Form E Financial Statement – Fill Out and Use This PDF

This form should only be completed in applications for a financial order (which can only be applied for as part of a divorce, dissolution, annulment or (judicial) separation in the High Court or family courts in England and Wales) or for applications for financial relief after an overseas divorce/dissolution etc. If the application is for any other financial remedy please complete Form E1.

This form should be used if the application is for the variation of an order for periodical payments where the applicant seeks the dismissal (immediate or otherwise) of the periodical payments order and its substitution with one or more of a lump sum order, a property adjustment order, a pension sharing order or a pension compensation sharing order. If you are making such an application, you must complete sections 1.14 and 5.1(e) of this form.

If the application is for any other variation of an order for a financial remedy please complete Form E2. Please fill in this form fully and accurately. Where any box is not applicable, write ‘N/A’.

You have a duty to the court to give a full, frank and clear disclosure of all your financial and other relevant circumstances.

A failure to give full and accurate disclosure may result in any order the court makes being set aside.

If you are found to have been deliberately untruthful, criminal proceedings may be brought against you for fraud under the Fraud Act 2006.

The information given in this form must be confirmed by a statement of truth. Proceedings for contempt of court may be brought against a person who makes or causes to be made, a false statement in a document verified by a statement of truth.

You must attach documents to the form where they are specifically sought and you may attach other documents where it is necessary to explain or clarify any of the information that you give.

Essential documents that must accompany this statement are detailed in the form.

If there is not enough room on the form for any particular piece of information, you may continue on an attached sheet of paper.

If you are in doubt about how to complete any part of this form you should seek legal advice.

1 General Information

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1.12 Details of the present and proposed future educational arrangements for the children.

1.13Details of any child support maintenance calculation or any maintenance order or agreement made in respect of any children of the family. If no calculation, order or agreement has been made, give an estimate of the liability of the non-resident parent in respect of the children of the family under the Child Support Act 1991.

1.14If this application is to vary an order, attach a copy of the order and give details of the part that is to be varied and the changes sought. You may need to continue on a separate sheet.

1.15Details of any other court cases between you and your spouse/civil partner, whether in relation to money, property, children or anything else.

1.16Your present residence and the occupants of it and on what terms you occupy it (e.g. tenant, owner-occupier).

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2.1Complete this section in respect of the family home (the last family home occupied by you and your spouse/civil partner) if it remains unsold.

Documentation required for attachment to this section:

a)A copy of any valuation of the property obtained within the last six months. If you cannot provide this document, please give your own realistic estimate of the current market value

b)A recent mortgage statement confirming the sum outstanding on each mortgage

Property name and address

Land Registry title number

Mortgage company name(s) and address(es) and account number(s)

Type of mortgage

Details of who owns the property and the extent of your legal and beneficial interest in it (i.e. state if it is owned by you solely or jointly owned with your spouse/civil partner or with others)

If you consider that the legal ownership as recorded at the Land Registry does not reflect the true position, state why

Current market value of the property

Balance(s) outstanding on any mortgage(s)

If a sale at this stage would result in penalties payable under the mortgage, state amount

Estimate the costs of sale of the property

Total equity in the property

(i.e. market value less outstanding mortgage(s), penalties if any and the costs of sale)

TOTAL value of your interest in the family home: Total A £

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2.2Details of your interest in any other property, land or buildings. Complete one page for each property you have an interest in.

Documentation required for attachment to this section:

a)A copy of any valuation of the property obtained within the last six months. If you cannot provide this document, please give your own realistic estimate of the current market value

b)A recent mortgage statement confirming the sum outstanding on each mortgage

Property name and address

Land Registry title number

Mortgage company name(s) and address(es) and account number(s)

Type of mortgage

Details of who owns the property and the extent of your legal and beneficial interest in it (i.e. state if it is owned by you solely or jointly owned with your spouse/civil partner or with others)

If you consider that the legal ownership as recorded at the Land Registry does not reflect the true position, state why

Current market value of the property

Balance outstanding on any mortgage(s)

If a sale at this stage would result in penalties payable under the mortgage, state amount

Estimate the costs of sale of the property

Total equity in the property

(i.e. market value less outstanding mortgage(s), penalties if any and the costs of sale)

Total value of your interest in this property

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2.3Details of all personal bank, building society and National Savings Accounts that you hold or have held at any time in the last twelve months and which are or were either in your own name or in which you have or have had any interest. This applies whether any such account is in credit or in debit. For joint accounts give your interest and the name of the other account holder. If the account is overdrawn, show a minus figure.

Documentation required for attachment to this section:

For each account listed, all statements covering the last 12 months.

2.4Details of all investments, including shares, PEPs, ISAs, TESSAs, National Savings Investments (other than already shown above), bonds, stocks, unit trusts, investment trusts, gilts and other quoted securities that you hold or have an interest in. (Do not include dividend income as this will be dealt with separately later on.)

Documentation required for attachment to this section:

Latest statement or dividend counterfoil relating to each investment.

TOTAL value of your interest in ALL holdings: (C2) £

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2.5Details of all life insurance policies including endowment policies that you hold or have an interest in. Include those that do not have a surrender value. Complete one page for each policy.

Documentation required for attachment to this section:

A surrender valuation of each policy that has a surrender value. Name of company

Policy type Policy number

If policy is assigned, state in whose favour and amount of charge

TOTAL value of your interest in ALL policies: (C3) £

2.6Details of all monies that are OWED TO YOU. Do not include sums owed in director’s or partnership accounts which should be included at section 2.11.

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2.7Details of all cash sums held in excess of £500. You must state where it is held and the currency it is held in.

2.8Details of personal belongings individually worth more than £500.

INCLUDE:

•Cars (gross value)

•Collections, pictures and jewellery

•Furniture and house contents

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2Financial Details Part 2 Capital: Liabilities and Capital Gains Tax

2.9 Details of any liabilities you have. EXCLUDE liabilities already shown such as:

•Mortgages

•Any overdrawn bank, building society or National Savings accounts

INCLUDE:

•Money owed on credit cards and store cards

•Bank loans

•Hire purchase agreements

List all credit and store cards held including those with a nil or positive balance. Where the liability is not solely your own, give the name(s) of the other account holder(s) and the amount of your share of the liability.

2.10If any Capital Gains Tax would be payable on the disposal now of any of your real property or personal assets, give your estimate of the tax liability.

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2Financial Details Part 3 Capital: Business assets and directorships

2.11Details of all your business interests. Complete one page for each business you have an interest in. Documentation required for attachment to this section:

a)Copies of the business accounts for the last two financial years

b)Any documentation, if available at this stage, upon which you have based your estimate of the current value of your interest in this business, for example a letter from an accountant or a formal valuation.

It is not essential to obtain a formal valuation at this stage

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2.12List any directorships you hold or have held in the last 12 months (other than those already disclosed in Section 2.11).

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2.13Give details of all your pension rights and all PPF compensation entitlements, including prospective entitlements. Complete a separate page for each pension or PPF compensation entitlement.

EXCLUDE:

•Basic State Pension

INCLUDE (complete a separate page for each one):

•Additional State Pension (SERPS and State Second Pension (S2P))

•Free Standing Additional Voluntary Contribution Schemes (FSAVC) separate from the scheme of your employer

•Membership of ALL pension plans or schemes

•PPF compensation entitlement for each scheme you were a member of which has transferred to PPF

Documentation required for attachment to this section:

a)A recent statement showing the cash equivalent (CE) provided by the trustees or managers of each pension arrangement; for the additional state pension, a valuation of these rights or for PPF a valuation of PPF compensation entitlement

b)If any valuation is not available, give the estimated date when it will be available and attach a copy of your letter to the pension company, administrators, or PPF Board from whom the information was sought and/or state the date on which an application for a valuation of an Additional State Pension was submitted to the Department of Work and Pensions

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2.14Give details of any other assets not listed in Parts 1 to 4 above. INCLUDE (the following list is not exhaustive):

•Any personal or business assets not yet disclosed

•Unrealisable assets

•Share option schemes, stating the estimated net sale proceeds of the shares if the options were capable of exercise now, and whether Capital Gains Tax or income tax would be payable

•Business expansion schemes

•Futures

•Commodities

•Trust interests (including interests under a discretionary trust), stating your estimate of the value of the interest and when it is likely to become realisable. If you say it will never be realisable, or has no value, give your reasons

•Any asset that is likely to be received in the foreseeable future

•Any asset held on your behalf by a third party

•Any asset not disclosed elsewhere on this form even if held outside England and Wales

You are reminded of your obligation to disclose all your financial assets and interests of ANY nature.

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2.16You will have already given details of your business and provided the last two years accounts at section 2.11. Complete this section giving details of your income from your business. Complete one page for each business.

Documentation required for attachment to this section:

a)A copy of your last tax assessment or, if that is not available, a letter from your accountant confirming your tax liability

b)If net income from the last financial year and estimated net income for the next 12 months is significantly different, a copy of management accounts for the period since your last account

Name of the business

Date to which your last accounts were completed

Your share of gross business profit from the last completed accounts

Income tax and national insurance payable on your share of gross business profit above

Net income for that year (using the two figures directly above, gross business profit less income tax and national insurance payable)

Details and value of any benefits in kind, perks or other remuneration received from this business in the last year

e.g. provision of a car, payment of travel, accommodation, meal expenses, etc.

Amount of any regular monthly or other drawings that you take from this business

If the estimated figure directly below is different from the net income as at the end date of the last completed accounts, briefly explain the reason(s)

Your estimate of your net annual income for the next 12 months

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2Financial Details Part 8 Income: Income from investments

e.g. dividends, interest or rental income

2.17Details of income received in the last financial year (the year ended last 5th April), and your estimate of your income for the current financial year. Indicate whether the income was paid gross or net of income tax. You are not required to calculate any tax payable that may arise.

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2.18 Details of all state benefits that you are currently receiving.

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2Financial Details Part 10 Income: Any other income

2.19 Details of any other income not disclosed above.

INCLUDE:

Any source including a Pension (excluding State Pension), and Pension Protection Fund (PPF) compensation

•from which income has been received during the last 12 months (even if it has now ceased)

•from which income is likely to be received during the next 12 months

You are reminded of your obligation to give full disclosure of your financial circumstances

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2.21 Summary of your estimated income for the next 12 months (Parts 6 to 10).

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3 Financial Requirements Part 1 Income needs

3.1Income needs for yourself and for any children living with you or provided for by you. ALL figures should be annual, monthly or weekly (state which). You must not use a combination of these periods. State your current income needs and, if these are likely to change in the near future, explain the anticipated change and give an estimate of the future cost.

The income needs below are:WeeklyMonthlyAnnual (delete those not applicable)

I anticipate my income needs are going to change because

3.1.1Income needs for yourself.

INCLUDE:

•All income needs for yourself

•Income needs for any children living with you or provided for by you only if these form part of your total income needs (e.g. housing, fuel, car expenses, holidays, etc)

INCLUDE:

•Only those income needs that are different to those of your household shown above

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3 Financial Requirements Part 2 Capital needs

3.2Set out below the reasonable future capital needs for yourself and for any children living with you or provided for by you.

3.2.1Capital needs for yourself.

INCLUDE:

•All capital needs for yourself

•Capital needs for any children living with you or provided for by you only if these form part of your total capital needs (e.g. housing, car, etc.)

•Only those capital needs that are different to those of your household shown above

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4 Other Information

4.1Details of any significant changes in your assets or income. At both sections 4.1.1 and 4.1.2, INCLUDE:

•ALL assets held both within and outside England and Wales

•The disposal of any asset

4.1.1 Significant changes in assets or income during the LAST 12 months.

4.1.2 Significant changes in assets or income likely to occur during the NEXT 12 months.

4.2Brief details of the standard of living enjoyed by you and your spouse/civil partner during the marriage/civil partnership.

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4.3Are there any particular contributions to the family property and assets or outgoings, or to family life, or the welfare of the family that have been made by you, your partner or anyone else that you think should be taken into account? If there are any such items, briefly describe the contribution and state the amount, when it was made and by whom.

INCLUDE:

•Contributions already made

•Contributions that will be made in the foreseeable future

4.4Bad behaviour or conduct by the other party will only be taken into account in very exceptional circumstances when deciding how assets should be shared after divorce/dissolution. If you feel it should be taken into account in your case, identify the nature of the behaviour or conduct below.

4.5Give details of any other circumstances that you consider could significantly affect the extent of the financial provision to be made by or for you or any child of the family.

INCLUDE (the following list is not exhaustive):

•Earning capacity

•Disability

•Inheritance prospects

•Redundancy

•Retirement

•Any agreement made between you and your spouse/civil partner before or after your marriage/civil partnership stating whether or not you rely upon the agreement giving your reasons

•Any plans to marry, form a civil partnership or live with a new partner

•Any contingent liabilities

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4.6If you have subsequently married or formed a civil partnership (or intend to) or are living with another person (or intend to), give brief details, so far as they are known to you, of his or her income, assets and liabilities.

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5 Order Sought

5.1If you are able at this stage, specify what kind of orders you are asking the court to make. Even if you cannot be specific at this stage, if you are able to do so, indicate:

a)If the family home is still owned, whether you are asking for it to be transferred to yourself or your spouse/civil partner or whether you are saying it should be sold

b)Whether you consider this is a case for continuing spousal maintenance/maintenance for your civil partner or whether you see the case as being appropriate for a ‘clean break’ (A ‘clean break’ means a settlement or order which provides amongst other things, that neither you nor your spouse/civil partner will have any further claim against the income or capital of the other party. A ‘clean break’ does not terminate the responsibility of a parent to a child.)

c)Whether you are seeking a

i)pension sharing order

ii)pension attachment order

iii)pension compensation sharing order

iv)pension compensation attachment order

d)If you are seeking a transfer or settlement of any property or assets, identify the property or assets in question

e)Where you seek the dismissal, immediate or otherwise, of an order for periodical payments and its substitution with another order, whether the substituted order you seek is for

i)a lump sum order

ii)a property adjustment order

iii)a pension sharing order and/or

iv)a pension compensation sharing order.

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5.2If you are seeking a variation of an ante-nuptial or post-nuptial settlement or a relevant settlement made during, or in anticipation of, a civil partnership, identify the settlement, by whom it was made, its trustees and beneficiaries and state why you allege it is a settlement which the court can vary.

5.3If you are seeking an avoidance of disposition order, or if you have already applied for such an order, identify the property to which the disposition relates and the person or body in whose favour the disposition is alleged to have been made.

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Statement of Truth

*delete as appropriate

*[I believe] [the Applicant/Respondent believes] that the facts stated in this statement are true *I am duly authorised by the Applicant/Respondent to sign this statement

and confirm that the information given above is a full, frank, clear and accurate disclosure of my financial and other relevant circumstances.

Print full name

Address for service

Postcode

Name of Applicant’s/ Respondent’s solicitor’s firm

Position or office held

(if signing on behalf of firm or company)

Proceedings for contempt of court may be brought against a person who makes or causes to be made, a false statement in a document verified by a statement of truth.

Address all communications to the Court Manager of the Court and quote the case number. If you do not quote this number, your correspondence may be returned.

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