Post-Decree Financial Affidavit - Oklahoma District Court Page 3

Rent

Interest Income

Trust Income

Annuities

Social Security Benefits

W orkers' Compensation Benefits

Unemploym ent Insurance Benefits

Disability Insurance Benefits

Gifts

Prizes

All other sources (Specify)

TOTAL GROSS MONTHLY INCOME

YOU MUST DISCLOSE ALL GROSS INCOME (12 O.S. 1170).

IF REQUIRED TO DO SO BY DISCOVERY CODE; COURT RULE; COURT ORDER; IN THIS CASE, PLEASE

INDICATE IF YOU FILED TAX RETURNS FOR THE LAST THREE YEARS:

YES / NO (CIRCLE ONE).

IF REQUIRED TO DO SO BY THE DISCOVERY CODE; COURT RULE; COURT ORDER IN THIS CASE, ATTACH

COPIES OF YOUR FEDERAL AND STATE INCOME TAX RETURNS FOR THE LAST THREE (3) YEARS INCLUDING

ALL SCHEDULES AND ATTACHMENTS. COPIES SHOULD BE PROVIDED TO THE OTHER PARTY IN THE CASE

OR HIS/HER ATTORNEY AND THE COURT.

DID YOU OR THE OTHER PARTY IN THE CASE RECEIVE THE EARNED INCOME TAX CREDIT FOR ANY OF THE

PAST THREE TAX YEARS _________YES _________NO (CHECK ONE).

DEDUCTIONS PER PAY PERIOD

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