Petition For Dissolution Of Marriage Page 3
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15II.
FINANCIAL INFORMATION AND AGREEMENT OF PETITIONERS
Each party must attach a copy of his or her most recent federal tax return and most recent pay
stubs to verify income and deductions.
The following income and deductions are
monthly
yearly.
If your work is seasonal, show yearly income.
A. Gross Income (Do not list ATAP or SSI below.)
Husband
Wife
Gross Wages
$
$
Value of employer-provided housing/food/etc.
$
$
Unemployment Compensation
$
$
Permanent fund dividend
$
$
Other:
$
$
$
$
$
$
0.00
0.00
$
$
TOTAL INCOME
B. Deductions Allowable Under Civil Rule 90.3
Federal, state and local income tax
$
$
Social security tax or self-employment tax
$
$
Medicare tax
$
$
Employment security tax
$
$
Mandatory retirement contributions
$
$
Mandatory union dues
$
$
Voluntary retirement contributions if plan earnings
are tax-free or tax-deferred, up to 7.5% of gross
wages and self-employment income when
$
$
combined with mandatory contributions
Other mandatory deductions (specify):
$
$
$
$
Child support/alimony ordered in other cases and
currently being paid
$
$
Child support for children from prior
relationships living with this parent, calculated
under Civil Rule 90.3
$
$
Work-related child care for children of this
marriage
$
$
0.00
0.00
TOTAL DEDUCTIONS
$
$
C. Net Income
0.00
0.00
TOTAL INCOME from section A
$
$
0.00
0.00
TOTAL DEDUCTIONS from section B
$
$
Subtract deductions from income to get
0.00
0.00
$
$
NET INCOME
Husband’s Signature
Wife’s Signature
Page 3 of 15
DR-105 (4/09)(cs)
AS 25.24.200-.260
PETITION FOR DISSOLUTION OF MARRIAGE (WITH CHILDREN)
Civil Rule 90.1(a), f(2)(A)(B), (i)(1)
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