Fill and Sign the Colorado Affidavit Printable Form

 District Court _________________________________________ County, Colorado Court Address: In Re: Petitioner: Respondent/Co-Petitioner: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E-mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom AFFIDAVIT OF ARREARS I, ________________________________________________________________, declare under oath that: 1. The type of support ordered is  child support  maintenance  other (specify): 2. The amount of support ordered to be paid each month is $ . 3. The support payment has not been timely made and: (check applicable statement)  a. (if payments were to be made into the court registry or Family Support Registry) The full payment was not received by the registry on or before the due date of ___________________________.  b. (if payments were to be made to the Obligee directly) I did not receive the full payment on or before the due date of _________________________. 4. If any modifications have been made to the Support Order complete the following: a. Effective date of any modification: ________________________ b. Amount of any modification: $____________________________ 5. Total child support due (________ payments due x $_____________) $__________ a. Total amount of child support paid - $__________ b. Total principal of amount of child support due $__________ c. One twenty-fourth of Line 5b $__________ + interest at ____% (12% unless otherwise agreed) JDF 1807 R7/00 AFFIDAVIT OF ARREARS PAGE 1 OF 2 6. Total maintenance due (______ payments due x $______________) a. Total amount of maintenance paid - $__________ b. Total principal amount of maintenance due $__________ c. One twenty-fourth of Line 6b $__________ + interest at ____% (8% unless otherwise agreed) Attach a copy of the payment record maintained by the Family Support Registry, if payment is ordered through the Family Support Registry, or detail period(s) on a separate sheet of paper of the time when the arrears accrued for child support and for maintenance. I declare under penalty of perjury that I have read this affidavit and the statements contained are true to the best of my knowledge.  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. (Checking this box requires you to remove JDF number and copyright at the bottom of the form.) Date: Obligee My Commission expires : Notary Public/Deputy Clerk CERTIFICATE OF SERVICE I certify that on _________________________ (date) I sent the original and one copy of this Affidavit of Arrears to the COURT, by United States Mail, first class postage prepaid, addressed as follows: AND I certify that I sent a copy of the Affidavit of Arrears to the Obligor by United States Mail, first class postage prepaid addressed as follows: Signature JDF 1807 R8/17 AFFIDAVIT OF ARREARS PAGE 2 OF 2