Affidavit Of Arrears
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2q
District Court
_________________________________________ County, Colorado
Court Address:
In Re:
Petitioner:
Respondent/Co-Petitioner:
COURT USE ONLY
Attorney or Party Without Attorney
:
Case Number:
(Name and Address)
Phone Number:
E-mail:
FAX Number:
Atty. Reg.#:
Division
Courtroom
AFFIDAVIT OF ARREARS
I, ________________________________________________________________, declare under oath
that:
1.
The type of support ordered is
q
child support
q
maintenance
q
other (specify):
2.
The amount of support ordered to be paid each month is $
.
3.
The support payment has not been timely made and: (check applicable statement)
q
a. (if payments were to be made into the court registry or Family Support Registry)
The full payment was not received by the registry on or before the due date of
___________________________.
q
b. (if payments were to be made to the Obligee directly)
I did not receive the full payment on or before the due date of _________________________.
4.
If any modifications have been made to the Support Order complete the following:
a.
Effective date of any modification: ________________________
b.
Amount of any modification: $____________________________
5.
Total child support due (________ payments due x $_____________)
$__________
a.
Total amount of child support paid
-
$__________
b.
Total principal of amount of child support due
$__________
c.
One twenty-fourth of Line 5b
$__________ + interest at ____%
(12% unless otherwise agreed)
JDF 1807
R7/00
AFFIDAVIT OF ARREARS
PAGE 1 OF 2
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