Declaration Of Income And Expenses printable pdf download

Declaration Of Income And Expenses

_________________________________

Name

_________________________________

Address

_________________________________

City

_________________________________

Telephone

______________________________________________________________________________

IN THE_________________DISTRICT JUVENILE COURT

FOR ____________________COUNTY

______________________________________________________________________________

IN THE INTEREST OF_________________, )

DECLARATION OF INCOME

A MINOR.

)

AND EXPENSES

)

JUVENILE NO.__________________

)

______________________________________________________________________________

I solemnly swear or affirm that the following is true:

Income:

I was born on:

9 I have the following job(s). My employer’s

Monthly pay before

Monthly pay after

name and address is:

deductions:

$_______________

(If you do not have a job, write “None” in this

space)

9 I have income from sources other than

Source of Income

Monthly income,

employment. Include such sources as rental

non-wage

income, money or other support.

$_______________

May 6, 2006

Declaration Of Income And Expenses