Family Law Financial Affidavit (Short Form) - Florida Circuit Court Page 6

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28. $_______ TOTAL MONTHLY EXPENSES (add ALL monthly amounts in A through F above)
SUMMARY
29. $_______ TOTAL PRESENT MONTHLY NET INCOME (from line 27 of SECTION I. INCOME)
30. $_______ TOTAL MONTHLY EXPENSES (from line 28 above)
31. $_______ SURPLUS (If line 29 is more than line 30, subtract line 30 from line 29. This is the amount
of your surplus. Enter that amount here.)
32. ($_______) (DEFICIT) (If line 30 is more than line 29, subtract line 29 from line 30. This is the amount
of your deficit. Enter that amount here.)
SECTION III. ASSETS AND LIABILITIES
Use the nonmarital column only if this is a petition for dissolution of marriage and you believe an item
is “nonmarital,” meaning it belongs to only one of you and should not be divided. You should indicate
to whom you believe the item(s) or debt belongs.
(Typically, you will only use this column if
property/debt was owned/owed by one spouse before the marriage. See the “General Information for
Self-Represented Litigants” found at the beginning of these forms and section 61.075(1), Florida
Statutes, for definitions of “marital” and “nonmarital” assets and liabilities.)
A. ASSETS:
Nonmarital
DESCRIPTION OF ITEM(S). List a description of each separate item
Current
owned by you (and/or your spouse, if this is a petition for dissolution
(check correct
Fair
of marriage). LIST ONLY LAST 4 DIGITS OF ACCOUNT NUMBERS. Check
column)
Market
the line next to any asset(s) which you are requesting the judge
Value
award to you.
husband
wife
Cash (on hand)
$
Cash (in banks or credit unions)
Stocks, Bonds, Notes
Real estate: (Home)
(Other)
Automobiles
Other personal property
Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)
Other
____Check here if additional pages are attached.
Total Assets (add next column)
$
Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form)
(01/15)

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