SECTION I. INCOME
LAST YEAR'S GROSS INCOME:
PRESENT MONTHLY GROSS INCOME:
All amounts must be MONTHLY. If paid weekly, multiply by 4.3; if paid every two weeks, multiply by 2.17.
| 17. | $0.00 | TOTAL PRESENT MONTHLY GROSS INCOME: |
PRESENT MONTHLY DEDUCTIONS:
All amounts must be MONTHLY.
| 26. | $0.00 | TOTAL DEDUCTIONS ALLOWABLE UNDER SECTION 61.30, FLORIDA STATUTES: |
| 27. | $0.00 | PRESENT NET MONTHLY INCOME: |
SECTION II. AVERAGE MONTHLY EXPENSES
SECTION IIIA. ASSETS
Describe all assets. Include items held in a revocable trust. List only the last 4 digits of account numbers. Give fair market value as of the date you sign this affidavit.
SECTION IIIB. LIABILITIES
Describe all liabilities. List only the last 4 digits of account numbers. Give principal balance owed as of the date you sign this affidavit.
SECTION IIIC. CONTINGENT ASSETS
Describe all contingent assets (potential future assets that depend on certain conditions). List only the last 4 digits of account numbers. Give estimated fair market value if the contingency occurs as of the date you sign this affidavit.
SECTION IIID. CONTINGENT LIABILITIES
Describe all contingent liabilities (potential future debts that depend on certain conditions). List only the last 4 digits of account numbers. Give estimated principal balance if the contingency occurs as of the date you sign this affidavit.
SECTION IIIE. CHILD SUPPORT GUIDELINES WORKSHEET
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet, MUST be filed with the court at or prior to a hearing to establish or modify child support. This requirement cannot be waived by the parties.
Under penalties of perjury, I declare that I have read this document and the facts stated in it are true.
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished on , by to at .
