************************************************************************ I. GENERAL INFORMATION:
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULE OF PROCEDURE FORM (c), FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM)(09/12) Instructions
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULE OF PROCEDURE FORM 12.902(c), FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM)(09/12) Instructions YOU DO NOT NEED TO FILL OUT THIS FORM IF YOU WORK WITH DIVORCE AND MEDIATION
In the Iowa District Court for County where your case is filed
Rule 17.200 Form 224: Financial Affidavit for a Dissolution of Marriage with Children Each party must complete one of these forms. Provide as much information as you can. Caution: This form may require
IN THE SUPERIOR COURT OF CHEROKEE COUNTY STATE OF GEORGIA DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
IN THE SUPERIOR COURT OF CHEROKEE COUNTY STATE OF GEORGIA, ) ) Plaintiff, ) ) CIVIL ACTION FILE NO. vs. ) ), ) ) Defendant. ) DOMESTIC RELATIONS FINANCIAL AFFIDAVIT 1. AFFIANT S NAME Age Spouse s Name
IN THE SUPERIOR COURT OF FLOYD COUNTY, STATE OF GEORGIA
IN THE SUPERIOR COURT OF FLOYD COUNTY, STATE OF GEORGIA _, ) Plaintiff / Petitioner, ) ) CIVIL ACTION FILE v. ) ) No., ) Defendant / Respondent. ) ) DOMESTIC RELATIONS FINANCIAL AFFIDAVIT 1. AFFIANT S
In the Superior Court of County, Georgia. ), Petitioner ) ) vs. ) Civil Action No. ), Respondent ) ) DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
In the Superior Court of County, Georgia, Petitioner vs. Civil Action No., Respondent DOMESTIC RELATIONS FINANCIAL AFFIDAVIT 1. AFFIANT S NAME (your name: Age Spouse s Name: _ Age Date of Marriage: Date
IN THE SUPERIOR COURT OF HOUSTON COUNTY, GEORGIA DOMESTIC RELATIONS FINANCIAL AFFIDAVIT OF PLAINTIFF. 1. AFFIANT S NAME: Age.
IN THE SUPERIOR COURT OF HOUSTON COUNTY, GEORGIA, Plaintiff vs. Civil Action No., Defendant DOMESTIC RELATIONS FINANCIAL AFFIDAVIT OF PLAINTIFF 1. AFFIANT S NAME: Age Spouse s Name: Age Date of Marriage:
IN THE SUPERIOR COURT OF STATE OF GEORGIA., Plaintiff, v., CIVIL ACTION Defendant. FILE NO. DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
IN THE SUPERIOR COURT OF STATE OF GEORGIA COUNTY, Plaintiff, v., CIVIL ACTION Defendant. FILE NO. DOMESTIC RELATIONS FINANCIAL AFFIDAVIT 1. AFFIANT S NAME: Ag e Spouse s Name: Ag e Date of Marriage: Date
24.2. Financial data required; scheduling and notice of temporary hearing.
24.2. Financial data required; scheduling and notice of temporary hearing. At the time of filing any action for temporary or permanent child support, alimony, equitable division of property, modification
FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM)
IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA, Petitioner, Case No.: Division: and, Respondent. FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM) ($50,000 or more Individual Gross Annual
JUDICIAL CIRCUIT, IN AND FOR Sarasota COUNTY, FLORIDA. Petitioner,
IN THE CIRCUIT COURT OF THE Twelfth JUDICIAL CIRCUIT, IN AND FOR Sarasota COUNTY, FLORIDA Harold J Jones and Petitioner, Case No.: 07-32323 Division: II Marianne P Jones Respondent. FAMILY LAW FINANCIAL
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT. 1. AFFIANT S NAME: Age Spouse s Name: Dates of Marriage: Date of Separation:
In the Superior Court of County, Georgia, Plaintiff vs. Civil Action No., Defendant DOMESTIC RELATIONS FINANCIAL AFFIDAVIT 1. AFFIANT S NAME: Age Spouse s Name: Age Dates of Marriage: Date of Separation:
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT - DIVORCE. Date of Separation:
IN THE SUPERIOR COURT OF COUNTY Plaintiff, vs. Defendant. Civil Action No. DOMESTIC RELATIONS FINANCIAL AFFIDAVIT - DIVORCE 1. AFFIANT'S NAME: Spouse s Name: Age: Age: Date of Marriage: Date of Separation:
DRESSLER & DRESSLER Attorneys at Law 110 Dixie Lane Cocoa Beach, FL (321)
DRESSLER & DRESSLER Attorneys at Law 110 Dixie Lane Cocoa Beach, FL 3231 (321) 783-2714 INSTRUCTIONS FOR FLORIDA FAMILY LAW FINANCIAL AFFIDAVIT FAMILY LAW RULES OF PROCEDURE FORM 12.02(c) (LONG FORM -
FINANCIAL STATEMENT (Long Form)
Division Commonwealth of Massachusetts The Trial Court Probate and Family Court Department FINANCIAL STATEMENT (Long Form) INSTRUCTIONS: If your income is less than 75,000.00 annually, you must complete
IN THE CHANCERY COURT OF JACKSON COUNTY, MISSISSIPPI PLAINTIFF DEFENDANT RULE 8.05 FINANCIAL STATEMENT I.GENERAL INFORMTION NAME: ADDRESS:
IN THE CHANCERY COURT OF JACKSON COUNTY, MISSISSIPPI VERSUS PLAINTIFF CAUSE NO: DEFENDANT RULE 8.05 FINANCIAL STATEMENT I.GENERAL INFORMTION NAME: ADDRESS: CITY, STATE AND ZIP CODE: DATE OF BIRTH: SOCIAL
FAMILY LAW FINANCIAL AFFIDAVIT
IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA, Petitioner, Case No.: Division: and, Respondent. FAMILY LAW FINANCIAL AFFIDAVIT ($50,000 or more Individual Gross Annual Income)
STATE OF WISCONSIN CIRCUIT COURT COUNTY. Case No. Name. Birthdate Age Birthdate Age Employer. Employer
STATE OF WISCONSIN CIRCUIT COURT COUNTY In re the marriage of: (Petitioner s name), -and- (Respondent s name), Petitioner Respondent Case No. (Ptnr s) (Resp s) FINANCIAL DISCLOSURE STATEMENT Name Address
DISSOLUTION OF MARRIAGE: FINANCIAL DECLARATION FORM STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS OF LAKE COUNTY
DISSOLUTION OF MARRIAGE: FINANCIAL DECLARATION FORM STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS OF LAKE COUNTY In Re: The Marriage / Matter of: Case No. (Select: Mother, Father, Wife, Husband) and (Select:
State of Georgia., Plaintiff., Defendant AFFIDAVIT AND MOTION TO PROCEED IN FORMA PAUPERIS
In the Superior Court of State of Georgia County, Georgia vs., Plaintiff, Defendant Civil Action File No. AFFIDAVIT AND MOTION TO PROCEED IN FORMA PAUPERIS I,, the undersigned, having been duly sworn,
Commonwealth of Massachusetts
Plaintiff / Petitioner Division Commonwealth of Massachusetts The Trial Court Probate and Family Court Department FINANCIAL STATEMENT (LONG FORM) v. Defendant / Petitioner INSTRUCTIONS: This financial
In the Superior Court of County, Georgia. 1. AFFIANT S NAME: Age. Spouse s Name:
In the Superior Court of County, Georgia, Plaintiff vs. Civil Action No., Defendant TIC FINANCIAL RELATIONS AFFIDAVIT FINANCIAL AFFIDAVIT 1. AFFIANT S NAME: Age Spouse s Name: Age Names and birth dates
MONTANA TWENTY-FIRST JUDICIAL DISTRICT COURT RAVALLI COUNTY
Name Address City State Zip Code Phone Number FORM #17a MONTANA TWENTY-FIRST JUDICIAL DISTRICT COURT RAVALLI COUNTY In re the Marriage of:, Co-Petitioner, and, Co-Petitioner. Cause No.: Department No.:
ALL COUNTS CONFERENCE INCOME AND EXPENSE STATEMENT. You must provide your recent tax return and W-2 form at the time of your All Counts Conference.
ALL COUNTS CONFERENCE INCOME AND EXPENSE STATEMENT You must provide your recent tax return and W-2 form at the time of your All Counts Conference. Name Address Telephone Date Social Security Income Employer
Form CAFC040 - Property and Debt Statement and Proposed
Form CAFC040 - Property and Debt Statement and Proposed Separation Agreement (For use in Dissolution of Marriage Cases) In what Missouri county will this case be filed? In the Circuit Court of MISSOURI
IN THE COMMON PLEAS COURT OF SUMMIT COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS
IN THE COMMON PLEAS COURT OF SUMMIT COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS Plaintiff Address CASE NO. SETS NO. Marital Residence Attorney Yes No Phone: JUDGE MAGISTRATE Atty Address Atty Phone vs.
Commonwealth of Massachusetts The Trial Court Probate and Family Court Department. FINANCIAL STATEMENT (LONG FORM) v.
Plaintiff / Petitioner I. PERSONAL INFORMATION Division Commonwealth of Massachusetts The Trial Court Probate and Family Court Department FINANCIAL STATEMENT (LONG FORM) v. Docket No. Defendant / Petitioner
Uniform Support Affidavit Instructions for Form 6F
Uniform Support Affidavit Instructions for Form 6F The Uniform Support Affidavit must be completed when the payment of child support is an issue. It provides basic information about expenses and ability
FINANCIAL STATEMENT (Long Form)
INSTRUCTIONS: If your income is less than 75,000.00 annually, you must complete the SHORT FORM financial statement, unless otherwise ordered by the court. I. Plaintiff/Petitioner PERSONAL INFORMATION vs.
POST-DISSOLUTION DECREE FINANCIAL DECLARATION FORM
POST-DISSOLUTION DECREE FINANCIAL DECLARATION FORM STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS OF PORTER COUNTY In accordance with Local Rule 2200.1 of the Porter Superior Court and Indiana Trial Rules
In the Superior Court of County, Georgia. In re (Child(ren)): ) ) ), Petitioner ) ) vs. ) Civil Action No. ), Respondent ) )
In the Superior Court of County, Georgia In re (Child(ren:, Petitioner vs. Civil Action No., Respondent DOMESTIC RELATIONS FINANCIAL AFFIDAVIT 1. AFFIANT S NAME (your name: Age Opposing Party s Name: _
SUPERIOR COURT OF CALIFORNIA COUNTY OF ORANGE SELF-HELP CENTER
SUPERIOR COURT OF CALIFORNIA COUNTY OF ORANGE SELF-HELP CENTER www.occourts.org/self-help DISSOLUTION, LEGAL SEPARATION OR NULLITY OF MARRIAGE STEP 3: DECLARATION OF DISCLOSURE All documents must be typed
DISCLOSURE STATEMENT (Pursuant to Rule )
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT - DOMESTIC RELATIONS DIVISION IN RE The Marriage Custody Parentage Support of: [ ] Petitioner / [ ] Counter-Respondent, -vs- [ ] Respondent
Motion for Modification of Child Support Order
Petitioner vs Respondent Case Number Motion for Modification of Child Support Order Failure to provide the Petitioner s, Respondent s, and Attorney s complete information WILL delay the filing of this
ANDERSON ELDER LAW ELDER LAW ESTATE PLANNING SPECIAL NEEDS PLANNING LONG-TERM CARE PLANNING QUESTIONNAIRE (COUPLE)
ANDERSON ELDER LAW ELDER LAW ESTATE PLANNING SPECIAL NEEDS PLANNING LONG-TERM CARE PLANNING QUESTIONNAIRE (COUPLE) This form is extremely important. Your accuracy and completeness in responding will help
FORM 6 OPENING DISCOVERY INTERROGATORIES IN THE CIRCUIT COURT OF COLE COUNTY, MISSOURI
FORM 6 OPENING DISCOVERY INTERROGATORIES IN THE CIRCUIT COURT OF COLE COUNTY, MISSOURI In re: the Marriage of ), and ) ) ), ) ) Petitioner, ) Case No. ) v. ) ), ) ) Respondent. ) OPENING INTERROGATORIES
The Wise Wealth Planning Workshop Questionnaire
The Wise Wealth Planning Workshop Questionnaire The Wise Wealth Planning Program Instructions After completion of form, click the submit button to e-mail data to Savant or print off a copy and mail it
SWORN FINANCIAL STATEMENT
District Court Denver Juvenile Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petitioner: and Co-Petitioner/Respondent: Attorney
IN THE CIRCUIT COURT FOR THE SECOND JUDICIAL CIRCUIT COUNTY, ILLINOIS. Pre-Judgment Post-Judgment I. INTRODUCTION
IN THE CIRCUIT COURT FOR THE SECOND JUDICIAL CIRCUIT COUNTY, ILLINOIS IN RE THE MARRIAGE OF: ) ), ) ) Petitioner, ) and ) No. ), ) ) Respondent. ) FINANCIAL AFFIDAVIT Pre-Judgment Post-Judgment I. INTRODUCTION
STANDARD FAMILY LAW INTERROGATORIES FOR
STANDARD FAMILY LAW INTERROGATORIES FOR The answers to the following questions are intended to supplement the information provided in the Financial Affidavits, Florida Family Law Rules of Procedure Form
David E. Bolger, Attorney at Law
WORKSHEET GUIDELINES David E. Bolger, Attorney at Law 506 Wilkesboro Blvd. Ste 230 Lenoir, NC 28645 Phone: 828-757-2800 Fax: 828-757-0502 Visit our website at www.davebolgerlaw.com Please print clearly
In the District Court of County, Utah. Court Address
My Name This is a private record. Address City, State, Zip Phone Email I am the In the District Court of County, Utah Court Address Financial Declaration v. Case Number Judge Commissioner Instructions:
CHRISTOPHER J. TAMMS 5 West Main Street Westerville, Ohio Phone: (614) Fax: (614)
CHRISTOPHER J. TAMMS 5 West Main Street Westerville, Ohio 43081 Phone: (614) 859-9529 Fax: (614) 567-0031 chris.tamms@gmail.com www.tammslaw.com CLIENT INFORMATION- Full Legal Addresses where you lived
VERIFIED PERSONAL FINANCIAL STATEMENT
VERIFIED PERSONAL FINANCIAL STATEMENT EACH PARTY MUST PROVIDE THE OTHER WITH A COMPLETED COPY OF THIS VERIFIED PERSONAL FINANCIAL STATEMENT WITHIN TWENTY ONE (21) DAYS AFTER DEFENDANT FILES THIS FIRST
Case Information Statement - Client Intake Form.
Case Information ment - If you have a question about this form, please contact your attorney's office. PART A - CASE INFORMATION Your Attorney s Information Attorney's Name Address DeTorres & DeGeorge,
Total Monthly Income $ Miscellaneous Income Royalties, Trusts, and Other Investments $ Contributions from Others $ Dependent Children s monthly gross
District Court Denver Juvenile Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petitioner: and Co-Petitioner/Respondent: Attorney
ESTATE PLANNING INFORMATION FORM
ESTATE PLANNING INFORMATION FORM Please complete this form to the best of your ability. Date: Please bring copies of previous estate planning documents (Will, Trust, Advance Directive, Power of Attorney,
CLIENT QUESTIONNAIRE
15333 North Pima Road # 130 Scottsdale, AZ 85260 Office 480.478.0709 Fax 480.478.0787 www.scottsdalelawgroup.com Martin McCue Christina Mertz mmccue@scottsdalelawgroup.com cmertz@scottsdalelawgroup.com
IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT IN AND FOR PINELLAS COUNTY, STATE OF FLORIDA FAMILY LAW DIVISION CASE NO.
In Re: The Marriage Of IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT IN AND FOR PINELLAS COUNTY, STATE OF FLORIDA FAMILY LAW DIVISION CASE NO. and Petitioner,, Respondent. / STANDARD FAMILY LAW INTERROGATORIES
IN THE COMMOM PLEAS COURT OF SUMMIT COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS. CASE NO. Petitioner (1) SETS NO. JUDGE
IN THE COMMOM PLEAS COURT OF SUMMIT COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS CASE NO. Petitioner (1) SETS NO. Address: JUDGE Attorney MAGISTRATE Attorney Address Attorney telephone V. Petitioner (2)
FINANCIAL DISCLOSURE AFFIDAVIT, 2015
FINANCIAL DISCLOSURE AFFIDAVIT OF, 2015 1 STATE OF NEW YORK SUPREME COURT : COUNTY OF ERIE, vs., Plaintiff, Defendant. FINANCIAL DISCLOSURE AFFIDAVIT (DRL Section 236) Index No: SF, the Plaintiff/Defendant
IN THE SUPERIOR COURT OF COBB COUNTY STATE OF GEORGIA DOMESTIC RELATIONS FINANCIAL AFFIDAVIT. (1) Your Name: Your Age:
IN THE SUPERIOR COURT OF COBB COUNTY STATE OF GEORGIA Petitioner: and Civil Action File No.: Respondent: DOMESTIC RELATIONS FINANCIAL AFFIDAVIT (1) Your Name: Your Age: Spouse s Name: Spouse s Age: Date
STATE OF MAINE. v. PLAINTIFF S DEFENDANT S FINANCIAL STATEMENT [M.R. CIV P. 80 (c)], Defendant
![STATE OF MAINE. v. PLAINTIFF S DEFENDANT S FINANCIAL STATEMENT [M.R. CIV P. 80 (c)], Defendant](/thumbs/85/91941724.jpg "STATE OF MAINE. v. PLAINTIFF S DEFENDANT S FINANCIAL STATEMENT [M.R. CIV P. 80 (c)], Defendant")
STATE OF MAINE SUPERIOR COURT county, ss. CV- DISTRICT COURT DIVISION OF LOCATION DOCKET NO., Plaintiff v. PLAINTIFF S DEFENDANT S FINANCIAL STATEMENT [M.R. CIV P. 80 (c)], Defendant INSTRUCTIONS This
INTAKE FORM FOR DIVORCE CASE WITHOUT CHILDREN
DATE: INTAKE FORM FOR DIVORCE CASE WITHOUT CHILDREN The information requested in this form is all required by the court and/or the Kansas Department of Vital Statistics. Please answer all questions as
Case No.: Division: FAMILY LAW FINANCIAL AFFIDAVIT ($50,000 or more Individual Gross Annual Income)
IN THE IRUIT OURT OF THE IN AND FOR, Petitioner, ase No.: Division: JUDIIAL IRUIT, OUNTY, FLORIDA and, Respondent. FAMILY LAW FINANIAL AFFIDAVIT ($50,000 or more Individual Gross Annual Income) I, {full
IN THE FRANKLIN COUNTY COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS AND JUVENILE BRANCH. Case No. Judge. Magistrate
IN THE FRANKLIN COUNTY COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS AND JUVENILE BRANCH Plaintiff/Petitioner v./and Case No. Judge Magistrate Respondent/Petitioner Instructions: This affidavit
BROWN, TARLOW, BRIDGES & PALMER, P.C.
BROWN, TARLOW, BRIDGES & PALMER, P.C. DISSOLUTION CLIENT INFORMATION SHEET (Please answer all questions on all pages) Husband's Name: (Father s name, if unmarried) Address: Employer's Name: Employer's
APPLICATION FOR FINANCIAL ASSISTANCE / SCHOOL YEAR
APPLICATION FOR FINANCIAL ASSISTANCE 2016-2017 / 5776-5777 SCHOOL YEAR MECHINA HIGH SCHOOL and the CENTER FOR THE ADVANCEMENT OF JEWISH EDUCATION APPLICATION FOR FINANCIAL ASSISTANCE 2016-2017 / 5776-5777
CLIENT QUESTIONNAIRE FOR 2017
CLIENT QUESTIONNAIRE FOR 2017 Thank you very much for calling our office for legal assistance relating to your debt problems. Please fill out this form as completely as possible so we can provide you with
FINANCIAL INFORMATION CHECK LIST o Real estate information: Address, purchase price and date purchased (Final HUD settlement form) Copies of Final HUD
Client Data Organizer Celia Griffin, CPA, CDFA Celia Griffin, CPA, PLLC 19125 North Creek Parkway, Suite 120, Bothell, WA 98011 Phone (425) 954-8500 Fax (425) 954-8500 Email: celia@celiagriffincpa.com
Married? Husband's name Wife's name Mailing Address:
DATE COMPLETED: Date of Birth U.S. Citizen? Married? Husband's name Wife's name Mailing Address: email address Date and place of marriage Children Child's Date of Birth Married? Grandchildren Parent Grandchild's
INITIAL INTERVIEW QUESTIONNAIRE (BANKRUPTCY)
DATE: MACHI & ASSOCIATES, P.C. 1521 N. Cooper, Suite 550 990 N. Walnut Creek, Suite 2016 Arlington, Texas 76011 Mansfield, Texas 76063 Local 817-335-8880 Metro 972-445-5387 Toll Free 866-DEBTDRS (866-332-8377)
P. J. FRANKLIN ATTORNEY AT LAW
P. J. FRANKLIN ATTORNEY AT LAW 7322 S. W. FREEWAY STE. 700 HOUSTON, TX 77074 Telephone: (713) 414-3066 Fax: (713) 414-3067 E-Mail: pjf@pjfranklin.com Website:www.pjfranklin.com BANKRUPTCY QUESTIONAIRE
GAITA & LISZT, P.L. -A Professional Law Practice- Bankruptcy Document Checklist
GAITA & LISZT, P.L. -A Professional Law Practice- Bankruptcy Document Checklist The following documents will be required to complete your bankruptcy petition. You only need to provide the documents that
ESTATE PLANNING INFORMATION QUESTIONNAIRE (SINGLE PERSON)
ESTATE PLANNING INFORMATION QUESTIONNAIRE (SINGLE PERSON) Date: 1. Personal Information: Full Name: Social Security #: Date of Birth: Place of Birth: Address: Home Phone: Work Phone: Cell Phone: Facsimile:
Financial Data Entry Sheet for Net Worth Statement
Financial Data Entry Sheet for Net Worth Statement Your name: Spouse s name: I. FAMILY DATA Your birth date: Spouse s birth date: Spouse s place of birth: Spouse s Social Security number: Date married:
NEWARK-FREMONT LEGAL CENTER BANKRUPTCY WORKSHEET
NEWARK-FREMONT LEGAL CENTER BANKRUPTCY WORKSHEET Complete the form below and then call our office for an appointment. 794-LAWS Please Print Clearly! DEBTOR JOINT DEBTOR Full Name Street Address Mailing
PERSONAL FINANCIAL STATEMENT for National Equity Funding. Federal law requires all financial institutions obtain,
PERSONAL FINANCIAL STATEMENT for National Equity Funding Federal law requires all financial institutions obtain, verify and record information that identifies each person who opens an account. When you
IN THE SUPREME COURT OF FLORIDA IN RE: AMENDMENTS TO THE FLORIDA FAMILY LAW RULES OF PROCEDURE, CASE NO. SC
The Florida Supreme Court adopted amendments to the Florida Family Law Rules proposed by the Florida Bar s Family Law Rules Committee (committee) to implement 2008 legislative changes to equitable distribution.
, ) ) Civil No: Plaintiff, ) ) RULE 8.3, N.D.R.CT., vs. ) PRETRIAL CONFERENCE ) STATEMENT, ) ) Defendant. ) Full Name. Present Mailing Address
STATE OF NORTH DAKOTA COUNTY OF IN DISTRICT COURT JUDICIAL DISTRICT, ) ) Civil No: Plaintiff, ) ) RULE 8.3, N.D.R.CT., vs. ) PRETRIAL CONFERENCE ) STATEMENT, ) ) Defendant. ) 1. PERSONAL INFORMATION Full
CHECKLIST OF FORMS TO BE COMPLETED
Fairfield County Court of Common Pleas Domestic Relations Division CONTEMPT CHECKLIST OF FORMS TO BE COMPLETED Forms to be completed by the requesting party, unless otherwise specified: 1. Motion and Affidavit
IN THE SUPERIOR COURT OF COUNTY STATE OF GEORGIA., ) ) Petitioner, ) ) Civil Action File No. vs. ) ), ) ) Respondent. ) ) ANSWERS TO INTERROGATORIES
IN THE SUPERIOR COURT OF COUNTY STATE OF GEORGIA, Petitioner, Civil Action File No vs, Respondent ANSWERS TO INTERROGATORIES No later than thirty (30 days from the filing of the Complaint, each party is
Is your home(s) in foreclosure? Yes No If yes, what is the scheduled foreclosure sale date? Full Name: Age: Address: City/Zip Code: County:
8900 E. 13 Mile Rd., Warren, MI 48093 Attorneys and Counselors: 26200 Lahser Road, Suite 330, Southfield, MI 48033 William D. Johnson 23400 Michigan Ave, Suite 715, Dearborn, MI 48124 Christopher W. Jones
Budgets and Cash Flows
Select Portfolio Management, Inc 26800 Aliso Viejo Parkway Suite 150 Aliso Viejo, CA 92656 949-975-7900 800-445-9822 info@selectportfolio.com www.selectportfolio.com Budgets and Cash Flows Page 1 of 9,
STATE OF ILLINOIS UNITED STATES OF AMERICA COUNTY OF DUPAGE COUNTY IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT
IN RE THE MARRIAGE OF: ) ) Harold J Jones ) CASE NUMBER PETITIONER ) -VS- ) 44-32323 ) Marianne P Jones ) RESPONDENT ) COMPREHENSIVE FINANCIAL STATEMENT PURSUANT TO LOCAL COURT RULE 15.01.3 INSTRUCTIONS
IN THE SUPERIOR COURT OF FULTON COUNTY STATE OF GEORGIA FAMILY DIVISION., ) ) Petitioner, ) ) Civil Action File No. and ) ), ) ) Respondent.
IN THE SUPERIOR COURT OF FULTON COUNTY FAMILY DIVISION, Petitioner, Civil Action File No. and, Respondent. REQUIRED DOCUMENTS TO BE PRODUCED No later than thirty (30 days from the filing of the Complaint,
CLIENT PROFILE DAN A. COLLINS CERTIFIED SPECIALIST - ESTATE PLANNING AND PROBATE LAW ADMITTED IN SOUTH CAROLINA AND NORTH CAROLINA JULIE M.
CLIENT PROFILE DAN A. COLLINS CERTIFIED SPECIALIST - ESTATE PLANNING AND PROBATE LAW ADMITTED IN SOUTH CAROLINA AND NORTH CAROLINA JULIE M. COLLINS ADMITTED IN SOUTH CAROLINA AND NORTH CAROLINA 17A CALEDON
FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM)
ENTER YOUR OWN HEADER LINE IN THIS SPACE IN THE CIRCUIT COURT OF THE FIRST JUDICIAL CIRCUIT, IN AND FOR ESCAMBIA COUNTY, FLORIDA Paul A. Sample, Petitioner, and Case No: FA-2012-489 Division: Family Martha
DR-502 Page 1 of 7 Rev 4/18
COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION CLERMONT COUNTY, OHIO Plaintiff Case Number: vs. Defendant Instructions: Check local court rules to determine when this form must be filed. List ALL OF
Failure to accurately complete the form may result in denial of your request.
The San Fernando Valley Bar Association Mandatory Fee Arbitration Committee accepts client petitions for arbitration of disputes involving attorney fees without regard to a petitioner s ability to pay.
In The First Judicial District Court of the State of Nevada In and for Carson City
Name: Address: Phone: Email: In The First Judicial District Court of the State of Nevada In and for Carson City, Plaintiff, vs., Defendant. / Case No. 1B Dept. No. GENERAL FINANCIAL DISCLOSURE FORM You
Domestic Relations Affidavit
Domestic Relations Affidavit IN THE JUDICIAL DISTRICT COUNTY, KANSAS IN THE MATTER OF and Case No. DOMESTIC RELATIONS AFFIDAVIT OF (name 1. Residence XXX-XX- Birth Month/Year Social Security Number Telephone
STANDARD INTERROGATORIES FOR ORIGINAL OR ENFORCEMENT PROCEEDINGS
STANDARD INTERROGATORIES FOR ORIGINAL OR ENFORCEMENT PROCEEDINGS 1. BACKGROUND INFORMATION: a. State your full legal name and any other name by which you have been known. b. State your present residence
Anderson Elder Law. Elder Law Estate Planning Special Needs Planning LONG-TERM CARE PLANNING QUESTIONNAIRE (COUPLE)
Anderson Elder Law Elder Law Estate Planning Special Needs Planning LONG-TERM CARE PLANNING QUESTIONNAIRE (COUPLE) This form is extremely important. Your accuracy and completeness in responding will help