Indiana Form Financial Declaration PDF Details

At the heart of family law proceedings in Indiana, especially those involving divorce, child support, and custody disputes, is the Indiana Financial Declaration Form—a comprehensive document designed to provide the court with a detailed snapshot of the financial status of the parties involved. By requiring disclosure of both parties' incomes, expenses, assets, and liabilities, this form plays a critical role in guiding decisions on financial support and division of property. The form covers several critical areas including gross weekly income from various sources, deductions for taxes and insurance, monthly living expenses, and the value and ownership of a wide array of assets, from household goods to retirement accounts. It takes into account not just the traditional forms of income but also includes sources like business income, dividends, and even extraordinary expenses such as healthcare or education for children of the marriage. With sections dedicated to the disclosure of assets acquired prior to the marriage or through inheritance or gifts, it underscores the importance of transparency in ensuring fairness in the dissolution of marital relationships. Moreover, the form's structure underscores a legal obligation towards accuracy and truthfulness, mandating updates if any previously provided information changes, thereby ensuring that the judicial system has the most current data to make informed decisions.

QuestionAnswer
Form NameIndiana Form Financial Declaration
Form Length13 pages
Fillable?Yes
Fillable fields440
Avg. time to fill out30 min 25 sec
Other nameshow to fill out a financial declaration form indiana, downlod marion county indiana fillable financial declaration, financial declaration form, marion county indiana financial declaration form

Form Preview Example

STATE OF INDIANA : CIRCUIT COURT : SUPERIOR COURT : MARION COUNTY

 

 

 

 

CAUSE NO.

 

 

Petitioner

 

 

 

 

 

 

-vs-

 

DATED:

 

 

 

 

 

VERIFIED FINANCIAL DECLARATION OF

 

 

Respondent

 

[HUSBAND/FATHER] [WIFE/MOTHER]

 

 

 

 

 

 

 

HUSBAND/FATHER:

 

WIFE/MOTHER:

Name:

 

 

Name:

 

Address:

 

 

Address:

 

 

 

 

 

 

 

 

Occupation:

 

 

Occupation:

 

Employer:

 

 

Employer:

 

Date of Birth:

 

 

Date of Birth:

 

 

 

 

 

 

 

ATTORNEYS

 

SPACE BELOW FOR USE OF COURT CLERK ONLY

Name, Address, and Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GROSS WEEKLY INCOME – ATTACH LAST THREE (3) PAYROLL STUBS

AMOUNTS

 

 

 

1.

Gross Weekly SALARY, WAGES and COMMISSIONS

 

 

 

 

2.

Gross Weekly PENSIONS/RETIRMENT/SOCIAL SECURITY/DISABAILITY/UNEMPLOYMENT/WORKMAN’S COMP

 

3.

Gross Weekly CHILD SUPPORT received from any prior marriage (not this marriage)

 

 

 

 

4.

Gross Weekly DIVIDENDS and INTEREST

 

 

 

 

5.

Gross Weekly RENTS/ROYALTIES less ordinary and necessary expenses (Attach calculations)

 

 

 

 

6.

Gross Weekly BUSINESS/SELF-EMPLOYMENT INCOME less ordinary and necessary expenses (Attach calculations)

 

 

 

 

7.

ALL OTHER SOURCES (Specify)*

 

 

 

 

8.

TOTAL GROSS WEEKLY INCOME (Total of Lines 1 through 7)

 

 

 

 

9.Minus Weekly COURT ORDERED CHILD SUPPORT for Prior Children – amounts actually paid

10.Minus Weekly LEGAL DUTY CHILD SUPPORT for Prior Children

11.Minus Weekly HEALTH INSURANCE PREMIUMS for Children of This Marriage Only)

12.Minus Weekly ALIMONY/SUPPORT/MAINTENANCE Paid to Prior Spouses – amounts actually paid

13.WEEKLY AVAILABLE INCOME (Line 8 less Lines 9 through 12)

14.Weekly WORK RELATED CHILD CARE COSTS for Custodial Parent to work for Children of This Marriage Only

15.Weekly EXTRAORDINARY HEALTHCARE EXPENSES (Children of This Marriage Only – Uninsured Only)

16.Weekly EXTRAORDINARY EDUCATION EXPENSES (Children of This Marriage Only)

*Includes Bonuses; Alimony and Maintenance Received from Prior Marriages; Capital Gains; Trust Income; Gifts; Prizes: In-Kind Benefits from Employment such as Company Car; Free Housing; Reimbursed Meals. DO NOT INCLUDE ADC, SSI, General Assistance, Food Stamps.

© Copyright, 1990, Indianapolis Bar Association

Page 1

Names and relationship of all members of household whose expenses are included:

Monthly Expenses And Deductions From Income

 

 

 

 

 

1.

FEDERAL INCOME TAXES (weekly deductions times 4.3)

 

 

 

2.

STATE INCOME TAXES (weekly deductions times 4.3)

 

 

 

 

3.

LOCAL INCOME TAXES (weekly deductions times 4.3)

 

 

 

 

4.

SOCIAL SECURITY TAXES (weekly deductions times 4.3)

 

 

 

 

 

5.

RETIREMENT/PENSION FUND [

Mandatory] [

Optional] (weekly deductions times 4.3)

 

 

 

6.

RENT/MORTGAGE PAYMENTS (Residence)

 

 

 

7.

RESIDENCE/PROPERTY TAXES/INSURANCE-if not included in Mortgage Payment (Total for year ÷ 12)

 

 

 

 

8.

MAINTENANCE ON RESIDENCE

 

 

 

 

 

9.

FOOD/HOUSEHOLD SUPPLIES/LAUNDRY/CLEANING

 

 

 

 

 

10.

ELECTRICITY (Total for year ÷ 12)

 

 

11.GAS (Total for year ÷ 12 or Monthly Budget Amount)

12.WATER/SEWER/SOLID WASTE/TRASH COLLECTION (Total for year ÷ 12)

13. TELEPHONE (including Long Distance Charges)

14. CLOTHING

15. MEDICAL/DENTAL EXPENSES (Not reimbursed by Insurance)

16. AUTOMOBILE – LOAN PAYMENT

17. AUTOMOBILE – GAS/OIL

18. AUTOMOBILE – REPAIRS

19. AUTOMOBILE – INSURANCE (Total for year ÷ 12)

20. LIFE INSURANCE

21. HEALTH INSURANCE (exclude payments for children shown on Page 1, line 11)

22. DISABILITY/ACCIDENT/OTHER INSURANCE (Please specify)

23. ENTERTAINMENT (Clubs, Social Obligations, Travel, Recreation, Cable Television)

24. CHARITABLE/CHURCH CONTRIBUTIONS

25. PERSONAL EXPENSES (Haircuts, cosmetics, grooming, tobacco, alcohol, etc.)

26. BOOKS/MAGAZINES/NEWSPAPERS

27. EDUCATION/SCHOOL EXPENSES (Self and children you have custody of)

28. DAYCARE/WORK RELATED CHILD CARE COSTS (weekly amount times 4.3)

29. OTHER EXPENSES (Please specify)

30.

31.

MONTHLY LOAN/CHARGE CARD EXPENSES

FOR

 

BALANCE

PAYMENTS

 

(Do not include monthly payments shown above)

 

 

 

 

 

 

32.

 

 

 

 

 

 

 

 

 

 

 

33.

 

 

 

 

 

 

 

 

 

 

 

34.

 

 

 

 

 

 

 

 

 

 

 

35.

 

 

 

 

 

 

 

 

 

 

 

36.

 

 

 

 

 

 

 

 

 

 

 

37.

 

 

 

 

 

 

 

 

 

 

 

38.

 

 

 

 

 

 

 

 

 

 

39.

Total Monthly Expenses And Deductions From Income (Total of Lines 1 through 38)

 

 

40.Average Weekly Expenses And Deductions (Total monthly expenses year ÷ 4.3)

Page 2

ASSETS

Disclose all assets known to you, even if you do not know the value. Under ownership, H = Husband; W = Wife; J = Joint. Lien amount includes only those debts secured by an item, such as a mortgage against a house, debts shown on title to vehicle, loans against life insurance policies or loans where an item is pledged as collateral. Value assets as of date Petition for Dissolution of Marriage was filed.

Show valuation date here:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GROSS

LESS: LIENS/

NET

 

TITLE

 

 

 

DESCRIPTION

VALUE

MORTGAGE

VALUE

H

W

J`

 

A. HOUSEHOLD FURNISHINGS, FURNITURE, APPLIANCES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

In possession of Husband:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2..

In possession of Wife:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. . AUTOMOBILES, TRUCKS, RECREATIONAL VEHICLES (Include Make, Model and Year)

3.

4.

5.

6.

C.SECURITIES – STOCKS, BONDS, AND STOCK OPTIONS

7.

8.

9.

10.

D.CASH, CHECKING, SAVINGS, DEPOSIT ACCOUNTS, CDs (Include name of Bank/Credit Union and type of account)

11.

12.

13.

14.

15.

E. REAL ESTATE (including Land Sales Contracts)

16.Marital Residence (Show Address)

Basis of Valuation:

Name of lender first Mortgage:

Name of lender second Mortgage:

17.Other (Show Address)

Basis of Valuation:

Name of lender first Mortgage:

Name of lender second Mortgage:

18.Other (Show Address)

Basis of Valuation:

Name of lender first Mortgage:

Name of lender second Mortgage:

Page 3

 

GROSS

LESS: LIENS/

NET

 

TITLE

 

DESCRIPTION

VALUE

MORTGAGE

VALUE

H

W

J`

F.CASH RETIREMENT ACCOUNTS (IRAs, SEPS, KEOUGHS, 401K (Employee savings plans, stock ownership/profit sharing plans, etc.)

19.

20.

21.

22.

23.

G.RETIREMENT BENEFITS, DEFERRED COMPENSATION PLANS AND PENSIONS (Include information available on benefits, whether benefits are vested or in pay status)

24,

25.

H. BUSINESS INTERESTS

26.

27.

28.

I.LIFE INSURANCE (Show Company and Death Benefits) Term and Group

29.

Named Beneficiary:

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

30.

Named Beneficiary:

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

31.

Named Beneficiary:

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

Whole Life and Others (Show Cash Value under Gross Value)

 

 

 

32.Named Beneficiary:

33.Named Beneficiary:

34.Named Beneficiary:

J.OTHER ASSETS Include any type of assets having value, including jewelry, personal property, assets located in safety deposit boxes, accrued bonuses, etc.

35.

36.

37.

38.

39.

40.

41.

Page 4

ASSETS ACQUIRED BY YOU PRIOR TO THE MARRIAGE OR THROUGH INHERITANCE OF GIFT

(Whether now owned or not)

 

 

 

 

 

 

 

 

LESS: LEINS/

 

 

 

VALUATION

SHOW SIGNIFICANT ASSETS ONLY

 

 

 

GROSS VALUE

MORTGAGES

 

NET VALUE

DATE

A.

ASSETS OWNED BY YOU PRIOR TO

 

 

 

 

 

 

 

 

 

 

 

 

MARRIAGE (value as of date of marriage)

 

 

 

 

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

 

 

 

 

 

 

 

 

 

 

 

 

 

B.

ASSETS ACQUIRED BY YOU DURING MARRIAGE

 

 

 

 

 

 

 

 

 

 

 

THROUGH INHERITANCE OR GIFTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(value as of date of acquisition

 

 

 

 

 

 

 

 

 

 

 

6.

Acquired from whom:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

Acquired from whom:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

Acquired from whom:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I declare under penalty of perjury that the foregoing, including any attachments, is true and correct,

that this declaration was executed on the

 

 

day of

 

 

, 20

_ .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature:

Printed Name:

You are under a duty to supplement or amend this Financial Declaration prior to trial if you learn the information provided is incorrect or the information provided is no longer true.

 

 

 

 

 

CERTIFICATE OF SERVICE

 

 

 

I hereby certify that a true, exact and authentic copy of the foregoing has been served upon

the following, [

 

by United States mail, first class postage prepaid], [

 

hand delivery]

this

 

day of

 

 

, 20 _ :

 

 

Attorney for [Husband/Father] [Wife/Mother]

Attorney’s Address/Phone Number

Page 5

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How you can fill in financial declaration for divorce portion 1

2. After filling out this step, head on to the next stage and complete all required particulars in all these blanks - ATTORNEYS Name Address and, SPACE BELOW FOR USE OF COURT CLERK, GROSS WEEKLY INCOME ATTACH LAST, AMOUNTS, Gross Weekly SALARY WAGES and, Gross Weekly DIVIDENDS and, Gross Weekly RENTSROYALTIES less, Gross Weekly, ALL OTHER SOURCES Specify, TOTAL GROSS WEEKLY INCOME Total, Minus Weekly COURT ORDERED CHILD, and Minus Weekly HEALTH INSURANCE.

How one can complete financial declaration for divorce part 2

3. The following segment is considered rather easy, Weekly WORK RELATED CHILD CARE, Includes Bonuses Alimony and, Copyright Indianapolis Bar, and Page - all of these empty fields must be filled in here.

Part no. 3 in submitting financial declaration for divorce

Be really careful when completing Includes Bonuses Alimony and and Weekly WORK RELATED CHILD CARE, because this is where many people make mistakes.

4. Filling out Names and relationship of all, Monthly Expenses And Deductions, FEDERAL INCOME TAXES weekly, STATE INCOME TAXES weekly, LOCAL INCOME TAXES weekly, SOCIAL SECURITY TAXES weekly, RETIREMENTPENSION FUND Mandatory, Optional weekly deductions times, RENTMORTGAGE PAYMENTS Residence, RESIDENCEPROPERTY TAXESINSURANCEif, MAINTENANCE ON RESIDENCE, FOODHOUSEHOLD, ELECTRICITY Total for year, GAS Total for year or Monthly, and WATERSEWERSOLID WASTETRASH is key in the fourth section - don't forget to be patient and take a close look at each and every field!

A way to fill out financial declaration for divorce stage 4

5. To finish your form, the particular part features some extra blank fields. Filling out MEDICALDENTAL EXPENSES Not, LIFE INSURANCE, HEALTH INSURANCE exclude payments, DISABILITYACCIDENTOTHER INSURANCE, ENTERTAINMENT Clubs Social, CHARITABLECHURCH CONTRIBUTIONS, PERSONAL EXPENSES Haircuts, BOOKSMAGAZINESNEWSPAPERS, EDUCATIONSCHOOL EXPENSES Self and, DAYCAREWORK RELATED CHILD CARE, OTHER EXPENSES Please specify, MONTHLY LOANCHARGE CARD EXPENSES, Do not include monthly payments, FOR, and BALANCE will certainly finalize the process and you'll surely be done in a short time!

Part no. 5 of completing financial declaration for divorce

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