Financial Affidavit For Child Support Page 6
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811. I have other children I am supporting.
Number of children: _____________.
(number of other children)
Children’s names and years of birth:
_________________________________ ______________________
(name)
(year of birth)
_________________________________ ______________________
(name)
(year of birth)
_________________________________ ______________________
(name)
(year of birth)
_________________________________ ______________________
(name)
(year of birth)
For the other child(ren) I am supporting, check the box [ ] that applies:
[ ] If support is court-ordered:
_____________________________________________
(method of support)
_____________________________________________
(name of court)
_____________________________________________
(case number)
_____________________________________________
(amount of support)
OR
[ ] If support is not court-ordered:
____________________________________________
(method of support)
_____________________________________________
(name of other parent)
_____________________________________________
(gross monthly income of other parent)
Continued on next page …
Financial Affidavit for Child Support, DC 6:5(2), PSC Nebraska.
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