Family Law Financial Affidavit Page 4
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8PRESENT EXPENSES for Children Common to Both Parties
* Explanations
Please provide a statement or the WEEKLY
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Monthly nursery, babysitting or day care
amount you pay.
Include any private school payments here
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Monthly school tuition
Do you buy textbooks? How much do you spend
on average each YEAR for back to school
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Monthly school supplies, books and fees
supplies? (i.e., in August and/or Jan)
Please include all sports, music, etc. here. We
can calculate the monthly averages from the
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Monthly after school activities
detailed information provided.
How much do spend each week, per child, during
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Monthly lunch money
the school year?
Monthly private lessons, tutoring or physical/occupational/speech therapy
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(not covered by insurance)
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Monthly allowances
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Monthly clothing and uniforms
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Monthly entertainment (movies, parties, etc.)
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Monthly health insurance
Anything insurance does NOT pay.
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Monthly medical, dental, prescriptions (nonreimbursed only)
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Monthly psychiatric/psychological/counselor
Anything insurance does NOT pay.
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Monthly orthodontic
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Monthly vitamins
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Monthly beauty parlor/barber shop
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Monthly nonprescription medication
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Monthly cosmetics, toiletries and sundries
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Monthly gifts from child(ren) to other (relatives, teachers etc.)
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Monthly camp or summer activities
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Monthly Clubs (Boy/Girl Scouts, etc.)
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Monthly access expenses for parenting contact
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Monthly miscellaneous
Please be specific
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Early Learning Academy:
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Family Wizard
NOTE: This section is for any expenses you have
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for the CHILDREN. Please complete each line
item in this section even if it does not have a
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specific note attached. If possible, please list
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EACH CHILD's expenses SEPARATELY.
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PRESENT EXPENSES for Children from Another Relationship
* Explanations
(other than court-ordered child support)
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MONTHLY INSURANCE
* Explanations
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Health Ins. (excluding portion for minor child(ren) of this relationship)
Please provide a current statement for any type of
insurance for which you pay. Please specify if
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Life insurance
insurance premiums are a pre-tax payroll
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Life insurance
deduction. We can calculate the monthly
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Dental insurance
averages using your statements and /or pay
stubs.
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Disability
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Page 4 of 8
Florida Family Law Rules of Procedure Form 12.902(c) Family Law Financial Affidavit
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