Domestic Relations Financial Affidavit
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6COUNTY SUPERIOR COURT
STATE OF GEORGIA
,
Plaintiff,
Civil Action
vs.
Case Number
,
Defendant.
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
(1) Your Name:
Your Age:
Spouse’s Name:
Spouse’s Age:
Date of Marriage:
Date of Separation:
Names and birth dates of children for whom support is to be determined in this action:
Name
Date of Birth
Resides with
Names and birth dates of your other children:
Name
Date of Birth
Resides with
(2) S
Y
I
N
:
(fill out this part after you complete pages 2-5)
UMMARY OF
OUR
NCOME AND
EEDS
(A) Gross Monthly Income (from Item 3A below)
$
(B) Net Monthly Income (from Item 3B below)
$
(C) Average Monthly Expenses (Item 5A below)
$
Monthly Payments to Creditors (Item 5B below)
$
Total Monthly Expenses & Payments to Creditors (Item 5C below)
$
Domestic Relations Financial Affidavit -
Page 1 of 6
rev. DRAFT January 8, 2007
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