Financial Declaration Page 6
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Business interests.
Business
Nature of
Percent
Current
Monthly
Name
Address & Phone
Business
Owned By
Value
Payments
___% Petitioner
___%Respondent
$
$
___% Petitioner
___%Respondent
$
$
(10)
Financial Assets.
(Attach evidence of items listed, such as bank statements, contracts, etc.)
In Whose
Holder
Asset
Name?
Current Value
(Name & Address)
Petitioner
Bank or Credit Union Account
Respondent
Last 4 digits of acct number: _________
Both
$
Petitioner
Bank or Credit Union Account
Respondent
Last 4 digits of acct number: _________
Both
$
Stocks, Bonds, Securities, Money
Petitioner
Market Fund
Respondent
Both
Last 4 digits of acct number: _________
$
Stocks, Bonds, Securities, Money
Petitioner
Market Fund
Respondent
Both
Last 4 digits of acct number: _________
$
Retirement Account
Petitioner
(Pension,
Respondent
401(k), IRA, etc.)
Both
Last 4 digits of acct number: _________
$
Retirement Account
Petitioner
(Pension,
Respondent
401(k), IRA, etc.)
Both
Last 4 digits of acct number: _________
$
Financial Declaration
Approved Board of District Court Judges September 10, 2008
Page 6 of 11
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