AOC-238
Rev 1-11
Page 6 of 8
7.
Retirement Plans (Pensions, 401(k), Tax Deferred Savings, IRAs, etc.)*:
Type and Name of Plan
Plan Administrator
Balance or Value
_______________________________________________________________________________________________
_______________________________________________________________________________________________
8.
Interests In/Ownership of Business:
Location of Business,
% and
Tax Returns &
Business Name & Address
Type of Business
Financial Documents
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
9.
Household Property in Dispute:
Item
Location
Fair Market Value
Loan Balance
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
* Bank statements, canceled checks, registers, carbon copies of checks, deposit tickets, periodic statements from
investments, statements on life insurance, periodic statements from retirement plans, periodic statements reflecting assets
held in name of or on behalf of children, and documents reflecting debts and credit card statements for past 12 months should
be in possession of answering party or answering party’s attorney when this statement is served on the opposing party.
10.
Safety Deposit Box?
Yes
No
If yes:
Location
Contents
Value
Date of Last Visit
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
11.
Other Property - (specify item and value):
Jewelry: _________________________________________________________________________________
Furs: ___________________________________________________________________________________
Antiques: ________________________________________________________________________________
Art: _____________________________________________________________________________________
Collections: _______________________________________________________________________________
Country Club Memberships: _________________________________________________________________
Season Tickets: ___________________________________________________________________________
Income Tax Refunds Expected: _______________________________________________________________
Frequent Flyer Miles: _______________________________________________________________________
Accounts Receivables/Loans: ________________________________________________________________
Claims Against Others: ______________________________________________________________________
Accrued Vacation Pay: _______________________________________________________________________
Others: _________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
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