Form 13 - Financial Statement (Support Claims) Page 6
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8Form 13:
Financial Statement (Support Claims)
(page 6)
Court file number
PART 4: DEBTS
Full Amount
Monthly
Are Payments
Type of Debt
Creditor
(name and address)
Now Owing
Payments
Being Made?
$
$
Yes
No
Mortgages, Lines
of Credits or other
Loans from a
$
$
Yes
No
Bank, Trust or
Finance Company
$
$
Yes
No
$
$
Yes
No
Outstanding Credit
$
$
Yes
No
Card Balances
$
$
Yes
No
$
$
Yes
No
Unpaid Support
$
$
Yes
No
Amounts
$
$
Yes
No
$
$
Yes
No
$
$
Other Debts
Yes
No
$
$
Yes
No
Total Amount of Debts Outstanding
$
PART 5: SUMMARY OF ASSETS AND LIABILITIES
Total Assets
$
Subtract Total Debts
$
Net Worth
$
NOTE: This financial statement must be updated no more than 30 days before any court event by either completing and filing:
·
a new financial statement with updated information, or
·
an affidavit in Form 14A setting out the details of any minor changes or confirming that the information contained in this
statement remains correct.
Sworn/Affirmed before me at
municipality
in
province, state or country
Signature
(This form is to be signed in front of a
on
lawyer, justice of the peace, notary public
date
Commissioner for taking affidavits
or commissioner for taking affidavits.)
(Type or print name below if signature is
illegible.)
FLR 13 (February 1, 2010)
Page 6 of 8
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