Affidavit Of Income And Expenses - Ohio Court Of Common Pleas
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7COURT OF COMMON PLEAS
COUNTY, OHIO
Case No.
Plaintiff/Petitioner 1
Judge
v./and
Magistrate
Defendant/Petitioner 2
Instructions: Check local court rules to determine when this form must be filed.
This affidavit is used to make complete disclosure of income, expenses and money owed. It is used to determine child and
spousal support amounts. Do not leave any category blank. Write “none” where appropriate. If you do not know exact
figures for any item, give your best estimate and put “EST.” If you need more space, add additional pages.
AFFIDAVIT OF INCOME AND EXPENSES
Affidavit of
(Print Your Name)
Date of marriage
Date of separation
SECTION I - INCOME
___________________ Your Name
________________Spouse’s Name
Employed
Yes
No
Yes
No
Employer
Payroll address
Payroll city, state, zip
Scheduled paychecks per year
12
24
26
52
12
24
26
52
A.
YEARLY INCOME, OVERTIME, COMMISSIONS AND BONUSES FOR PAST THREE YEARS
___________________ Your Name
_______________Spouse’s Name
$
3 years ago
20
$
Base yearly income
$
2 years ago
20
$
$
Last year
20
$
$
3 years ago
20
$
Yearly overtime, commissions
$
2 years ago
20
$
and/or bonuses
$
Last year
20
$
Supreme Court of Ohio
Uniform Domestic Relations Form – Affidavit 1
Affidavit of Income and Expenses
Approved under Ohio Civil Rule 84
Amended: March 15, 2016
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