Complaint For Divorce Page 18

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In the Superior Court of ______________ County, Georgia
)
______________________, Plaintiff
)
)
vs.
)
Civil Action No. ___________
)
______________________, Defendant
)
)
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT OF HUSBAND
1. AFFIANT’S NAME:______________________________
Age _________
Spouse’s Name: _______________________________
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 affiant’s other children:
Name
Date of Birth
Resides with
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
2. SUMMARY OF AFFIANT’S INCOME AND NEEDS
(a) Gross monthly income (from item 3A)
$ ______________
(b) Net monthly income (from item 3C)
______________
(c) Average monthly expenses (item 5A)
$ ______________
Monthly payments to creditors
+ ______________
Total monthly expenses and payments
to creditors (item 5C)
_______________
18

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