Short Form Financial Declaration
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81
Code:
Name: ______________________________
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Address: ____________________________
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____________________________________
Telephone:___________________________
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IN THE _______________ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
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IN AND FOR THE COUNTY OF __________________
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__________________________________, )
Plaintiff/Petitioner
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Case No. ____________________
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vs
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Dept. No. ___________________
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__________________________________, )
Defendant/Respondent)
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____________________________________)
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SHORT FORM FINANCIAL DECLARATION
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STATE OF NEVADA
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County of ________________)
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I, __________________________________, being duly sworn and under the penalties of
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(print your name)
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perjury, depose and state as follows:
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I have read the contents of this Financial Declaration and am competent to testify as to the
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contents, and the contents are true of my own knowledge except for those matters stated on
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information and belief, and as to those matters, I believe them to be true.
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SUBSCRIBED and SWORN to before me
_____________________________________
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(signature)
this _______day of _____________________, 20____.
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____________________________________________
NOTARY PUBLIC
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Parent category: Financial