Form #4 - Financial Affidavit - Pitt County General Court Of Justice Page 4
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6Form #4
PART 2 CONTINUED
Date of Separation
Current
Date:
Date:
Expense
Self
Children
Total
Self
Children
Total
Spousal support for
another spouse
Child support for another
child
Education
(tuition, fees, supplies)
Extracurricular
(piano, sports, dance, etc.)
Work-related child care
expense, including
summer camps
School Lunches
Allowances for Children
Babysitting, child care,
summer camp
(not included above)
College Fund
School Loans
Other: ______________
Other: _______________
GRAND TOTALS FOR
PART 2:
4
Pitt County Family Court Domestic Forms, 2017
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Parent category: Legal