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West Virginia Financial Statement

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Marital Separation and Property Settlement Agreement

IN THE FAMILY COURT OF COUNTY, WEST VIRGINIA

IN RE THE MARRIAGE OF: CIVIL ACTION NO.

Circuit Judge

PETITIONER

Social Security Number

Address

Daytime Phone Number

RESPONDENT

Social Security Number

Address

Daytime Phone Number

MARITAL SEPARATION AND PROPERTY SETTLEMENT AGREEMENT

NOTICE: THIS IS AN IMPORTANT LEGAL AGREEMENT AND HAS SUBSTANTIAL LEGAL CONSEQUENCES ON YOU, YOUR RIGHTS AND OBLIGATIONS. YOU ARE ADVISED TO CONSULT AN ATTORNEY FOR INDEPENDENT LEGAL ADVICE PRIOR TO EXECUTION OF THIS AGREEMENT.

STATE OF WEST VIRGINIA

COUNTY OF

WHEREAS, , hereinafter referred to as "Wife", and , hereinafter referred to as "Husband", are now married, having been married on the day of , , in County, ;

WHEREAS, the parties were separated on or about the day of , 20, while residing in County, , and since that date have been living separate and apart; and

WHEREAS, irreconcilable differences have arisen in the marriage of the parties and there is no chance of staying together...

WHEREAS, There are no minor children of said marriage, and the wife is not now pregnant. All children of the marriage are over the age of twenty-one (21) and emancipated;

SECTION 1.
SEPARATION; RELINQUISHMENT OF MARITAL RIGHTS

The parties shall continue to live separate and apart...

SECTION 2.
FINANCIAL DISCLOSURES

By execution of this instrument, each party warrants and represents to the other party that he or she has fully disclosed their financial status...

SECTION 3.
ASSETS

A. In General. Husband and Wife are in possession of all personal property belonging to each...

B. Wife shall receive as her own...

Description of Item(s) Wife Shall Receive Current Fair Market Value
Cash (on hand)
Cash (in banks/credit unions)
Stocks/Bonds
Notes (money owed to you in writing)
Money owed to you (not evidenced by a note)
Real estate: (Home)
(Other)
Business interests
Automobiles
Boats
Other vehicles
Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)
Furniture & furnishings in home
Furniture & furnishings elsewhere
Collectibles
Jewelry
Life insurance (cash surrender value)
Sporting and entertainment (T.V., stereo, etc.) equipment
Other assets

Total Assets to Wife $

C. Husband shall receive as his own...

Description of Item(s) Husband Shall Receive Current Fair Market Value
Cash (on hand)
Cash (in banks/credit unions)
Stocks/Bonds
Notes (money owed to you in writing)
Money owed to you (not evidenced by a note)
Real estate: (Home)
(Other)
Business interests
Automobiles
Boats
Other vehicles
Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)
Furniture & furnishings in home
Furniture & furnishings elsewhere
Collectibles
Jewelry
Life insurance (cash surrender value)
Sporting and entertainment (T.V., stereo, etc.) equipment
Other assets

Total Assets to Husband $

D. Contingent Assets and Liabilities shall be divided as follows:

E. Additional Retirement Account Provisions:

Retirement Accounts Person to Receive Current Fair Market Value
Husband Accounts
Wife Accounts

F. Additional Life Insurance Provisions:

G. Additional Household Furnishing and Effects Provisions:

The household furnishings and effects of the parties have been mutually divided by the parties...

Wife agrees that the Husband shall retain all of the household furnishings...

Husband agrees that the Wife shall retain all of the household furnishings...

Premises at

H. Additional Marital Home Provisions.

The marital home of the parties shall be:

i) Occupied by Husband Wife.

ii) Titled in the name of Husband Wife.

Mortgage payments paid by Wife Husband, terminates

Utilities and upkeep paid by Wife Husband, terminates

Taxes, insurance and assessments paid by Wife Husband, terminates

I. Additional Provisions or explanations:

SECTION 4.
DEBTS, LIABILITIES AND EXPENSES

A. Except as otherwise provided herein each party agrees to pay their respective individual debts.

B. Division of Liabilities/Debts. Wife shall pay as her own the following:

C. Husband shall pay as his own the following:

SECTION 5.
FUTURE EARNINGS AND ACQUISITIONS

All income, earnings, or other property received or acquired by either party on or after the date of execution...

SECTION 6.
SPOUSAL SUPPORT (ALIMONY)

The parties mutually waive any and all claim or right to temporary or permanent alimony.

Husband Wife agrees to pay spousal support (alimony) in the amount of $ every beginning continuing until

Explain type of alimony and specifics:

Life insurance in the amount of $ to secure the above support.

SECTION 7.
CHILD(REN)

The following child(ren) have been born to the marriage of the parties:

Name Birth date

SECTION 8.
MUTUAL INDEMNITY

The parties agree in regard to the payment of debts and other liabilities...

SECTION 9.
INCOME TAXES

The parties shall file separately for the year and each year thereafter.

SECTION 10.
ADDITIONAL OR FURTHER DOCUMENTS; COOPERATION

Each party agrees that he or she will sign and execute any further or additional documents...

SECTION 11.
DIVORCE

It is agreed and understood that this Agreement finally settles all rights of the parties...

SECTION 12.
MODIFICATION

This Agreement shall estop and preclude either party from making other or further demands...

SECTION 13.
ABSENCE OF DURESS OR UNDUE INFLUENCE

The parties agree and state that each has freely and voluntarily entered into this agreement.

SECTION 14.
RELEASE, WAIVER, BINDING EFFECT, AND ESTATES

Except as otherwise provided for in this Agreement, each party shall be divested of and each party waives...

SECTION 15.
ENFORCEMENT

This Agreement may be enforced by actions and proceedings for Contempt of Court...

SECTION 16.
BANKRUPTCY

To the extent of any obligation contained herein is discharged in bankruptcy...

SECTION 17.
ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the parties...

SECTION 18.
FULLY READ AND UNDERSTAND; INFORMED CONSENT

Each party represents and acknowledges that he or she has fully read this Agreement...

SECTION 19.
SEVERABILITY

If any portion of the agreement shall be held to be void, voidable or unenforceable...

SECTION 20.
CONTROLLING LAW

This Agreement shall be governed, enforced and interpreted according to the laws of the State of West Virginia.

SECTION 21.
HEIRS AND ASSIGNS

This agreement shall be binding upon their legal representatives, successor, heirs and assigns.

EXECUTED AND AGREED ON THE DATES SET FORTH BELOW. I certify that I have been open and honest in entering into this settlement agreement.

Dated:

Signature of Wife

Printed Name

Address

City, State, Zip

Telephone Number

Fax Number

Dated:

Signature of Husband

Printed Name

Address

City, State, Zip

Telephone Number

Fax Number

STATE OF WEST VIRGINIA

COUNTY OF

Sworn to or affirmed, acknowledged, executed, signed and delivered before me on by .

_________________________________________
NOTARY PUBLIC

My Commission Expires:

Print Name:

STATE OF WEST VIRGINIA

COUNTY OF

Sworn to or affirmed, acknowledged, executed, signed and delivered before me by .

_________________________________________
NOTARY PUBLIC

My Commission Expires:

Print Name:

Enter text✕

What the West Virginia Financial Statement Is and When It’s Used

The West Virginia Financial Statement is a standardized document used to present a party’s income, assets, liabilities, and relevant financial details for legal, regulatory, or transactional purposes. Typical uses include family law proceedings, court-ordered disclosures, loan underwriting, asset verification, and administrative reviews. The form organizes schedules for income, expenses, bank accounts, retirement plans, and outstanding debts, and it often requires an attestation and signature under penalty of perjury. Accuracy and completeness are essential because the statement supports decisions about maintenance, division of assets, credit, or eligibility for benefits.

Why a Clear Financial Statement Matters

A clear, accurate financial statement creates a single, verifiable record of financial position that supports legal or financial decisions, reduces follow-up requests, and helps resolve disputes more quickly while creating an auditable trail of data.

Why a Clear Financial Statement Matters

Who Typically Prepares and Reviews This Statement

The West Virginia Financial Statement is completed by individuals, business representatives, or counsel when financial disclosure is required; reviewers include courts, lenders, opposing counsel, and government agencies.

  • Individuals completing family law, child support, or divorce disclosures; completed with supporting pay stubs and tax returns.
  • Business officers or authorized signers supplying corporate financial information for credit applications or regulatory filings.
  • Attorneys, judges, loan officers, and administrative reviewers who rely on standardized schedules to evaluate claims and eligibility.

Provide complete documentation when you file or share the statement to minimize inquiry cycles and speed review.

Step-by-step: Completing a West Virginia Financial Statement

Follow these steps in order to assemble, verify, and submit the statement accurately.

  • 01
    Gather documents: Collect pay stubs, tax returns, bank statements, and loan statements.
  • 02
    Fill schedules: Complete income, expense, asset, and liability sections with current values.
  • 03
    Attach exhibits: Include supporting documents labeled to match the schedules.
  • 04
    Sign and certify: Sign, date, and notarize if required by the recipient or court.

How to set up a digital workflow for this statement

Map the document flow and required checks before distributing the statement for signature or review.

Field Configuration
Upload Document Use a searchable PDF or DOCX for fillable field placement
Required Fields Mark income, assets, and signature as required fields
Authentication Choose email+SMS or stronger verification for higher-risk filings
Retention Enable tamper-evident storage and audit trail retention

Typical submission flow for the West Virginia Financial Statement

A consistent flow reduces errors and speeds processing; follow the chain below for digital or paper filing.

  • Prepare: Assemble statements and supporting exhibits, verify calculations.
  • Authorize: Sign, date, and notarize if required by the recipient.
  • Deliver: Submit to the court, lender, or requesting agency per their instructions.
  • Archive: Store original signed copies and scanned records securely.

Digital file and platform requirements

Digital submissions should use common formats and a platform that preserves an audit trail and supports required authentication.

  • Accepted formats: PDF or DOCX preferred
  • Authentication options: Email, SMS, or stronger multi-factor verification
  • Integrations: Works with common storage and workflow systems

Verify the recipient’s preferred format and authentication before sending to avoid rejection or requests for re-submission.

Common timing expectations for providing a financial statement

Timing depends on the triggering event; anticipate requests and allow time for documentation and, where needed, notarization.

Upon request:

Provide within the period specified by the requesting party, often 14–30 days.

Court-ordered deadline:

Comply with the court schedule or face sanctions for noncompliance.

Loan application:

Submit with underwriting package; delays can affect loan approval timelines.

Annual review:

Some lenders or trustees request yearly updates for ongoing monitoring.

Correction window:

Promptly correct material errors once discovered to limit downstream risk.

Key processing milestones from preparation to archive

Track these milestones to keep a controlled record while preparing and submitting the statement.

01

Document collection

Gather paystubs, tax returns, bank statements and supporting exhibits.

02

Initial completion

Populate schedules and check arithmetic before review.

03

Review and notarization

Perform review, obtain notary if required, and amend as needed.

04

Submission and retention

Submit to recipient and archive signed originals and electronic copies.

Consequences and legal risks of inaccurate statements

Inaccurate income: May lead to sanctions
Missing signatures: Can render statement invalid
Unsigned notarization: May be rejected by courts
Late submission: Can cause procedural penalties
Tax exposure: Triggers audit or penalties
Perjury risk: Potential criminal consequences

Common preparation problems to avoid

  • Relying on estimates instead of current documentation often creates disputes and follow-up requests from reviewers.
  • Submitting mismatched names or account numbers can prevent verification and force corrected filings or affidavits.
  • Omitting supporting schedules or bank statements increases rejection risk and prolongs processing time.
  • Failing to notarize when required by recipient or court frequently leads to returned submissions and administrative delays.

Essential sections to include in a professional financial statement

A complete statement organizes data into consistent sections so reviewers can verify and compare information easily.

Header and identification

Include declarant name, statement date, case or account number, and contact details so reviewers can match records to the correct matter.

Income schedule

List all income sources, pay frequency, gross and net amounts, and year-to-date totals with supporting pay stubs or tax returns.

Assets and accounts

Itemize bank accounts, investment accounts, retirement plans, real property, and business interests with current valuations and account identifiers.

Liabilities and payments

Detail mortgages, loans, credit card balances, minimum payments, and creditor names so obligations are clear and verifiable.

Exhibits and schedules

Attach labeled supporting documents—bank statements, tax returns, appraisal reports, and creditor statements—to substantiate each line item.

Declaration and signature

Include a signed attestation under penalty of perjury, printed name, date, and notarization where required to affirm accuracy.

Real-world uses of the West Virginia Financial Statement

These two examples show how the statement is used and the outcomes it supports.

Divorce proceeding

A spouse completes the statement to disclose income and assets

  • The court uses the schedules when allocating support and dividing property
  • Accurate supporting exhibits shortened discovery and helped the parties reach a settlement without additional hearings by clarifying values and monthly obligations.

Loan underwriting

A small business owner submits a statement with bank and tax records

  • The lender verifies cash flow and collateral
  • Providing organized statements and labeled exhibits reduced underwriting questions and accelerated the loan decision timeline.

Representative eSignature vendor pricing and capabilities

Compare common pricing and capability criteria for electronic signature platforms; signNow is listed first per standard comparison format.

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Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
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Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Who signs and certifies the statement

Individual Declarant

The person whose financial position is reported signs and certifies accuracy. If a declarant lacks capacity or represents an entity, an authorized agent or legal representative signs with documentation of authority.

Authorized Signer

Business officers, trustees, or counsel may sign for entities. Include a statement of authority and any corporate resolution or power-of-attorney documentation when acting on behalf of another party.

Frequently asked questions about the West Virginia Financial Statement

Answers to common questions about completion, submission, authentication, and corrections for the financial statement.


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