Form 13 - Financial Statement (Support Claims) (Page 7 of 8) in pdf

Form 13 - Financial Statement (Support Claims) Page 7

Schedule A

Additional Sources of Income

Line

Income Source

Annual Amount

Net partnership income

Net rental income (Gross annual rental income of $

)

Total amount of dividends received from taxable Canadian corporations

Total capital gains ($

) less capital losses ($

)

Registered retirement savings plan withdrawals

Any other income

(specify source)

Subtotal:

Schedule B

Other Income Earners in the Home

Complete this part only if you are making or responding to a claim for undue hardship or spousal support. Check and complete all

sections that apply to your circumstances.

I live alone.

I am living with

(full legal name of person you are married to or cohabiting with)

I/we live with the following other adult(s):

I/we have

child(ren) who live(s) in the home.

(give number)

My spouse/partner

works at

(place of work or business)

does not work outside the home.

My spouse/partner

earns

per

(give amount)

does not earn any income.

My spouse/partner or other adult residing in the home contributes about $

per

towards the household expenses.

FLR 13 (February 1, 2010)

Page 7 of 8

Form 13 - Financial Statement (Support Claims) Page 7