Domestic Relations Financial Affidavit Page 8
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13B.
PAYMENTS TO CREDITORS
Account #
Monthly
To Whom
(last 4 digits)
Balance Due
Payments
Name(s)on Account
____________
__________
___________
__________
_________________
____________
__________
___________
__________
_________________
____________
__________
___________
__________
_________________
____________
__________
___________
__________
_________________
____________
__________
___________
__________
_________________
____________
__________
___________
__________
_________________
____________
__________
___________
__________
_________________
____________
__________
___________
__________
_________________
TOTAL (Section B)
$___________ $___________
C.
TOTAL MONTHLY EXPENSES AND PAYMENTS
TO CREDITORS
$________________
6.
ASSETS
(If you claim or agree that all or part of an asset is non-marital, indicate the non-marital
portion under the appropriate spouse's column. “Non-marital” means your spouse or you had
this asset before the marriage or received it by personal gift or inheritance during the
marriage. The total value of each asset must be listed in the “value” column. “Value” means
what you believe to be the fair market value of the item or property.
ACCOUNT(S) ACCOUNT #
VALUE
HUSBAND’S
WIFE’S
NAME
(last 4 digits)
Non-Marital
Non-Marital
RETIREMENT ACCOUNTS:
401-K
______________ ___________ _________ ____________
___________
Pension
______________ ___________ _________ ____________
___________
IRA
______________ ___________ _________ ____________
___________
Other
______________ ___________ _________ ____________
___________
NON-RETIREMENT ACCOUNTS:
Stocks
______________ ___________ _________ ____________
___________
Bonds
______________ ___________ _________ ____________
___________
CDs
______________ ___________ _________ ____________
___________
Investments ______________ ___________ _________ ____________
___________
Money Market ______________ ___________ _________ ____________
___________
Cash on hand _____________ ___________ _________ ____________
___________
Other accounts _____________ ___________ _________ _____________
___________
(Describe) _______________________________________________________________
________________________________________________________________________
Domestic Relations Financial Affidavit
Fulton County Family Division
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