Fillable Property And Debt Statement And Proposed Separation Agreement (Page 12 of 13) in pdf

Property And Debt Statement And Proposed Separation Agreement Page 12

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I certify under oath that I have given the other party a copy of this Property and Debt Statement pursuant to Supreme Court

Rule 43.01(d) by: (You MUST check at least ONE of the following five boxes)

Serving a copy with the original pleadings herein.

____________________

Mailing a copy to the other party or his or her attorney on

at the following address:

(Date)

________________________________________________________________________

(Street)

_________________________

__________________

______________

(City)

(State)

(Zip)

____________________

Handing a copy to the other party or his or her attorney on

(Date)

Sending a copy to the other party or his or her attorney by fax to

____________________

_______________ (fax number) on

at ____________

(Date)

(Time)

Sending a copy via electronic mail to the other party or his or her attorney at

____________________

____________________________________________

(Email Address)

(Date)

Instructions: The following information MUST be filled in before a notary public. Your Statement of Property and Debt is required to be verified before

a notary public.

COUNTY OF ______________ )

) ss.

STATE OF ________________ )

Wife, of lawful age, being duly sworn on her oath, states that she is the Wife named herein and

that the facts stated in this Statement of Property and Debt are true according her best knowledge and

belief, and that she agrees with the terms and conditions set forth herein.

Further, Wife states that she executed this Statement of Property and Debt as her free act and

deed.

__________________________________

►__________________________________

WIFE – SIGN HERE