Form Dr-100 - Petition For Dissolution Of Marriage (No Minor Children) Page 3
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8II.
FINANCIAL INFORMATION
Each party must attach a copy of his or her most recent federal tax return, W2, and at least two of
his or her most recent paystubs to verify income and deductions. If work is seasonal, show yearly
income. If income or deductions will change after the dissolution, file documents showing expected
income and deductions. The following income and deductions are
monthly
yearly.
A. Gross Income (Do not list ATAP or SSI.)
Party A
Party B
Gross wages
$
$
Value of employer-provided
housing/food/BAH/BAS/COLA/etc.
$
$
Unemployment compensation
$
$
Permanent Fund Dividend
$
$
Other:
$
$
$
$
$
$
$
$
TOTAL INCOME
$
$
B. Deductions
Federal, state, and local income tax
$
$
Social security (FICA) or self-employ. tax
$
$
Medicare tax
$
$
Employment security tax (SUI)
$
$
Mandatory retirement deductions
$
$
Mandatory union dues
$
$
Voluntary retirement contributions if plan
earnings are tax-free or deferred, up to
7.5% of gross wages & self-employ. income
when combined with mandatory contrib.
$
$
Other mandatory deductions (specify):
$
$
Spousal support (alimony) ordered in other
cases and currently paid
$
$
Child support ordered for prior children of a
1
different relationship and currently paid
$
$
In-kind support for prior children of a
different relationship calculated under
2
90.3(a)(1)(D)
$
$
Work-related child care for children in this
case
$
$
TOTAL DEDUCTIONS
$
$
C. Net Income
TOTAL INCOME from section A
$
$
TOTAL DEDUCTIONS from section B
$
$
Subtract deductions from income to get
NET INCOME
$
$
Signature of Party A
Signature of Party B
1
Not to exceed support amount calculated under 90.3(a)(2). “Prior children” includes children from a different
relationship who were born or adopted before the children in this case.
2
For more information, see
Prior Child Deduction Chart
and Civil Rule 90.3.
Page 3 of 8
DR-100 (8/15)(cs)
AS 25.24.200-.260
PETITION FOR DISSOLUTION OF MARRIAGE (NO MINOR CHILDREN)
Civil Rule 90.1(a), f(2)(A)(B), (i)(1)
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