Affidavit Verifying Income

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Full Name of Party Filing This Document
Mailing Address (Street or Post Office Box)
City, State and Zip Code
Telephone Number
IN THE DISTRICT COURT OF THE
JUDICIAL DISTRICT OF
THE STATE OF IDAHO, IN AND FOR THE COUNTY OF
Case No.: ___________________
_____________________________________,
Plaintiff,
AFFIDAVIT VERIFYING INCOME
vs.
_____________________________________,
Defendant.
STATE of Idaho
)
) ss.
County of
)
I hereby state under oath that the following information is true:
A.
GROSS INCOME
FATHER
MOTHER
1.
Wages, salary, commissions, bonuses, etc.
________
2.
Rent, royalties, trade, or business income, etc.
________
(Net of ordinary & necessary expenses)
3.
Interest, dividends, pensions, annuities, etc.
________
4.
Social security, worker's compensation, unemployment
benefits, disability, veterans' benefits, etc.
________
5.
Public assistance, welfare for self (not children)
________
6.
Alimony
________
7.
Grants, distributions from trusts, etc.
________
8.
Other
________
9.
SUBTOTAL
________
B.
DEDUCTIONS FROM GROSS INCOME (I.C.S.G. Sections 6 and 7)
1.
Straight line depreciation on assets
________
2.
One-half of self-employment Social Security taxes
________
3.
Child support & alimony from another relationship
________
4.
Support for child of another relationship living
in the home
________
5.
DEDUCTIONS SUBTOTAL
________
AFFIDAVIT VERIFYING INCOME
PAGE 1
CAO 1-11 2/25/2005

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