Domestic Relations Financial Affidavit Page 5
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6Lawn Care:
Repairs:
Pest Control:
Tags and License:
Insurance:
CHILDREN'S EXPENSES
AFFIANT'S OTHER EXPENSES
Child Care (total monthly
cost):
Dry Cleaning / Laundry:
School Tuition:
Clothing:
Tutoring:
Medical, Dental, Prescription
(out-of-pocket / uncovered
expenses):
Private Lessons (e.g. music,
dance):
Affiant's Gifts (special
holidays):
School Supplies / Expenses:
Lunch Money:
Entertainment:
Other Educations Expenses
Recreational Expenses (e.g.
(list):
fitness):
Vacations:
Travel Expenses for
Visitation:
Allowance:
Clothing:
Publications:
Diapers:
Dues, Clubs:
Medical, Dental, Prescription
Religoius and Charities:
(out-of-pocket / uncovered
expenses):
Pet Expenses:
Grooming, Hygiene:
Alimony Paid to Former
Spouse:
Gifts from Children to Others:
Child Support Paid for Other
Children:
Entertainment:
Date of Initial Order:
Activities (including extra-
curricular, school, religious,
Other (attach sheet):
cultural, etc.):
Summer Camps:
OTHER INSURANCE:
Health:
Children's Portion:
Domestic Relations Financial Affidavit
Page 5 of 6
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