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Fill and Sign the Family Law Financial Affidavit Florida Supreme Court Form

Fill and Sign the Family Law Financial Affidavit Florida Supreme Court Form

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- 1 - VER IF IE D S T A TEM EN T I D EN TIF Y IN GM ARIT A L A ND N O N-M ARIT A L A SSE TS D ate o f C om m en cem en t o f a ctio n: _ __________ _________C lie n t I n fo rm atio n: P etitio n er o r R esp onden tN am e: _ _____ ____ ______ _____ __________ __________ _________A ddre ss : _ ___ ______ _____ ______ __________ ______ ____ _________ _ _________ ____ _______ __________ __________ _________ S ocia l S ecu rity N o: _ _____ ____D ate o f B ir th : _ _________T ele p ho ne N o: ( W ) _ ______ ___ ( H ) _ _________P re se n t E m plo yer: _ ______ ____ __________ __________ _________ _ __ ________ __________ ___ _______ _________ _ __ ________ __________ ___ _______ _________ P ositio n: _ _________ _____ ______ __________ __________ _________S P O USE : P etitio ner o r R esp onden tN am e: _ _________ _______ ____ __________ _______ ___ _________A ddre ss : _ ___ ______ _____ ______ __________ ______ ____ _________ _ _________ ____ _______ __________ __________ _________ _ _________ ____ _______ __________ __________ _________ S ocia l S ecu rity N o: _ _____ ____ D ate o f B ir th : _ ______ ___T ele p ho ne N o: ( W ) _ ____ _____ ( H ) _ _________P re se n t E m plo yer: _ _____ _____ __________ _______ ___ _________A ddre ss : _ ___ ______ _____ ______ __________ ______ ____ _________ _ _________ ________ ___ __________ __________ _________ _ _________ ________ ___ __________ __________ _________ - 2 - Positio n: _ _________ ______ _____ __________ __________ _________ - 3 - MARIT A L I N FO RM ATIO N Date o f M arria g e: _ _______ __ C ity /S ta te : _ _________C hild re n - N am e ( s ) Bir th day Age R esid in g W ith_ _ _____ ___ _ _______ __ __ _ ___________ _____ ___ _ _______ __ __ _ ___________ _____ ___ _ _______ __ __ _ ___________ _____ ___ _ _______ __ __ _ ___________ _____ ___ _ _______ __ __ _ ___________ _____ ___ _ _______ __ __ _ ___________ _____ ___ _ _______ __ __ _ ___________ _____ ___ _ _______ __ __ _ _________ L IQ UID A SS E TS Cash n ot i n F in an cia l I n stitu tio n A m ount: _ _________L ocatio n o f C ash n ot i n F in an cia l I n stitu tio n: _ ________ ___ _____ ___ __________ __ _________ __________ __________ _________ C ASH I N B A NK O R A T F IN ANCIA L I N ST IT U TIO N Bala n ce a t B an k/F in an cia l C om men cem en t I n sti tu tio n Acco unt N o. Type of A ctio n__ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ _________ - 4 - Tota l B an k A cco unts _ ____ _____ - 5 - FE D ER AL/S T A TE/C IT Y /M UNIC IP A LIT Y O R O TH ER G OVER NM EN T S E C URIT Y O R O BLIG ATIO N Curre n t Matu rity D esc rip tio n Locatio n Valu e D ate_ _ _____ ___ _ _______ __ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ _________ S E C URIT IE S P U BLIC LY T R ADED Fin an cia l Mark et V alu atio n D esc rip tio n # o f S hare s In stitu tio n Valu e M eth od__ _____ ___ _ _______ __ _ _________ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ _________ _ _________ S E C URIT IE S N O T P U BLIC LY T R ADED F in an cia l M ark et V alu atio n D esc rip tio n # o f S hare s I n stitu tio n V alu e M eth od__ _____ ___ _ _______ __ _ _________ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ _________ _ ___________ _____ ___ _ _______ __ _ _________ _ _________ _ _________ - 6 - __ _____ ___ _ _______ __ _ _________ _ _________ _ _________ O TH ER I N VEST M EN TS D esc rip tio n Valu e Valu atio n M eth od__ _____ ___ __________ __________ _ __________ ___________ _____ ___ __________ __________ _ __________ ___________ _____ ___ __________ __________ _ __________ ___________ _____ ___ __________ __________ _ __________ ___________ _____ ___ __________ __________ _ __________ ___________ _____ ___ __________ __________ _ __________ _________N O TES, A CC O UNTS R EC EIV ABLE ( in clu de d esc rip tio n & r e aso n f o r l o an )D eb to rD esc rip tio n B ala n ce L oan D ate D ue N am e1. _ _ ___ _____ _ ___ _ _ __ _ ____ ___ _ ____ ____ ___2. _ _ ___ _____ _ ___ _ _ __ _ ____ ___ _ ____ ____ ___ L IF E I N SU RAN CE FaceIn su re d Com pan y Polic y N um ber Valu e__ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ _________ - 7 - __ _____ ___ __________ __________ __________ _ ___________ _____ ___ __________ __________ __________ _ _________C ash V alu e L oan A m ount B en efic ia ry_ _ _____ ___ _ ________ _ _ __________ ___________ _____ ___ _ ________ _ _ __________ ___________ _____ ___ _ ________ _ _ __________ ___________ _____ ___ _ ________ _ _ __________ _________ - 8 - REA L E ST A TE 1. Hom este a d : _ _____ _____ __________ _________ A ddre ss: _ ________ ____________ __________ _________L eg al D esc rip tio n: L ot _ _________ B lo ck _ ___ ______S ubdiv is io n _ _____ _____ __________ ________ __ _________O th er D esc rip tio n _ __________ __________ ___________________ ______ _____ __________ __________ _________M ark et v alu e $ ____ ______, b ase d u pon ( ta x a sse ssm en t/ f o rm al a p pra is a l b y _ _____ ____ o th er/ _ _________)S ubje ct t o t h e f o llo w in g e n cu m bra n ce(s ):C ontr a ct f o r d eed w ith _ _________, b ala n ce $ _ _________F ir s t M ortg ag e w ith _ _________, b ala n ce $ _ __ _______S eco nd M ortg ag e w ith _ _________, b ala n ce $ _ _________E quity L oan w ith _ __ _______, b ala n ce $ _ _____ ____Im pro vem en t L oan _ _________, b ala n ce $ _ _________T itle h eld i n n am e(s ) o f: _ __________ _______ ___ _________M ortg ag ees P hone # : _ __________ __________ _________ 2. O th er R ea l E sta te : _ __ ________ __________ _________ A ddre ss: _ ________ ____________ __________ _________L eg al D esc rip tio n: L ot _ _________ B lo ck _ _________S ubdiv is io n _ _____ _____ __________ ________ __ _________O th er D esc rip tio n _ __________ __________ ___________________ ______ _____ __________ __________ _________ - 9 - Mark et v alu e $ _ ____ _____, b ase d u pon ( ta x a ss e ssm en t/ f o rm al a p p ra is a l b y _ ___ ______ o th er/_ _________) S ubje ct t o t h e f o llo w in g e n cu m bra n ce(s ):C ontr a ct f o r d eed w ith _ _________, b ala n ce $ _ _________F ir s t M ortg ag e w ith _ _________, b ala n ce $ _ __ _______S eco nd M ortg ag e w ith _ _________, b ala n ce $ _ _________E quity L oan w ith _ __ _______, b ala n ce $ _ _____ ____Im pro vem en t L oan _ _________, b ala n ce $ _ _________T itle h eld i n n am e(s ) o f: _ __________ _______ __M ortg ag es P hone # : _ __________ __________ _________ 3. Oth er R ea l E sta te : _ __________ __________ _________ A ddre ss: _ ________ ____________ __________ _________L eg al D esc rip tio n: L ot _ _________ B lo ck _ ___ ______S ubdiv is io n _ _____ _____ __________ ________ __ _________O th er D esc rip tio n _ __________ __________ ___________________ ______ _____ __________ __________ _________M ark et v alu e $ _ ____ _____, b ase d u pon ( ta x a ss e ssm en t/f o rm al a p pra is a l b y _ _____ ____ o th er/_ _________) S ubje ct t o t h e f o llo w in g e n cu m bra n ce(s ):C ontr a ct f o r d eed w ith _ _________, b ala n ce $ _ _________F ir s t M ortg ag e w ith _ _________, b ala n ce $ _ __ _______S eco nd M ortg ag e w ith _ _________, b ala n ce $ _ _________E quity L oan w ith _ __ _______, b ala n ce $ _ _____ ____Im pro vem en t L oan _ _________, b ala n ce $ _ _________ - 10 - D EFE R RED C O M PE N SA TIO N P L A NS How m an y y ears t o r e tir e m en t a n d/o r d is tr ib utio n _ ____ _____ - 11 - D EFIN ED B EN EFIT P L A N Pla n N am e: _ _________ P la n # :_ _________P la n A dm in is tr a to r: _ _____ ____ % o f V estin g: _ ______ ___N um ber o f Y ears t o 1 00% V estin g: _ _________ P re se n t V alu e: _ _________F unds L ocatio n: _ ________ __ __________ __________ _ ________V alu atio n M eth od: _ ______ ____ __________ __________ _________ D EFIN ED C O NTR IB U TIO N P L A N Pla n N am e: _ _________ P la n # : _ _________P la n A dm in is tr a to r: _ _____ ____ % o f V estin g: _ ______ ___N um ber o f Y ears t o 1 00% V estin g: _ _________ P re se n t V alu e: _ _________F unds L ocatio n: _ ________ __ __________ __________ _ ________V alu atio n M eth od: _ ______ ____ __________ __________ _________ IR A'S L ocatio n o f F unds: _ ______ ___ A cco unt # : _ _________P re se n t V alu e: _ _________ M atu rity D ate : _ _________R ate o f I n te re st_ _________ __________ S E P's o r K EO UG H's L ocatio n o f F unds: _ ______ ___ A cco unt # : _ _________P re se n t V alu e: _ _________ P la n A dm in is tr a to r: _ _____ ____L oan s:_ _________ ________ ___ __________ ________ __ _________ - 12 - PE R SO NAL P R O PE R TY A uto m ob ile s a n d/o r T ru ck sM ak e, M odel a n d Y ear: _ __ ________ __________ _____ ____C urre n t A m ount F in an cin g: _ __________ __________ _________L oan F in an cin g: _ ________ ____________ _________C urre n t V alu e: _ _________ ___________ _________V alu atio n M eth od: _ ______ ____ __________ __________ _________A uto m ob ile s a n d/o r T ru ck sM ak e, M odel a n d Y ear: _ __ ________ __________ _____ ____C urre n t A m ount F in an cin g: _ __________ __________ _________L oan F in an cin g: _ ________ ____________ __________ _ ________C urre n t V alu e: _ _________ ___________ __________ _________V alu atio n M eth od: _ ______ ____ __________ _________R ecrea tio n al V eh ic le s ( B oa ts , B ic y cle s, M oto rcy cle s, S now m ob ile s, e tc .) M ak e, M odel a n d Y ear: _ __ ________ __________ _____ ____C urre n t A m ount F in an cin g: _ __________ __________ _________L oan F in an cin g: _ ________ ____________ __________ _ ________C urre n t V alu e: _ _________ ___________ __________ _________V alu atio n M eth od: _ ______ ____ __________ __________ _________M ak e, M odel a n d Y ear: _ __ ________ __________ _____ _____ _________C urre n t A m ount F in an cin g: _ __________ __________ _________ - 13 - Loan F in an cin g: _ ________ ____________ __________ _ ________C urre n t V alu e: _ _________ ___________ __________ _________V alu atio n M eth od: _ ______ ____ __________ __________ _________ H O USE H OLD G OODS A N D F U RNIS H IN G S Desc rip tio n Valu e Locatio n M eth od o f V alu atio n__ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ _________v J E W ELR Y Purc h ase Date o fIn su re d M ark et M eth od o f D esc rip tio n Pric e Purc h ase Valu e Valu e Valu atio n__ _____ ___ _____ _____ __ _______ _______ _ ________ _____ ___ _____ _____ __ _______ _______ _ ________ _____ ___ _____ _____ __ _______ _______ _ ________ _____ ___ _____ _____ __ _______ _______ _ ________ _____ ___ _____ _____ __ _______ _______ _ ________ _____ ___ _____ _____ __ _______ _______ _ ________ _____ ___ _____ _____ __ _______ _______ _ ______ O TH ER P R O PE R TY Lis t a n y i te m s w ith a v alu e o f $ 300 o r m ore , i n clu din g b ut n ot l im ite d t o , a n tiq ues, h eir lo om s, g uns, st e re o e q uip m en t, t e le v is io ns & v id eo e q uip m en t, c o lle ctio ns o r f u rn itu re : B asis f o r D esc rip tio n Valu e Valu e C la im ed Locatio n__ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ ___________ _____ ___ _ ________ _ __________ _ ________ __ _________ - 14 - O th er i te m s, a tta ch s c h ed ule s a s n ecessa ry . M IS C ELLA NEO US P R O PE R TY Pate n ts , T ra d em ark s, C opyrig hts a n d R oyaltie s D esc rip tio n Valu e __ _____ ___ __________ __ _________ __________ __________ ___________ _____ ___ __________ __ _________ __________ __________ ___________ _____ ___ __________ __ _________ __________ __________ ___________ _____ ___ __________ __ _________ __________ __________ _________ O W NED B U SIN ESS I N TER EST S SO LE P R O PR IE TO RSH IP SPro prie to rs h ip N am e: _ ____ ______ __________ _________B usin ess L ocatio n: _ ______ ____ __________ __________ ___________ _____ ___ __________ __ _________ __________ __________ _________T ype o f B usin ess: _ ______ _ ___ __________ ________ __ _________% o f O wners h ip : _ _______ __Y ears E sta b lis h ed : _ _________L ast Y ear T ax R etu rn F ile d : _ _________ V alu e ( e st.) _ _________V alu atio n M eth od: _ ______ ____ __________ __________ _________B uy-S ell A gre em en ts : Y es N o P A RTN ER SH IP - G en era l o r L im it e d ( s p ecif y )P artn ers h ip N am e: _ ______ ____ __________ ________ __ _________B usin ess L ocatio n: _ ______ ____ __________ __________ ___________ _____ ___ __________ __ _________ __________ __________ _________T ype o f B usin ess: _ ______ _ ___ __________ ________ __ _________% o f O wners h ip : _ _______ __Y ears E sta b lis h ed : _ _________L ast Y ear T ax R etu rn F ile d : _ _________ V alu e ( e st.) _ _________V alu atio n M eth od: _ ______ ____ __________ __________ _________B uy-S ell A gre em en ts : Y es N o C O RPO RATIO NS - S ub S O R C ( s p ecif y )N am e: _ _________ _______ ____ __________ __________ _________B usin ess L ocatio n: _ ______ ____ __________ __________ ___________ _____ ___ __________ __ _________ __________ __________ _________T ype o f B usin ess: _ ______ _ ___ __________ ________ __ _________% o f O wners h ip : _ _______ ___ __________ _________ - 15 - Y ears E sta b lis h ed : _ ______ ___L ast Y ear T ax R etu rn F ile d : _ _________ V alu e ( e st.) _ _________V alu atio n M eth od: _ ______ ____ __________ __________ _________B uy-S ell A gre em en ts : Y es No - 16 -T R UST S N am e o f N am e o f V alu e o f B en efic ia ry 'sB en efic ia ry T ru ste e T ru st I n te re st i n T ru st1 . _ _ ___ _____ _ ________ _ __________ ___________ _________2. _ _ ___ _____ _ ________ _ __________ ___________ _________3. _ _ ___ _____ _ ________ _ __________ ___________ _________4. _ _ ___ _____ _ ________ _ __________ ___________ _________ P E R SO NAL P R O PE R TY H ELD F O R Y O U B Y A NO TH ER (In clu din g c ash a n d n eg oti a b le s e cu ritie s) P ers o n D esc rip tio n H old in g T itle T o V alu e E ncu m bra n ce_ _ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ _________ N O N-M ARIT A L P R O PE R TY D esc rip tio n D ate Non-M arita l S ourc es o f A cq uir e d V alu e Non-M arita l I n te re st _ _ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ _________ - 17 - __ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ _________ L IA BIL IT IE S D eb ts ( C re d it c ard s) C re d ito r's R esp onsib le Bala n ce a s o f Pay m en t P er N am e P arty C om men cem en t D ate M onth_ _ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ ___________ _____ ___ _ ________ _ __________ ___________ _________D ate d :P etitio ner/R esp onden tS ub sc rib ed a n d s w orn t o b efo re m eth is _ __ __ d ay o f _ ________ ___, 2 0___._ __ ___ _________________________N OTA RY P U BLIC

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