Commonwealth of Massachusetts
|
|
|
- Curtis Dorsey
- 6 years ago
- Views:
Transcription
1 Plaintiff / Petitioner Division Commonwealth of Massachusetts The Trial Court Probate and Family Court Department FINANCIAL STATEMENT (LONG FORM) v. Defendant / Petitioner INSTRUCTIONS: This financial statement should be completed if your income equals or exceeds 75, or if ordered by the court. All items on both sides of this form must be addressed either with the appropriate amount or the word "none" inserted for items that are not applicable to your personal situation. Additional sheets may be attached to supplement any item. You must complete and attach Schedule A if you are self-employed or have other business income, and/or Schedule B if you own rental property. I. PERSONAL INFORMATION Your name Social Security Number Address (street address) (city or town) (state) (zip code) Telephone Number Date of Birth Age Occupation Employer Employer's Address Employer's Telephone No. (street address) (city or town) (state) (zip code) Do you have health insurance? If yes, name of insurance provider Do you have any natural, adopted, stepchild(ren), foster child(ren) or child(ren) of partners who are living in your household half time or more? Yes If so, how many child(ren)? II. GROSS WEEKLY INCOME / RECEIPTS FROM ALL SOURCES (strike inapplicable words) a) Base pay, salary, wages b) Overtime c) Part-time job d) Self-employment (attach a completed Schedule A) e) Tips f) Commissions - Bonuses g) Dividends - interest h) Income from trusts and annuities i) Pension and retirement funds j) Social Security k) Disability, unemployment or worker's compensation l) Public Assistance m) Child Support - Alimony (actually received) n) Rental income (attach completed Schedule B) o) Royalties and other rights p) Contributions from household member(s) q) Other (specify) Total ADDITIONAL weekly income/receipts from schedule, if any TOTAL GROSS WEEKLY INCOME / RECEIPTS (Add items a-q) CJ-D 301-L (11/97) Page 1 TurboLaw (800) c.g.f.
2 III. WEEKLY DEDUCTIONS FROM GROSS INCOME TAX WITHHOLDING a) Federal tax withholding / estimated payments Number of withholding allowances claimed b) State tax withholding / estimated payments Number of withholding allowances claimed OTHER DEDUCTIONS c) F.I.C.A. d) Medicare e) Medical Insurance f) Union Dues g) Child Support h) Spousal Support i) Retirement j) Savings k) Deferred Compensation l) Credit Union (Loan) m) Credit Union (Savings) n) Charitable Contributions o) Life Insurance p) Other (specify) q) Other (specify) r) Other (specify) Total ADDITIONAL weekly deductions, from schedule, if any TOTAL WEEKLY DEDUCTIONS FROM PAY (Add items a-r) IV. NET WEEKLY INCOME a) Enter total gross weekly income / receipts b) Enter total weekly deductions from pay NET WEEKLY INCOME (Subtract IV.(b) from IV.(a)) V. GROSS INCOME FROM PRIOR YEAR (attach copy of all W-2 and 1099 forms for prior year and Schedule A, if self-employed) Number of years you have paid into Social Security VI. COUNSEL FEES Retainer amount(s) paid to your attorney(s) Legal fees incurred, to date, against the retainer(s) Anticipated range of total legal expense to prosecute this action 0.00 to Page 2
3 VII. WEEKLY EXPENSES NOT DEDUCTED FROM PAY INSTRUCTIONS: All expense figures must be listed by their WEEKLY total. DO NOT list expenses by their MONTHLY total. In order to compute the weekly expense, divide the monthly expense by 4.3. For example, if your rent is per month, divide 500 by 4.3. This will give you a weekly expense of Do not duplicate weekly expenses. Strike inapplicable words. Rent Mortgage (P & I, Taxes / Insurance, if escrowed) Property taxes and assessment Homeowner's Insurance Tenant's Insurance Maintenance Fees - Condominium Fees Maintenance / Repairs Heat (Type:) Electricity Propane / Natural Gas Telephone Water / Sewer Food House Supplies Laundry Dry cleaning Clothing Life insurance Medical insurance Uninsured medical - dental expenses Incidentals / toiletries Motor vehicle expenses Fuel Insurance Maintenance Loan payment(s) Entertainment Vacation Cable TV Child Support (attach a copy of the order, if issued by a different court) Child(ren)'s Day Care Expense Child(ren)'s Education Education (self) Employment related expenses (which are not reimbursed) Uniforms Travel Required continuing education Other (specify) Lottery tickets Charitable contributions / Church giving Child(ren)'s allowance Extraordinary travel expenses for visitation with child(ren) Other (specify) Other (specify) Other (specify) Total ADDITIONAL weekly expenses from schedule, if any TOTAL WEEKLY EXPENSES NOT DEDUCTED FROM PAY Page 3
4 VIII. ASSETS B. INSTRUCTIONS: List all assets including, but not limited to the following. If additional space is needed for any answer or to disclose additional assets an attached sheet may be filled. A. REAL ESTATE Real Estate -- Primary Residence Address Title held (city or town) (state) (zip) Outstanding 1st mortgage Outstanding 2nd mortgage or home equity loan Equity Purchase Price of the Property Current Assessed Value of the Property Date of Last Assessment Fair Market Value of the Property Real Estate -- Vacation or Second Home (including interest in time share) Address Title held (street address) (street address) (city or town) (state) (zip) Outstanding 1st mortgage Outstanding 2nd mortgage or home equity loan Equity Purchase Price of the Property Current Assessed Value of the Property Date of Last Assessment Fair Market Value of the Property Total ADDITIONAL real estate from schedule, if any MOTOR VEHICLES, including cars, trucks, ATVs, snowmobiles, tractors, motorcycles, boats, recreational vehicles, aircraft, farm machinery, etc. Type Make Model Purchase Price of Vehicle Fair Market Value Outstanding Loan Equity Type Make Model Purchase Price of Vehicle Fair Market Value Outstanding Loan Equity Total ADDITIONAL vehicles from schedule, if any Page 4
5 VIII. ASSETS CONTINUED C. PENSIONS Institution Account Number Listed Beneficiary Current Balance / Value Defined Benefit Plan Defined Contribution Plan D. OTHER ASSETS. List assets which are held individually, jointly, in the name of another person for your benefit, or held by you for the benefit of your minor child(ren). (List particulars as indicated, e.g., institution/plan name(s) and account number(s), named beneficiaries and current balances, if applicable.) Checking Account(s) Institution Account Number Listed Beneficiary Current Balance Savings Accounts(s) Cash on Hand Certificate(s) of Deposit Credit Union Account(s) Funds Held in Escrow Stocks Bonds Bond Fund(s) Notes Held Cash in Brokerage Account(s) Money Market Account(s) Page 5
6 Institution Account Number Listed Beneficiary Current Balance U.S. Savings Bond(s) IRAs Keough Profit Sharing Deferred Compensation Other Retirement Plans Annuity (please specify whether a tax deferred annuity or tax sheltered annuity). Life Insurance Cash Value (please specify whether a term or a whole/universal life insurance policy). Judgments/Liens Pending Legacies and/or Inheritances Jewelry Contents of Safe or Safe Deposit Box Firearms Collections Tools/Equipment Crops/Livestock Home Furnishings (value) Art and Antiques Other (specify) Other (specify) Total ADDITIONAL pensions and other assets from schedule, if any TOTAL ASSETS Page 6
7 XI. LIABILITIES (List loans, credit card debt, consumer debt, installment debt, etc., which are not listed elsewhere) INSTRUCTIONS: All payment figures must be listed by their WEEKLY amount. DO NOT list payments by their MONTHLY amount. In order to compute the weekly payment, divide the monthly payment by 4.3. For example, if your credit card liability is per month, divide 500 by 4.3. This will give you a weekly payment of CREDITOR KIND OF DEBT DATE INCURRED AMOUNT DUE WEEKLY PAYMENT Total ADDITIONAL other liabilities from schedule, if any TOTALS Page 7
8 CERTIFICATION BY AFFIANT I certify under the penalties of perjury that the information stated on this Financial Statement and the attached Schedules, if any, is complete, true and accurate. I UNDERSTAND THAT WILLFUL MISREPRESENTATION OF ANY OF THE INFORMATION PROVIDED WILL SUBJECT ME TO SANCTIONS AND MAY RESULT IN CRIMINAL CHARGES BEING FILED AGAINST ME. Date Signature COMMONWEALTH OF MASSACHUSETTS County of Then personally appeared the above and declared the foregoing to be true and correct, before me this day of Notary Public My Commission Expires: INSTRUCTIONS: In any case where an attorney is appearing for a party, said attorney MUST complete the Statement by Attorney. STATEMENT BY ATTORNEY I, the undersigned attorney, am admitted to practice law in the Commonwealth of Massachusetts -- am admitted pro hoc vice for the purposes of this case -- and am an officer of the court. As the attorney for the party on whose behalf this Financial Statement is submitted, I hereby state to the court that I have no knowledge that any of the information contained herein is false. Date Signature Name of Attorney Address Please Print Tel. No. BBO # Page 8
9 ADDITIONAL GROSS WEEKLY INCOME / RECEIPTS- LONG FORM (Part II., continued) Name: II. GROSS WEEKLY INCOME / RECEIPTS FROM ALL SOURCES (continued) SOURCE a. b. c. d. e. f. g. h. I. j. k. l. m. n. o. p. q. r. s. t. u. v. w. x. y. AMOUNT TOTAL ADDITIONAL GROSS WEEKLY INCOME / RECEIPTS PSC (800) c.g.f.
10 ADDITIONAL WEEKLY DEDUCTIONS FROM INCOME - LONG FORM (Part III., continued) Name: III. WEEKLY DEDUCTIONS FROM GROSS INCOME (continued) OTHER DEDUCTIONS ITEM / DESCRIPTION a. b. c. d. e. f. g. h. I. j. k. l. m. n. o. p. q. r. s. t. u. v. w. x. y. AMOUNT TOTAL ADDITIONAL WEEKLY DEDUCTIONS FROM PAY PSC (800) c.g.f.
11 ADDITIONAL WEEKLY EXPENSES - LONG FORM (Part VII., continued) Name: VII. WEEKLY EXPENSES NOT DEDUCTED FROM PAY (continued) INSTRUCTIONS: All expense figures must be listed by their WEEKLY total. DO NOT list expenses by their MONTHLY total. [See DOCUMENT TIPS for assistance.] Do not duplicate weekly expenses. ITEM / DESCRIPTION a. b. c. d. e. f. g. h. I. j. k. l. m. n. o. p. q. r. s. t. u. v. w. x. y. AMOUNT TOTAL ADDITIONAL WEEKLY EXPENSES PSC (800) c.g.f.
12 ADDITIONAL ASSETS (REAL ESTATE) - LONG FORM (Part VIII., continued) Name: VIII. ASSETS (continued) A. REAL ESTATE Additional Real Estate Address Title held (street address) (city or town) (state) (zip) Outstanding 1st mortgage Outstanding 2nd mortgage or home equity loan Equity Purchase Price of the Property Current Assessed Value of the Property Date of Last Assessment Fair Market Value of the Property Additional Real Estate Address (street address) (city or town) (state) (zip) Title held Outstanding 1st mortgage Outstanding 2nd mortgage or home equity loan Equity Purchase Price of the Property Current Assessed Value of the Property Date of Last Assessment Fair Market Value of the Property Additional Real Estate Address (street address) (city or town) (state) (zip) Title held Outstanding 1st mortgage Outstanding 2nd mortgage or home equity loan Equity Purchase Price of the Property Current Assessed Value of the Property Date of Last Assessment Fair Market Value of the Property Additional Real Estate Address (street address) (city or town) (state) (zip) Title held Outstanding 1st mortgage Outstanding 2nd mortgage or home equity loan Equity Purchase Price of the Property Current Assessed Value of the Property Date of Last Assessment Fair Market Value of the Property TOTAL ADDITIONAL REAL ESTATE PSC (800) c.g.f.
13 ADDITIONAL ASSETS (MOTOR VEHICLES) - LONG FORM (Part VIII., continued) Name: VIII. ASSETS (continued) B. MOTOR VEHICLES, including cars, trucks, ATVs, snowmobiles, tractors, motorcycles, boats, recreational vehicles, aircraft, farm machinery, etc. Type Make Model Purchase Price of Vehicle Fair Market Value Outstanding Loan Equity Type Make Model Purchase Price of Vehicle Fair Market Value Outstanding Loan Equity Type Make Model Purchase Price of Vehicle Fair Market Value Outstanding Loan Equity Type Make Model Purchase Price of Vehicle Fair Market Value Outstanding Loan Equity Type Make Model Purchase Price of Vehicle Fair Market Value Outstanding Loan Equity TOTAL ADDITIONAL MOTOR VEHICLES PSC (800) c.g.f.
14 ADDITIONAL ASSETS (OTHER) - LONG FORM (Part VIII., continued) Name: VIII. ASSETS CONTINUED C. PENSIONS (continued) Description Institution Account Number Listed Beneficiary Current Balance / Value D. OTHER ASSETS (continued) Description Institution Account Number Listed Beneficiary Current Balance TOTAL ADDITIONAL PENSIONS AND OTHER ASSETS PSC (800) c.g.f.
15 ADDITIONAL LIABILITIES - LONG FORM (Part XI., continued) Name: XI. LIABILITIES (List additional liabilities not listed elsewhere) (continued) CREDITOR KIND OF DEBT DATE INCURRED AMOUNT DUE WEEKLY PAYMENT TOTAL ADDITIONAL AMOUNT DUE TOTAL ADDITIONAL WEEKLY PAYMENTS PSC (800) c.g.f.
16 FINANCIAL STATEMENT SCHEDULE A Name: MONTHLY SELF-EMPLOYMENT OR BUSINESS INCOME GROSS MONTHLY RECEIPTS Monthly Business Expenses Cost of goods sold Advertising Bad debts Auto: Gas Insurance Maintenance Registration Commissions Depletion Dues and publications Employee Benefit Programs Freight Insurance (other than health); please specify type of insurance: Interest on mortgage to banks Interest on loans Legal and professional services Office expenses Laundry and cleaning Pension and profit sharing Rent on leased equipment Machinery/Equipment Other business property Repairs Supplies Taxes Travel Meals and entertainment Utilities and phone Wages Other expenses (specify) TOTAL MONTHLY EXPENSES WEEKLY BUSINESS INCOME (Gross monthly receipts less total monthly expenses divided by 4.3) Enter this amount in Section II, line (d) of CJ-D 301-L or Section 2(b). of CJ-D 301-S. CJ-D 301 Schedule A (11/97) PSC (800) c.g.f.
17 FINANCIAL STATEMENT SCHEDULE A - Continued NATURE OF SELF-EMPLOYMENT OR BUSINESS 1. Is this business seasonal in nature? Yes No 2. If a seasonal business, please specify percentage of income received and expenses incurred for each month of the year. MONTH January February March April May June July August September October November December PERCENTAGE OF INCOME RECEIVED EXPENSES INCURRED 3. State whether your business accounts on calendar year basis or fiscal year basis. Calendar Fiscal 4. If your business accounts on a fiscal year basis, give the starting and ending dates of your chosen fiscal year. Starting Ending 5. State your gross receipts, year to date. 6. State your gross expenses year to date.
18 FINANCIAL STATEMENT SCHEDULE B Name: RENT FROM INCOME PRODUCING PROPERTY ANNUAL RENT RECEIVED ANNUAL RENTAL EXPENSES Advertising Auto and travel Insurance Cleaning and maintenance Commissions Interest on mortgage to bank Other interest (specify) Legal and professional services Repairs Supplies Taxes Utilities Wages Other expenses (specify) TOTAL ANNUAL EXPENSES TOTAL WEEKLY RENTAL INCOME (Gross rent received less expenses, divided by 52). Enter this amount in Section II, line (n) of CJ-D 301-L or Section 2(j) of CJ-D 301-S. CJ-D 301 Schedule B (11/97) PSC (800) c.g.f.
19 EXPLANATORY NOTES TO FINANCIAL STATEMENT OF # Explanation of Notation 1
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
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
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.
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:
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
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:
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:
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:
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:
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,
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 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
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
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
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
APPLICATION FOR COMPROMISE FAMILY REUNIFICATION
STATE OF CALIFORNIA-HEALTH AND HUMAN SERVICES AGENCY APPLICATION FOR COMPROMISE FAMILY REUNIFICATION DEPARTMENT OF CHILD SUPPORT SERVICES PART I: INFORMATION ABOUT THE OBLIGOR PARENT AND CHILD 1. NAME
INITIAL FINANCIAL PLAN AMENDED FINANCIAL PLAN #
STATE OF SOUTH CAROLINA COUNTY OF IN THE PROBATE COURT CASE NUMBER: -GC- - IN THE MATTER OF:, a protected person. FINANCIAL PLAN OF CONSERVATOR INITIAL FINANCIAL PLAN AMENDED FINANCIAL PLAN # 1. What steps
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
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
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 -
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
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
TAX ORGANIZER Page 3
TAX ORGANIZER Page Basic Taxpayer Information Taxpayer Spouse Taxpayer Spouse First Name Initial Last Name Social Security No. Check if Date of Occupation Dependent Presidential Birth Disabled Blind of
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
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:
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
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: _
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
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
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
Bankruptcy Worksheet Brian W. Peters
Brian W. Peters 100 West 12th Street Tel. (563) 588-0547 P. O. Box 703 Fax (563) 588-1981 Soc. Sec. # Your Name: Date of Birth: Please list any other names (nicknames, maiden name, prior married name)
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
DATE OF APPOINTMENT (MM/DD/YYYY) INVENTORY VALUES AS OF DATE (MM/DD/YYYY) FILING DUE DATE (MM/DD/YYYY)
District Court Denver Probate Court County, Colorado Court Address: In the Interest of: Protected Person Attorney or Party Without Attorney (Name and Address): Case Number: COURT USE ONLY Phone Number:
SUPREME COURT OF YUKON FINANCIAL STATEMENT. FINANCIAL STATEMENT OF (Plaintiff/Defendant) I,, of the of,
Form 94 (Rule 63A (1) ) S.C. NO: SUPREME COURT OF YUKON Between: Plaintiff and Defendant FINANCIAL STATEMENT FINANCIAL STATEMENT OF _ (Plaintiff/Defendant) I,, of the of, in Yukon, SWEAR (or AFFIRM) THAT:
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.
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)
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:
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
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:
Name Social Security#: Spouse: Social Security#: Address: City/State: Zip: Alternate mailing address: Home Phone: ( ) Work Phone: ( ) Cell: ( )
DEBTOR QUESTIONNAIRE You may print this out and bring it with you to the appointment. Please Answer these questions to the best of your information and belief. Short and general answers are sufficient.
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
Form 72J APPENDIX OF FORMS FORM 72J FINANCIAL STATEMENT (FORM 72J) (Court, Court File Number, Style of Proceeding) FINANCIAL STATEMENT (FORM 72J)
APPENDIX OF FORMS FORM 72J FINANCIAL STATEMENT (FORM 72J) (Court, Court File Number, Style of Proceeding) FINANCIAL STATEMENT (FORM 72J) Financial statement of: I hereby make oath (or solemn affirmation)
SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF X Plaintiff,
SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF ---------------------------------------------------------------------X Plaintiff, - against - STATEMENT OF NET WORTH DATED: Index No. Date Action Commenced:
VOLUNTEER AND EXEMPT FIREMEN S BENEVOLENT ASSOCIATION OF FREEPORT, NEW YORK. Financial Disclosure FAMILY INFORMATION
VOLUNTEER AND EXEMPT FIREMEN S BENEVOLENT ASSOCIATION OF FREEPORT, NEW YORK Financial Disclosure FAMILY INFORMATION Your Information: Name Birth Date Soc. Sec. No. Address Telephone Occupation Job Title
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 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:
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
SUPERIOR COURT OF ARIZONA MOHAVE COUNTY
FOR CLERK S USE ONLY Name of Person Filing: Mailing Address: City, State, Zip Code: Daytime Phone Number: Evening Phone Number: ATLAS Number (if applicable): Attorney Bar Number (if applicable): Representing:
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
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
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.
Section 1 - Personal Information Section 2 - Property Section 3 - Debts Section 4 - Expired Leases and Contracts...
B A N K R U P T C Y Q U E S T I O N N A I R E INDEX Section 1 - Personal Information.............................. 2-3 Section 2 - Property........................................ 4-6 Section 3 - Debts............................................
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,
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
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
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
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
CLIENT QUESTIONNAIRE
Spencer Carr Attorney at Law Emily Carr Attorney at Law Quentin Carr Attorney at Law James H. Cox Of Counsel CLIENT QUESTIONNAIRE Thank you for calling THE CARR LAW GROUP for legal assistance relating
ESTATE OR TRUST TAX ORGANIZER FORM New Estate or Trust Administrators Information Needed
ESTATE OR TRUST TAX ORGANIZER FORM 1041 New Estate or Trust Administrators Information Needed This is a list of information which will be typically needed for us to work with you on tax issues for an estate
Office of the Prosecuting Attorney
Office of the Prosecuting Attorney Karen E. Richards Prosecuting Attorney Second Floor Keystone Building 602 South Calhoun Street Fort Wayne, IN 46802-1700 Phone (260) 449-7136 Fax (260) 449-4072 In order
FINANCIAL AFFIDAVIT 11.02
IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT LAKE COUNTY, ILLINOIS IN RE: The Marriage of: Custody of: Support of: ) ) ) Harold J Jones ) Petitioner ) and ) No. 44-32323 ) Marianne P Jones )
[Appendix V] FAMILY PART CASE INFORMATION STATEMENT
![[Appendix V] FAMILY PART CASE INFORMATION STATEMENT](/thumbs/72/66734849.jpg "[Appendix V] FAMILY PART CASE INFORMATION STATEMENT")
[Appendix V] FAMILY PART CASE INFORMATION STATEMENT Attorney(s): Office Address Tel. No./Fax No. Attorney(s) for: vs. Plaintiff, SUPERIOR COURT OF NEW JERSEY CHANCERY DIVISION, FAMILY PART COUNTY Defendant.
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
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
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
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
The Lee Accountancy Group, Inc th Street Oakland, CA
January 22, 2016 The Lee Accountancy Group, Inc. 369 13th Street Oakland, CA 94612-2636 Client, Dear : The Tax Organizer will assist you in collecting and reporting information necessary for us to properly
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
EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA ) Case No. Plaintiff,
vs. EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA Case No. Plaintiff, Dept. No. Defendant. GENERAL FINANCIAL DISCLOSURE FORM The judge uses this form to understand the financial position of the Plaintiff
, ) ) AFFIDAVIT OF FINANCIAL STANDING ) OF VS. ) (Name) ), ) Defendant. )
STATE OF NORTH CAROLINA COUNTY OF IREDELL IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION FILE NO.:, ) Plaintiff, ) AFFIDAVIT OF FINANCIAL STANDING ) OF VS. ) (Name) ), ) Defendant. ) The Affiant,
APPLICATION FOR HARDSHIP EXEMPTION FROM TAXES Assessment Year: 2019
IMPORTANT: CITY OF PETERSBURG APPLICATION FOR HARDSHIP EXEMPTION FROM TAXES Assessment Year: 2019 Attach copies of the most recent Federal and State Income Tax Returns for each person residing in the household.
BANKRUPTCY QUESTIONNAIRE
BANKRUPTCY QUESTIONNAIRE Questionnaire to be completed by CVLS volunteer. Do not conduct interview if Schedule I and J and Creditors Information Sheet have not previously been completed by the client.
Date of Dissolution of Marriage if applicable): Children of this Marriage: Birth date residing with Birth date residing with Birth date residing with
STATE OF ILLINOIS } } ss COUNTY OF DuPAGE } IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT DuPAGE COUNTY, ILLINOIS IN RE THE MARRIAGE OF: } } } Plaintiff, } vs. } Case No. } } Defendant. } COMPREHENSIVE
Bell County Justice of The Peace, Precinct 2 Judge Don Engleking
This section to be filled out by Court Personnel AFFIDAVIT OF INDIGENCE No/s. list cause numbers State of Texas In the Justice Court vs. Precinct 2 DEFENDANTS NAME Bell County Offense/s: offense as listed
CHESTERFIELD TOWNSHIP MACOMB COUNTY HARDSHIP EXEMPTION APPLICATION TAX YEAR 2015
B.O.R. Mar Jul Dec Letter / Appt Date: Time: Petition #: Parcel No. Name: CHESTERFIELD TOWNSHIP MACOMB COUNTY HARDSHIP EXEMPTION APPLICATION TAX YEAR 2015 A. DEADLINE YOU MUST COMPLETE THIS APPLICATION
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
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
FINANCIAL. 1. My information. Name of the person completing this Form (First Middle Last): Date this Form was completed (YYYY/MM/DD):
FINANCIAL INFORMATION Form I 1. My information Name of the person completing this Form (First Middle Last): Date this Form was completed : My financial circumstances My total annual income (before tax
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*
2017 TAX PROFORMA/ORGANIZER
2017 TAX PROFORMA/ORGANIZER This Tax Proforma/Organizer package was designed to assist you in collecting the information we need for the preparation of your 2017 income tax return. The following pages
WAHL, WILLEMSE & WILSON, LLP CERTIFIED PUBLIC ACCOUNTANTS 2018 TAX ORGANIZER
FILING STATUS FILING STATUS (See table) Filing Status MARRIED FILING SEPARATE AND LIVED WITH SPOUSE? 1 = Single SPOUSE'S DATE OF DEATH (mm/dd/yy), IF QUALIFYING WIDOW(ER) - 2017 or 2018 2 = Married filing
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
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:
WOLFE LAW FIRM 200 Kerens Avenue Elkins, WV Phone: (304) Fax: (304)
WOLFE LAW FIRM 200 Kerens Avenue Elkins, WV 26241 Phone: (304) 637-5755 Fax: (304) 637-1001 E-mail: wolfelaw@thewolfelaw.com BANKRUPTCY QUESTIONNAIRE WE ARE A LAW FIRM PROVIDING DEBT RELIEF SERVICE TO
MONTANA CHILD SUPPORT GUIDELINES FINANCIAL AFFIDAVIT
MONTANA CHILD SUPPORT GUIDELINES FINANCIAL AFFIDAVIT INSTRUCTIONS FOR COMPLETING THIS FORM: It must be signed and notarized. Provide complete information, attaching additional pages if needed. If a question
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
COMPLETING AN UP-TO-DATE PERSONAL NET WORTH STATEMENT
COMPLETING AN UP-TO-DATE PERSONAL NET WORTH STATEMENT (These Statements Are Not Subject To Public Disclosure) All owners claiming disadvantaged status MUST submit an up-to-date Personal Net Worth Statement,
1040 US Tax Organizer
1040 US Tax Organizer CLIENT INFORMATION First name and initial..... Last name............... Title/suffix............... Social security number... Occupation.............. Date of birth (m/d/y)......
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
STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS STATEMENT OF ASSETS, LIABILITIES, INCOME AND EXPENSES. vs.
FAMILY COURT, S.C Case # vs. Name: Telephone: Address: City/Town, State: Zip Code: Employer: Occupa@on: City/Town, State: Zip Code: Yes No Single Family Yes No Yes No $ $ TOTAL LIABILITIES (From Page 8)
Individual Income Tax Organizer 2016
MICHAEL R. ANLIKER, CPA, P.C. 5348 Twin Hickory Rd. Glen Allen, VA 23059 TELEPHONE: (804) 237-6044 FAX: (804) 237-6064 www.anlikerfinancial.com Individual Income Tax Organizer 2016 This Tax Organizer is
Laguna-Business-Services, LLC Fax:
Laguna-Business-Services, LLC. www.lbservices.com 480.967.4702 Fax: 480.753.6755 2017 Income Tax Checklist Please review the following 2017 checklist information. Provide statements or receipts for any
GROSS WEEKLY INCOME - ATTACH LAST THREE (3) PAYROLL STUBS
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:
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
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
4A-122. Interim monthly income and expenses statement.
4A-122. Interim monthly income and expenses statement. [For use with Rule 1-122 NMRA in the District Court] STATE OF NEW MEXICO COUNTY OF JUDICIAL DISTRICT, Petitioner, v. No., Respondent. INTERIM MONTHLY
Request to Modify Payment Plan
Request to Modify Payment Plan Chester County Adult Probation & Parole Department Instructions: Please complete pages 1-6 Complete page 7 if you are self-employed Make sure your name is at the bottom of
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:
Income Tax Organizer
Income Tax Organizer 1200 W. Cherry Lane, Suite 100 Meridian, ID 83642 208-888-6501 office 866-408-1836 fax 1. Personal Information Roberts Hart and Company, CPA's Income Tax Organizer Taxpayer Last Name