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Financial Affidavit Short Form

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Florida Family Law Rules of Procedure Form 12.902(b) — Family Law Financial Affidavit (Short Form)

INSTRUCTIONS

This form should be used when you are involved in a family law case which requires a financial affidavit and your individual gross income is under $50,000 per year.

This form should be typed or printed in black ink. After completing this form, you should sign the form before a notary public or deputy clerk.

If this is a domestic violence case and you want to keep your address confidential for safety reasons, do not enter the address, telephone, and fax information at the bottom of this form.

Hourly, daily, weekly, bi-weekly, and semi-monthly income and expense amounts must be converted to monthly amounts.

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA

Case No.: Division:

, Petitioner,

and

, Respondent.

FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM)

(Under $50,000 Individual Gross Annual Income)

I, , being sworn, certify that the following information is true:

My Occupation: Employed by:

Business Address:

Pay rate: $ ( ) every week ( ) every other week ( ) twice a month ( ) monthly ( ) other:

Check here if unemployed and explain on a separate sheet your efforts to find employment.

SECTION I. PRESENT MONTHLY GROSS INCOME:

All amounts must be MONTHLY. Attach more paper if needed.

1. Monthly gross salary or wages

2. Monthly bonuses, commissions, allowances, overtime, tips, and similar payments

3. Monthly business income

4. Monthly disability benefits/SSI

5. Monthly Workers’ Compensation

6. Monthly Unemployment Compensation

7. Monthly pension, retirement, or annuity payments

8. Monthly Social Security benefits

9. Monthly alimony actually received

10. Monthly interest and dividends

11. Monthly rental income

12. Monthly income from royalties, trusts, or estates

13. Monthly reimbursed expenses and in-kind payments

14. Monthly gains derived from dealing in property

15. Any other income of a recurring nature

17. Present monthly gross income total

PRESENT MONTHLY DEDUCTIONS:

18. Monthly federal, state, and local income tax

a. Filing Status

b. Number of dependents claimed

19. Monthly FICA or self-employment taxes

20. Monthly Medicare payments

21. Monthly mandatory union dues

22. Monthly mandatory retirement payments

23. Monthly health insurance payments

24. Monthly court-ordered child support actually paid

25. Monthly court-ordered alimony actually paid

26. Total deductions allowable

27. Present net monthly income

SECTION II. AVERAGE MONTHLY EXPENSES

A. Household

Mortgage or rent

Property taxes

Utilities

Telephone

Food

Meals outside home

Maintenance/Repairs

Other

B. Automobile

Gasoline

Repairs

Insurance

C. Child(ren)’s Expenses

Day care

Lunch money

Clothing

Grooming

Gifts for holidays

Medical/Dental (uninsured)

Other

D. Insurance

Medical/Dental

Child(ren)’s medical/dental

Life

Other

E. Other Expenses Not Listed Above

Clothing

Medical/Dental (uninsured)

Grooming

Entertainment

Gifts

Religious organizations

Miscellaneous

Other

F. Payments to Creditors

SUMMARY

29. Total present monthly net income

30. Total monthly expenses

31. Surplus

32. Deficit

SECTION III. ASSETS AND LIABILITIES

A. Assets

Check here if additional pages are attached.

B. Liabilities

Check here if additional pages are attached.

C. Contingent Assets and Liabilities

SECTION IV. CHILD SUPPORT GUIDELINES WORKSHEET

A Child Support Guidelines Worksheet is or will be filed in this case.

A Child Support Guidelines Worksheet is not being filed in this case.

I certify that a copy of this document was:

mailed faxed and mailed hand delivered on

Other party or his/her attorney:

Name:

Address:

City, State, Zip:

Fax Number:

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this affidavit.

Dated:

Signature of Party

Printed Name:

Address:

City, State, Zip:

Telephone Number:

Fax Number:

STATE OF FLORIDA

COUNTY OF

Sworn to or affirmed and signed before me on by

NOTARY PUBLIC or DEPUTY CLERK

Personally known

Produced identification

Type of identification produced

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:

I, , a nonlawyer, located at , , , , helped , who is the petitioner or respondent, fill out this form.

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What the Financial Affidavit Short Form Is and when it’s used

The Financial Affidavit Short Form is a concise sworn statement reporting an individual’s income, assets, debts, and monthly expenses for use in family law and related proceedings. Courts commonly use the short form to speed exchanges during divorce, temporary support, child support, or temporary relief hearings where a full financial statement is not required. The form summarizes key financial facts, supports interim orders, and may be attached to pleadings; some jurisdictions treat it as an official court filing and will require notarization or local filing procedures.

Why a short-form affidavit can be the right choice

The short form reduces preparation time and focuses the court on material financial facts for interim proceedings. It simplifies disclosure, makes routine updates easier, and clarifies numbers used to calculate temporary orders while still creating a sworn, court-admissible record.

Why a short-form affidavit can be the right choice

Who typically completes or relies on this short form

Typical users include litigants, family law attorneys, court clerks, and support enforcement agencies that need a quick, sworn snapshot of finances.

  • Individuals filing for temporary relief in divorce or child support matters.
  • Family law practitioners preparing interim financial exhibits for hearings.
  • Court staff and mediators who need standardized short summaries for scheduling or triage.

The form is most useful when time is limited or the court requests abbreviated financial disclosure rather than a full affidavit or detailed financial statement.

Common signers and submitters

Individual Filer

A party to the case who completes the form under oath. You must enter truthful, complete figures; inaccuracies can affect orders and expose you to court sanctions or credibility loss.

Attorney or Agent

A licensed attorney or authorized representative who prepares or reviews the short form before filing. They verify supporting documents and ensure the affidavit meets local court formatting and notarization rules.

Core components of a professional Financial Affidavit Short Form

A well-structured short form highlights essential financial elements and provides clear signatory and verification blocks so a court can rely on the statement without a full accounting.

Income summary

Net and gross income lines for employment, self-employment, and other sources, with a brief notes field to identify irregular income or recent changes.

Assets snapshot

Condensed asset list covering bank accounts, retirement accounts, vehicles, and real property with current approximate values and account identifiers where relevant.

Liabilities summary

Outstanding debts including mortgages, loans, credit cards, and tax obligations with current balances and monthly payment amounts.

Monthly expenses

Standard monthly household expenses—housing, utilities, insurance, childcare, transportation—summarized to support support calculations.

Supporting attachments

Space to list attached pay stubs, bank statements, tax returns, or account ledgers that substantiate the numbers provided on the form.

Oath and signature

Clear jurat or affirmation line with date, signature, and notary or witness block when required by local rules.

Stepwise process to complete and submit the short form

Follow these steps in order to prepare a complete affidavit and reduce the risk of filing delays or court rejection.

  • 01
    Gather documents: Collect pay stubs, bank statements, and recent tax returns.
  • 02
    Populate fields: Enter accurate amounts and date ranges on the form.
  • 03
    Attach evidence: Append supporting documents and label each attachment.
  • 04
    Sign and verify: Sign under oath and complete notarization or electronic jurat as required.

Typical digital workflow settings for online completion

Configure a consistent workflow so each affidavit follows the same authentication and storage rules when completed electronically.

Field Configuration
Authentication method Email link or SMS one-time code; consider stronger verification for court-sensitive filings
Required fields Mark name, case number, income, assets, liabilities, signature as mandatory
Attachments Require upload of supporting documents with specified file types (PDF preferred)
Notarization step Include conditional notarization field or RON routing when jurisdiction permits

How electronic completion and submission typically flow

A standard eSubmission workflow reduces turnaround and preserves a court-ready audit trail at each step.

  • Prepare document: Upload template and place required fields
  • Invite signer: Email or link-based access for party to review and sign
  • Authenticate signer: Confirm identity using email, SMS, or stronger methods
  • Complete and store: Signed document saved with audit trail for filing

Platform and technical requirements for eCompletion

Ensure the chosen platform supports required file types, signer authentication, and any notarization workflow your jurisdiction requires.

  • File formats: PDF, DOCX supported
  • Integrations: Salesforce, NetSuite, Microsoft 365
  • Authentication: Email/SMS, KBA, SSO options

Common timing expectations when filing the short form

Court timing varies widely; these typical timelines indicate when a court might expect a short-form disclosure during case progression.

Initial filing:

Submit with the petition or response when requested

Response window:

Often 14–30 days after service; varies by local rule

Hearing timeline:

Temporary support hearings typically scheduled within 30–90 days

Updated disclosures:

Provide new short forms when significant financial changes occur

Retention for evidence:

Keep signed copies until case closure plus retention period

Key legal risks and penalties for inaccurate affidavits

Perjury risk: May be criminal perjury
Contempt: Court sanctions or fines
Judgment impact: Orders altered due to false disclosure
Reputational harm: Credibility reduced in hearings
Financial penalties: Court-ordered reimbursements possible
Evidence exclusion: Document may be excluded

Common mistakes to avoid when preparing the form

  • Rounding or omitting liabilities which causes miscalculation of monthly obligations and undermines support figures.
  • Failing to attach supporting documents such as recent pay stubs or bank statements, which prompts requests for supplemental filings.
  • Using inconsistent date ranges between the form and attachments, which can create confusion about the reporting period and delay hearings.
  • Neglecting required jurat or notary fields when the local rule mandates notarization, resulting in rejection or need to re-file.

Practical tips for accurate and efficient completion

Follow these best practices to reduce errors, speed processing, and maintain a clear evidentiary trail.

Document organization and labeling
Number and label each supporting attachment clearly and reference those labels on the affidavit so the court and opposing counsel can match figures to evidence without rework.
Consistent date ranges
Use identical start and end dates on the affidavit and every supporting statement or pay stub to avoid discrepancies that could require supplemental filings.
Use MM/DD/YYYY dates
Enter dates in MM/DD/YYYY format to match court systems and reduce parsing errors during electronic filing or clerk review.
Preserve the audit trail
If completing electronically, ensure the platform records signer IP, timestamps, and an audit trail that courts accept under ESIGN and UETA standards.

Practical examples showing how short forms are used

These brief cases illustrate typical scenarios where a short form speeds court processes and improves clarity.

Optica Ventures — Executive Filing

A COO completed a short affidavit for a temporary hearing to summarize salary and expenses.

  • The concise format reduced back-and-forth with opposing counsel.
  • The court accepted the sworn short form with attachments and scheduled a temporary support hearing without requesting a full financial statement.

Martin Properties — Quick Interim Order

A small business owner used the short form to disclose personal income while resolving business valuation issues.

  • The short form isolated personal cash flow quickly.
  • The judge used the affidavit to set a temporary spousal support figure pending submission of a detailed business financial report.

Comparing e-signature vendor basics for completing and signing affidavits

This comparison highlights common plan differences and capabilities relevant to electronically signing, notarizing, and storing Financial Affidavit Short Forms; confirm vendor sites for full plan details.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial, no credit card required Check vendor site for trial terms Check vendor site for trial terms Check vendor site for trial terms Check vendor site for trial terms
Bulk Send Yes (Business Premium) Yes Yes Yes Varies by plan
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes (BAA available) Verify with vendor Verify with vendor Verify with vendor Verify with vendor
Envelope Cap No envelope cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Security and compliance features to verify for affidavit handling

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
Audit Trail: Timestamped signature events and IP logging
HIPAA: BAA required for PHI workflows
21 CFR Part 11: Supported for regulated records where needed
ESIGN / UETA: Compliant frameworks for legal enforceability
SOC 2 / ISO: SOC 2 Type II and ISO 27001 available

Frequently asked questions about the Financial Affidavit Short Form

Answers to common questions about e-signing, notarization, corrections, and admissibility for the short form.


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