Child Support Determination Form Page 7
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7Part 9 – Statement of each parent's assets and liabilities
Give cash amounts, amounts deposited in bank accounts or other financial institutions and the market value of property in each
ASSETS:
of the following categories (regardless of any debt related thereto): immovables, furniture, automobiles, works of art, jewellery, shares,
bonds, interests in a business, other investments, pension plans, retirement savings plans, receivables, etc.
: Give debts or financial commitments of any nature in the form of loans or credit (hypothecary loans, personal loans, lines of
LIABILITIES
credit, credit cards, instalment purchases, security, etc.) or that you must pay under a statute (fiscal debts, assessments, dues and other
unpaid duties or fees, etc.) or court decision (damages, support, employment insurance or income security overpayment, fines, etc.)
FATHER’S ASSETS
VALUE
FATHER’S LIABILITIES
VALUE
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Others (provide details)
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Others (provide details)
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TOTAL
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TOTAL
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S
(assets - liabilities)
____________
UMMARY
MOTHER’S ASSETS
VALUE
MOTHER’S LIABILITIES
VALUE
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Others (provide details)
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Others (provide details)
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TOTAL
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TOTAL
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S
(assets - liabilities)
____________
UMMARY
Part 10 – Declaration under oath
I declare that the above information is accurate
I declare that the above information is accurate
and complete for my part, and I sign:
and complete for my part, and I sign:
at
at
this
day of
this
day of
___________________________________________________
___________________________________________________
Father’s signature
Mother’s signature
Declaration made under oath before me
Declaration made under oath before me
at
at
this
day of
this
day of
___________________________________________________
____________________________________________________
Signature of person authorized to administer oaths
Signature of person authorized to administer oaths
7
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