Certificate Of Compliance With Mandatory Disclosure - Florida Circuit Court Page 2
ADVERTISEMENT
1
2
32.
FOR INITIAL, SUPPLEMENTAL, AND PERMANENT FINANCIAL RELIEF:
The date the following documents were served: __________________.
[check all that apply]
___
a.
Financial Affidavit (Filing of Financial Affidavit
cannot be waived).
( )
Florida Family Law Form 12.901(d) (short form)
( )
Florida Family Law Form 12.901(e) (long form)
___
b.
Child Support Guidelines Worksheet, Florida Family Law
Form 12.901(g), if child support involved.
___
c.
( )
All personal (1040) federal tax, gift tax, and
intangible personal property tax returns for the preceding 3
years;
( )
IRS forms W-2, 1099, and K-1 for the past year
because the income tax return for the past year has not been
prepared.
___
d.
Pay stubs or other evidence of earned income for the 3
months before the service of the financial affidavit.
___
e.
A statement identifying the source and amount of all
income for the 3 months before the service of the financial
affidavit, if not reflected on the pay stubs produced.
___
f.
All loan applications and financial statements prepared
for any purpose or used for any purpose within the 12 months
preceding the service of the financial affidavit.
___
g.
All deeds to real estate in which I presently own or
owned an interest within the past 3 years.
All promissory
notes in which I presently own or owned an interest within
the last 12 months.
All present leases in which I own an
interest.
___
h.
All periodic statements for the last 3 months for all
checking accounts and for the last year for all savings
accounts, money market funds, certificates of deposit, etc.
___
i.
All brokerage account statements for the last 12
months.
___
j.
Most recent statement for any pension, profit sharing,
deferred compensation, or retirement plan (for example, IRA,
401(k), 403(b), SEP, KEOGH, etc.) and summary plan
description for any such plan in which I am a participant or
alternate payee.
___
k.
The declarations page, the last periodic statement, and
the certificate for any group insurance for all life
insurance policies insuring my life or the life of my
spouse.
___
l.
All health and dental insurance cards covering either
of me or my spouse and/or our dependent child(ren).
___
m.
Corporate, partnership, and trust tax returns for the
last 3 tax years, in which I have an ownership or interest
greater than or equal to 30%.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business