Form 100-00127 - Financial Disclosure Affidavit Page 2
Download a blank fillable Form 100-00127 - Financial Disclosure Affidavit in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 100-00127 - Financial Disclosure Affidavit with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Financial Disclosure Affidavit
If YES, please describe below
I have additional assets
Y
N
Additional Assets:
Make, Model,Year
Fair Market
Amount Owed
Net value
Vehicles
Value (FMV)
Description
FMV
Mortgage
Net Value
Real Property
Description
FMV
Other Assets
e.g. tools, equipment,
recreational vehicles,
electronics, stocks,
bonds, etc.
Other Employed Household Members
Employer’s Address
Name of Household Member
Name of Employer
Change in Monthly Income:
If your current monthly income is significantly different from last year’s income,
please describe your current monthly income and the reasons why it changed.
My current monthly income is:
$
My current household income is:
$
The reason for the change is:
(This section must be filled out if you have a change in income.)
I hereby affirm of my own knowledge that the facts and financial information I have stated are true and correct as of the
date of this Affirmation and that I am not omitting any source or amount of income or other information requested on
this form. I understand that any false information may constitute perjury by me. I also understand that if I fail to
provide the required information or give misinformation, the judge may order sanctions against me.
Signed and sworn before me:
Defendant’s Signature
Date
Date
Notary Public
100-00127 – Financial Disclosure Affidavit (04/2015)
Page 2 of 2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal