Complaint For Divorce Page 26
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37(subsections (d) & (e) deleted)
3. A. AFFIANT’S GROSS MONTHLY INCOME (complete this section or attach Child Support
Schedule A)
(All income must be entered based on monthly average regardless of date of receipt.)
Salary or Wages
$ ______________
ATTACH COPIES OF 2 MOST RECENT WAGE STATEMENTS
Commissions, Fees, Tips
$ ______________
Income from self-employment, partnership, close corporations,
and independent contracts (gross receipts minus ordinary
and necessary expenses required to produce income)
ATTACH SHEET ITEMIZING YOUR CALCULATIONS
$ ______________
Rental Income (gross receipts minus ordinary and
necessary expenses required to produce income)
ATTACH SHEET ITEMIZING YOUR CALCULATIONS
$ ______________
Bonuses
$ ______________
Overtime Payments
$ ______________
Severance Pay
$ ______________
Recurring Income from Pensions or Retirement Plans
$ ______________
Interest and Dividends
$ ______________
Trust Income
$ ______________
Income from Annuities
$ ______________
Capital Gains
$ ______________
Social Security Disability or Retirement Benefits
$ ______________
Workers’ Compensation Benefits
$ ______________
Unemployment Benefits
$ ______________
Judgments from Personal Injury or Other Civil Cases
$ ______________
Gifts (cash or other gifts that can be converted to cash)
$ ______________
Prizes/Lottery Winnings
$ ______________
Alimony and maintenance from persons not in this case
$ ______________
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