Pre-Decree Financial Affidavit - Oklahoma District Court Page 2
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10PRIMARY EMPLOYER ADDRESS: ___________________________________________________________________
Street,
City,
State,
Zip Code
PRIMARY EMPLOYER TELEPHONE: ________________________________________________________________
AVERAGE NUMBER OF HOURS WORKED PER WEEK: ______________________________________________
CIRCLE THE BASIS ON WHICH YOUR PAY IS BASED:
HOURLY; WEEKLY; MONTHLY; ANNUALLY AND
INDICATE WHAT YOUR PAY IS FOR THE CIRCLED AMOUNT: $_____________________________________.
CIRCLE HOW OFTEN YOU ARE PAID:
W EEKLY; EVERY 2 WEEKS; TW ICE MONTHLY; MONTHLY;
HOW LONG HAVE YOU WORKED FOR THIS EMPLOYER:_____________________________________________
SECONDARY EMPLOYER NAME: ________________________________________________________________
SECONDARY EMPLOYER ADDRESS: _____________________________________________________________
Street,
City,
State,
Zip Code
SECONDARY EMPLOYER TELEPHONE: ___________________________________________________________
CIRCLE THE BASIS ON WHICH YOUR PAY IS BASED:
HOURLY; WEEKLY; MONTHLY; ANNUALLY AND
INDICATE WHAT YOUR PAY IS FOR THE CIRCLED AMOUNT: $_______________________________________
CIRCLE HOW OFTEN YOU ARE PAID: W EEKLY; EVERY 2 W EEKS; TW ICE MONTHLY; MONTHLY
HOW LONG HAVE YOU WORKED FOR THIS EMPLOYER: _______________________________________________
IF REQUIRED TO DO SO BY THE DISCOVERY CODE; COURT RULE; COURT ORDER IN THIS CASE, PLEASE
ATTACH COPIES OF YOUR LAST FOUR (4) PAY STUBS FROM YOUR PRIMARY AND SECONDARY
EMPLOYMENT.
INCOME / EXPENSES / ASSETS AND LIABILITIES:
GROSS MONTHLY INCOME
FATHER
MOTHER
Salary
W ages
Commissions
Dividends
Bonuses
Severance Pay
Pensions
Rent
Interest Income
Trust Income
Annuities
Social Security Benefits
W orkers' Compensation Benefits
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