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Contact Details
General Information
Court Information
Information about the parties and the person submitting the financial affidavit
i This is the party who filed the action
i This is the party who will be responding to a filed action
i Select either yes or no to identify whether there are any joint children in this case
i i.e., Herbert vs French
i The person who submitting this financial affidavit.
i If it is available
i If it is available
i If the financial affidavit if for a divorce type case. Ex. MM/DD/YYYY
i If it already has. Ex. MM/DD/YYYY.
i Ex. MM/DD/YYYY.
i Enter the social security number of submitter
Information about the submitter's employment status
i To identify whether the person submitting this financial affidavit is employed.
i Do not enter this explanation in the Notes column which is reserved to comments about the explanation.
i Do not enter this explanation in the Notes column which is reserved to comments about the explanation.
i Ex. MM/DD/YYYY.
i Enter the expected pay this person will receive, including the appropriate selected period.
Submitter's Job Details - No. 1
Retirement Information
i To identify whether the person submitting this financial affidavit is retired.
i Ex. MM/DD/YYYY
Submitter's Retired Job - No. 1
Child from this relationship - No. 1
i The child in this case or from this relationship
Other child in household - No. 1
i The non-joint child that is not in this case or from this relationship
Income Details
i The gross salary / wages earned in this taxable year and select the appropriate period
i The bonus earned or to be earned in this taxable year and select the appropriate period
i The commission(s) earned or to be earned in this taxable year and select the appropriate period
i The allowances received or to be received in this taxable year and select the appropriate period
i The overtime earned or to be earned in this taxable year and select the appropriate period
i The tips earned or to be earned in this taxable year and select the appropriate period
i The business and/or self-employment income earned or to be earned in this taxable year and select the appropriate period
i The disability benefits received or to be received in this taxable year and select the appropriate period
i The workers compensation received or to be received in this taxable year and select the appropriate period
i The unemployment received or to be received in this taxable year and select the appropriate period
i The pension received or to be received in this taxable year and select the appropriate period
i Any other retirement income received or to be received in this taxable year and select the appropriate period
i Any annuity income received or to be received in this taxable year and select the appropriate period
i Any Social Security income received or to be received in this taxable year and select the appropriate period
i Any interest income received or to be received in this taxable year and select the appropriate period
i Any dividends income received or to be received in this taxable year and select the appropriate period
i Any net rental income received or to be received in this taxable year and select the appropriate period
i Any royalties received or to be received in this taxable year and select the appropriate period
i Any dividends income received or to be received in this taxable year and select the appropriate period
i Any estate income received or to be received in this taxable year and select the appropriate period
i If you currently receive alimony from this case, enter the amount received or to be received in this taxable year and select the appropriate period
i If you currently receive alimony from another court order, enter the amount received or to be received in this taxable year and select the appropriate period.
i If you currently receive child support from this case or expect to, enter the amount received or to be received in this taxable year and select the appropriate period.
i If you currently receive child support from a previous court order, enter the amount received or to be received in this taxable year and select the appropriate period.
Other Income - No. 1
i The description of any other income received or to be received in this taxable year
i The value and appropriate period for other income received or to be received in this taxable year and then select and identify the type of income
Deductions
i The number of dependents that will be claimed in this taxable year
i The amount of Federal tax that will be paid in this taxable year (preferably actual tax and not tax deducted on pay stubs). Note: We can automatically obtain this information more accurately.
i The amount of State tax that will be paid in this taxable year (preferably actual tax and not tax deducted on pay stubs). Note: We can automatically obtain this information more accurately.
i The amount of Local tax that will be paid in this taxable year (preferably actual tax and not tax deducted on pay stubs). Note: We can automatically obtain this information more accurately.
i The amount of FICA or Self-Emp tax that will be paid in this taxable year (preferably actual tax and not tax deducted on pay stubs). Note: We can automatically obtain this information more accurately.
i The amount of Medicare tax that will be paid in this taxable year (preferably actual tax and not tax deducted on pay stubs). Note: We can automatically obtain this information more accurately.
i The amount of mandatory union dues that will be paid in this taxable year
i The amount of mandatory retirement payments that will be paid in this taxable year
i The premium paid for health insurance that will be paid in this taxable year

 

For the below sections, Check with your state or attorney before entering a value here. You may need to enter it in the Expense section instead. Do not enter in both Deduction and Expense.
 

 

i If alimony is being paid for a current marriage in this case, enter the amount that will be paid in this taxable year.
i If alimony is being paid for a previous marriage, enter the amount that will be paid in this taxable year.
i If you currently receive child support from this case or expect to, enter the amount received or to be received in this taxable year and select the appropriate period.
i If you currently receive child support from a previous court order, enter the amount received or to be received in this taxable year and select the appropriate period
Other Deductions - No. 1
i The description of any other allowed deduction for your state.
i The value and appropriate period for other deduction paid or to be paid in this taxable year
Assets - Property - Primary Home Residence(s)
Home - No. 1
i The total combined balance of the mortgage and home equity loan of the residence
i Choose who owns title to the property and whether it could be considered marital property
Assets - Property - Other Real Estate
Other Property - No. 1
i The total combined balance of the mortgage and home equity loan of the property
i Choose who owns title to the property and whether it could be considered marital property
Assets - Property - Auto, Boats, RVS, Motor Bikes, Etc.,
Auto, Boats, RVs, Motor Bikes, etc. No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Property - Other Personal Property
Other Personal Property - No. 1
i i.e., Jewelry, Furniture, etc.
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Cash on Hand
Cash on Hand - No. 1
i i.e., Safe deposit, Coins, etc.
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Bank Account
Bank Account - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Stocks
Stock - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Bond
Bond - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Mutual Fund
Mutual Fund - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Life Insurance
Life Insurance - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Retirement/Deferred Compensation
Retirement/Deferred Compensation - No. 1
i i.e., Pension, 401-K, IRA and the name of the company
i Choose who owns title to the property and whether it could be considered marital property
Assets - Financial - Other Financial Asset
Other Financial Asset - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Miscellaneous - Business Interests
Business Interests - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Miscellaneous - Other Asset
Other Asset - No. 1
i Choose who owns title to the property and whether it could be considered marital property
Assets - Miscellaneous - Contingent Asset
Contingent asset - No. 1
i An asset contingent upon receiving
i Choose who owns title to the property and whether it could be considered marital property
Assets - Miscellaneous - Asset Transferred in Past Year
Asset transferred in past year - No. 1
i An asset given to someone else in the past year
i Choose who owns title to the property and whether it could be considered marital property
Liabilities - Credit/Charge cards
Credit/Charge cards - No. 1
i The payment amount on the account based on the period selected
i Choose who owns title to the property and whether it could be considered marital property
Liabilities - Bank/Credit Union Loan
Bank/Credit Union Loan - No. 1
i The payment amount on the account based on the period selected
i Choose who owns title to the property and whether it could be considered marital property
Liabilities - Other Debit
Other Debit - No. 1
i The payment amount owed based on the period selected
i Choose who owns title to the property and whether it could be considered marital property
Liabilities - Contingent Liability
Contingent Liability - No. 1
i The payment amount owed based on the period selected
i Choose who owns title to the property and whether it could be considered marital property
Expenses - Household Expenses
i Enter the total mortgage payment based on the period selected, then select whether this expense is estimated or not
i Enter the total rent payment based on the period selected, then select whether this expense is estimated or not
i Enter the total home equity loan payment based on the period selected, then select whether this expense is estimated or not
i Enter the total real estate tax payment based on the period selected, then select whether this expense is estimated or not
i Enter the total real estate tax payment based on the period selected, then select whether this expense is estimated or not
i Enter the total home/rental insurance payment based on the period selected, then select whether this expense is estimated or not
i Enter the total heating oil payment based on the period selected, then select whether this expense is estimated or not
i Enter the total natural gas payment based on the period selected, then select whether this expense is estimated or not
i Enter the total electricity payment based on the period selected, then select whether this expense is estimated or not
i Enter the total telephone payment based on the period selected, then select whether this expense is estimated or not
i Enter the total cable/satellite TV payment based on the period selected, then select whether this expense is estimated or not
i Enter the total water payment based on the period selected, then select whether this expense is estimated or not
i Enter the total sewer payment based on the period selected, then select whether this expense is estimated or not
i Enter the total trash payment based on the period selected, then select whether this expense is estimated or not
i Enter the total other utilities payment based on the period selected, then select whether this expense is estimated or not
i Enter the total lawn care payment based on the period selected, then select whether this expense is estimated or not
i Enter the total maid/cleaning payment based on the period selected, then select whether this expense is estimated or not
i Enter the total laundry/dry cleaning payment based on the period selected, then select whether this expense is estimated or not
i Enter the total food/groceries payment based on the period selected, then select whether this expense is estimated or not
i Enter the total meals out payment based on the period selected, then select whether this expense is estimated or not
Expenses - Other Household Expenses
Other Household Expense - No. 1
i The payment amount owed based on the period selected and then select whether this amount is estimated or not
Expenses - Transportation Expenses
i Enter the total gas/oil payment based on the period selected, then select whether this expense is estimated or not
i Enter the total auto repair payment based on the period selected, then select whether this expense is estimated or not
i Enter the total auto repair payment based on the period selected, then select whether this expense is estimated or not
i Enter the total auto tags/emissions payment based on the period selected, then select whether this expense is estimated or not
i Enter the total auto rental/replacements payment based on the period selected, then select whether this expense is estimated or not
i Enter the total auto tags/emissions payment based on the period selected, then select whether this expense is estimated or not
i Enter the total parking payment based on the period selected, then select whether this expense is estimated or not
i Enter the total public/other transportation payment based on the period selected, then select whether this expense is estimated or not
i Enter the total car insurance payment based on the period selected, then select whether this expense is estimated or not
Expenses - Other Transportation Expenses
Other Transportation Expense - No. 1
i Enter the payment amount owed based on the period selected and then select whether this amount is estimated or not
Expenses - Personal
i Enter the total personal clothing payment based on the period selected, then select whether this expense is estimated or not
i Enter the total personal grooming payment based on the period selected, then select whether this expense is estimated or not
i Enter the total medical insurance payment based on the period selected, then select whether this expense is estimated or not
i Enter the total dental insurance payment based on the period selected, then select whether this expense is estimated or not
i Enter the total personal clothing payment based on the period selected, then select whether this expense is estimated or not
i Enter the total whole life insurance payment based on the period selected, then select whether this expense is estimated or not
i Enter the total unreimbursed medical/prescriptions payment based on the period selected, then select whether this expense is estimated or not
i Enter the total unreimbursed dental payment based on the period selected, then select whether this expense is estimated or not
i Enter the total cosmetics, toiletries, sundries payment based on the period selected, then select whether this expense is estimated or not
i Enter the total mandatory retirement payment based on the period selected, then select whether this expense is estimated or not
i Enter the total voluntary retirement payment based on the period selected, then select whether this expense is estimated or not
i Enter the total personal education payment based on the period selected, then select whether this expense is estimated or not
i Enter the total entertainment payment based on the period selected, then select whether this expense is estimated or not
i Enter the total club dues payment based on the period selected, then select whether this expense is estimated or not
i Enter the total club dues payment based on the period selected, then select whether this expense is estimated or not
i Enter the total vacation payment based on the period selected, then select whether this expense is estimated or not
i Enter the total periodicals/books/tapes/CD's payment based on the period selected, then select whether this expense is estimated or not
i Enter the total gifts payment based on the period selected, then select whether this expense is estimated or not
i Enter the total pet payment based on the period selected, then select whether this expense is estimated or not
i Enter the total religious payment based on the period selected, then select whether this expense is estimated or not
Expenses - Other Personal Expenses
Other Personal Expense - No. 1
i The payment amount owed based on the period selected and then select whether this amount is estimated or not
Expenses - Child
i The total children(s) nursery, babysitting, day care payment based on the period selected, then select whether this expense is estimated or not
i The total children(s) clothing payment based on the period selected, then select whether this expense is estimated or not
i The total children(s) grooming payment based on the period selected, then select whether this expense is estimated or not
i The total children(s) tuition/books payment based on the period selected, then select whether this expense is estimated or not
i The total children(s) lessons/clubs/camps payment based on the period selected, then select whether this expense is estimated or not
i The total children(s) entertainment payment based on the period selected, then select whether this expense is estimated or not
i The total children(s) life insurance payment based on the period selected, then select whether this expense is estimated or not
i The total children(s) life insurance payment based on the period selected, then select whether this expense is estimated or not
i Enter the total children(s) unreimbursed medical/dental insurance payment based on the period selected, then select whether this expense is estimated or not
Expenses - Other Child Expenses
Other Child Expense - No. 1
i The payment amount owed based on the period selected and then select whether this amount is estimated or not
Expenses - Children Other Relationship Expenses
Children Other Relationship Expense - No. 1
i The payment amount owed based on the period selected and then select whether this amount is estimated or not
Expenses - Miscellaneous
For the below sections, Check with your state or attorney before entering a value here. You may need to enter it in the Deductions section instead. Do not enter in both Deduction and Expense.


 
i The total alimony paid in this case based on the period selected, then select whether this expense is estimated or not.
i The total alimony paid in other cases based on the period selected, then select whether this expense is estimated or not.
i The total child support paid in this case based on the period selected, then select whether this expense is estimated or not.
i The total child support paid in other cases based on the period selected, then select whether this expense is estimated or not.
Expenses - Miscellaneous - Other Expenses
Other Expense - No. 1
i The payment amount owed based on the period selected and then select whether this amount is estimated or not