Clayton County Financial Form PDF Details

Navigating through the complexities of a legal case in Clayton County, Georgia, particularly those involving family matters, requires various forms and documents. Among these, the Clayton County Financial Affidavit stands out as a crucial piece of documentation that plays a vital role in domestic relations cases. Essentially, this form is a comprehensive statement where an individual discloses detailed information about their financial situation. It covers various sections: personal information, including a brief overview of the family composition and income statements; a detailed summary of monthly income and expenses; and a thorough listing of both marital and non-marital assets. This affidavit serves as a foundational document to inform the court about each party's financial status, aiding in decisions related to alimony, child support, and the equitable distribution of marital assets. It requires the disclosure of gross and net monthly income, along with documentation such as recent wage statements and calculations for self-employment income. Additionally, it demands transparency about monthly expenses across various categories and the enumeration of assets and liabilities. The goal is to provide a clear, fair view of one's financial capacity and needs, underscoring its importance in ensuring that court decisions are made with the best information available.

QuestionAnswer
Form NameClayton County Financial Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesclayton county courthouse expungement forms, fillable domestic financial affidavit, domestic relations financial, domestic financial affidavit

Form Preview Example

IN THE SUPERIOR COURT OF CLAYTON COUNTY

STATE OF GEORGIA

,

 

 

 

 

 

Plaintiff,

 

Civil Action

 

 

vs.

 

 

 

 

 

 

 

Case Number ______________________________

,

 

 

 

 

 

Defendant.

 

 

 

 

 

DOMESTIC RELATIONS FINANCIAL AFFIDAVIT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) Your Name:

 

 

Your Age:

 

 

 

 

 

 

Spouse’s Name:

 

 

Spouse’s Age:

 

 

 

 

 

 

Date of Marriage:

 

Date of Separation:

 

 

 

 

 

 

Names and birth dates of children for whom support is to be determined in this action:

 

 

 

 

 

 

Name

 

Date of Birth

 

Resides with

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Names and birth dates of your other children:

 

 

 

 

 

 

 

 

Name

 

Date of Birth

 

Resides with

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2) SUMMARY OF YOUR INCOME AND NEEDS: (fill out this part after you complete pages 2-5)

 

 

 

(A) Gross Monthly Income (from Item 3A below)

 

$

 

 

 

 

 

(B) Net Monthly Income (from Item 3B below)

 

 

 

$

 

 

 

(C) Average Monthly Expenses (Item 5A below)

 

$

 

 

 

Monthly Payments to Creditors (Item 5B below)

 

$

 

 

 

Total Monthly Expenses & Payments to Creditors (Item 5C below)

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

__________________________________________________________________________________________________

Domestic Relations Financial Affidavit - Rev. June 2007

Page 1 of 6

Provided by the Atlanta Legal Aid Society

 

(3) (A) YOUR 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.

Where applicable, income should be annualized.)

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

$

 

 

Worker’s 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

$

 

 

Assets which are used for support of family

$

 

 

Fringe Benefits (if significantly reduce living expenses)

$

 

 

Any Other Income (Do not include means-tested public assistance, such as TANF or food stamps.)

$

 

 

TOTAL Gross Monthly Income (also write in 2A on page one)

$

 

 

 

 

 

 

__________________________________________________________________________________________________

Domestic Relations Financial Affidavit - Rev. June 2007

Page 2 of 6

Provided by the Atlanta Legal Aid Society

 

(3)(B) Net Monthly Income From Employment (deducting only state and federal taxes and

$

FICA) (also write in 2B on page one)

 

 

 

 

 

Your Pay Period (i.e., monthly, weekly, etc.):

Number of Exemptions Claimed

 

 

by You for Tax Purposes:

 

 

 

 

(4)ASSETS

(List all assets here, including both non-marital and marital property. If you claim or agree that all or part of an asset is non-marital, indicate the non-marital portion under the appropriate spouse’s column and state the amount and the basis: pre-marital, gift, inheritance, source of funds, etc. The total value of each asset must be listed in the "value" column. "Value" means what you feel the item of property would be worth if it were offered for sale.)

 

 

 

Separate

Separate

Basis of the Claim

 

 

 

 

Asset of

Asset of

(pre-marital, gift,

 

Description

Value

 

Husband

Wife

inheritance, etc.)

 

 

 

 

 

 

 

 

Cash

$

$

$

 

 

 

 

 

 

 

 

 

Stocks, Bonds

$

$

$

 

 

 

 

 

 

 

 

 

CD’s / Money Market Accounts

$

$

$

 

 

 

 

 

 

 

 

 

Bank Accounts (list each account below):

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)

$

$

$

 

 

 

 

 

 

 

 

 

(2)

$

$

$

 

 

 

 

 

 

 

 

 

(3)

$

$

$

 

 

 

 

 

 

 

 

 

Retirement Pensions, 401(k), IRA or

$

$

$

 

 

Profit-Sharing

 

 

 

 

 

 

 

 

 

 

 

 

 

Money Owed to You (or Spouse)

$

$

$

 

 

 

 

 

 

 

 

 

Tax Refund Owed to You

$

$

$

 

 

 

 

 

 

 

 

 

Real Estate (list properties & mortgages):

 

 

 

 

 

 

 

 

 

 

 

 

 

Home

$

$

$

 

 

 

 

 

 

 

 

 

Debt owed on Home

$

 

 

 

 

 

Other Real Estate

$

$

$

 

 

 

 

 

 

 

 

 

Debt owed on Other Real

$

 

 

 

 

 

Estate

 

 

 

 

 

 

 

 

 

 

 

 

 

Automobiles / Vehicles (list vehicles & amounts owed on each one):

(1)

$

 

 

Debt owed on Vehicle (1)

$

 

 

$

$

__________________________________________________________________________________________________

Domestic Relations Financial Affidavit - Rev. June 2007

Page 3 of 6

Provided by the Atlanta Legal Aid Society

 

(2)

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Debt owed on Vehicle (2)

 

$

 

 

 

 

 

 

 

(4) ASSETS (continued)

 

 

 

 

Separate

Separate

Basis of the Claim

 

 

 

 

 

Asset of

Asset of

 

(pre-marital, gift,

Description

 

 

Value

 

Husband

Wife

 

inheritance, etc.)

 

 

 

 

 

 

 

 

 

 

Life Insurance (net cash value)

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Furniture / Furnishings

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Jewelry

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Collectibles

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Assets (specify):

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL ASSETS

 

$

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(5)(A) AVERAGE MONTHLY EXPENSES FOR YOU AND YOUR HOUSEHOLD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOUSEHOLD EXPENSES

 

 

 

 

 

 

 

 

 

 

 

 

 

Mortgage or Rent Payments

 

$

 

Gas

 

 

 

$

 

 

 

 

 

 

 

Property taxes

 

$

 

Repairs & Maintenance

 

$

 

 

 

 

 

 

 

 

 

Homeowner’s / Renter’s Insurance

 

$

 

Lawn Care

 

 

 

$

 

 

 

 

 

 

 

 

 

Electricity

 

$

 

Pest Control

 

 

 

$

 

 

 

 

 

 

 

Water

 

$

 

Cable TV / Internet Access

 

$

 

 

 

 

 

 

 

Garbage & Sewer

 

$

 

Misc. Household & Grocery Items

 

$

 

 

 

 

 

 

 

Telephones

 

 

 

Meals Outside Home

 

$

 

 

 

 

 

 

 

 

Residential Lines

 

$

 

Other (specify)

 

 

 

$

 

 

 

 

 

 

 

 

 

 

Cellular Telephones

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTOMOTIVE

 

 

 

 

 

 

 

 

 

Gasoline & Oil

 

$

 

Auto Tags / Registration / License

 

$

 

 

 

 

 

 

 

 

 

Repairs & Maintenance

 

$

 

Insurance

 

 

 

$

 

 

 

 

 

 

 

 

OTHER VEHICLES (boats, trailers, RVs, etc.)

 

 

 

 

 

 

 

Gasoline & Oil

 

$

 

Tags / Registration / License

 

$

 

 

 

 

 

 

 

 

 

Repairs & Maintenance

 

$

 

Insurance

 

 

 

$

 

 

 

 

 

 

 

 

 

 

__________________________________________________________________________________________________

Domestic Relations Financial Affidavit - Rev. June 2007

Page 4 of 6

Provided by the Atlanta Legal Aid Society

 

 

CHILDREN’S EXPENSES

 

 

 

 

 

 

Child Care (total monthly cost)

 

$

Allowance

$

 

 

 

 

 

School Tuition

 

$

Children’s Clothing

$

 

 

 

 

 

Tutoring

 

$

Diapers

$

 

 

 

 

 

Private lessons (e.g., music, dance)

 

$

Medical, Dental, Prescriptions

$

 

 

 

(out-of-pocket uncovered expenses)

 

 

 

 

 

 

School Supplies / Expenses

 

$

Grooming / Hygiene

$

 

 

 

 

 

Lunch Money

 

$

Gifts from children to others

$

 

 

 

 

Other Educational Expenses (list type & amount):

Entertainment

$

 

 

 

 

______________________

 

$

Activities (including extra-curricular,

$

 

 

school, religious, cultural, etc.)

 

 

 

 

 

 

 

 

 

 

______________________

 

$

Summer Camps

$

 

 

 

 

 

 

OTHER INSURANCE

 

 

 

 

 

Health Insurance

$

Life Insurance

$

 

 

 

 

Children’s portion:

$

Relationship of Beneficiary:

 

 

 

 

 

Dental Insurance

$

Disability Insurance

$

 

 

 

 

Children’s portion:

$

Other Insurance (specify)

$

 

 

 

 

Vision Insurance

$

 

$

 

 

 

 

Children’s portion:

$

 

$

 

 

 

 

 

YOUR OTHER EXPENSES

 

 

 

 

 

 

Dry Cleaning & Laundry

 

$

Publications

$

 

 

 

 

 

Clothing

 

$

Dues, Clubs

$

 

 

 

 

 

Medical / Dental / Prescription

 

$

 

$

(out-of-pocket uncovered

 

 

Religious & Charities

 

expenses)

 

 

 

 

 

 

 

 

 

Your Gifts (special holidays)

 

$

Pet expenses

$

 

 

 

 

 

Entertainment

 

$

Alimony Paid to Former Spouse

$

 

 

 

 

 

Recreational Expenses (e.g., fitness)

 

$

Child Support Paid for other children

$

 

 

 

 

 

Vacations

 

$

Date of initial CS order:

 

 

 

 

 

 

Travel Expenses for Visitation

 

$

Other (attach sheet to list)

$

 

 

 

 

 

 

 

 

 

 

__________________________________________________________________________________________________

Domestic Relations Financial Affidavit - Rev. June 2007

Page 5 of 6

Provided by the Atlanta Legal Aid Society

 

 

 

 

 

 

 

 

 

TOTAL ABOVE MONTHLY EXPENSES (also write on first line of 2C on page one)

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(5)(B) YOUR PAYMENTS & DEBTS TO CREDITORS

 

 

 

 

 

 

 

 

 

 

 

 

 

To Whom

 

Balance Due

Monthly

(Please check one)

 

 

 

 

 

 

Payments

Joint

Husband

Wife

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

Total Monthly Payments to Creditors (also write this total on line 2 of 2C on page one)

$

 

 

 

 

 

 

 

 

 

(5)(C)TOTAL MONTHLY EXPENSES

 

 

 

$

 

 

(Total Expenses from final line on page 5 + Total Monthly Payments to Creditors above)

 

 

 

(also write this total on line 3 of 2C on page one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_________________________________________________

G Plaintiff G Defendant Pro se

(Sign in front of notary public.)

Name: ___________________________________________

Address: __________________________________________

Daytime Phone: (

)_________________________

 

 

 

Subscribed and sworn before me on

, 20 .

__________________________________

Notary Public

__________________________________________________________________________________________________

Domestic Relations Financial Affidavit - Rev. June 2007

Page 6 of 6

Provided by the Atlanta Legal Aid Society