Certificate Of Compliance With Mandatory Financial Disclosures

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District Court
Denver Juvenile Court
__________________ County, Colorado
Court Address:
In re:
The Marriage of:
Parental Responsibilities concerning:
______________________________________________________
Petitioner:__________________________
and
COURT USE ONLY
Co-Petitioner/Respondent:____________________________
Attorney or Party Without Attorney
:
Case Number:
(Name and Address)
Phone Number:__________ E-mail:___________________________
Division _______ Courtroom ______
FAX Number:___________ Atty. Reg. #: ____________________
CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES
*****EACH PARTY MUST COMPLETE AND FILE THIS FORM WITH THE COURT*****
I, the
Petitioner
Co-Petitioner/Respondent (check one) hereby certify that I have sent the other party the following
Mandatory Disclosures as required by Rule 16.2(e)(7) of the Colorado Rules of Civil Procedure.
See JDF 1125: Mandatory Disclosure – Form 35.1 for explanation on what is required by the disclosures being listed.
Check those that you have furnished to the other party. (Note
: Only the Sworn Financial Statement and Child
Support Worksheet should be filed with the Court.)
Sworn Financial Statement
Retirement Plans
Income Tax Returns (most recent 3 years)
Bank/Financial Institution Accounts
Personal Financial Statements (last 3 years)
Income Documentation (Pay Stubs, etc.)
Business Financial Statements (last 3 years)
Employment and Education – Related child
Real Estate Documents (Appraisal, Title, etc.)
Care Documentation
Personal Debt (Loans, Title, Credit Card Statements, etc.)
Insurance Documentation
Investments
Extraordinary Children’s Expense
Documentation
Employment Benefits
If I have not provided information, it is because:
I hereby certify that, to the best of my knowledge, information, and belief, the disclosures I have made are
complete and correct as of this date.
________________________________________________
Petitioner/Co-Petitioner/Respondent Signature
Date
________________________________________________
Attorney Signature, if any
Date
You must complete the Certificate of Service below:
CERTIFICATE OF SERVICE
I certify that on _______________________ (date) a true and accurate copy of the CERTIFICATE OF COMPLIANCE WITH
MANDATORY FINANCIAL DISCLOSURES was served on the other party by:
Hand Delivery,
E-filed,
Faxed to this number ____________________, or
by placing it in the United States mail, postage pre-paid, and addressed to the following:
To: ___________________________________
___________________________________
___________________________________
(Your signature)
JDF 1104
R8/10
CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES

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