Fill and Sign the Order Re Modification or Restriction of Parenting Time Jdf Form

JDF 1104 R6/2016 CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES © 2016Colorado Judicial Department for use in the Courts of Colorado District Court Denver Juvenile Court __________________ County, ColoradoCourt Address:In re:The Marriage of:The Civil Union of:Parental Responsibilities concerning:______________________________________________________Petitioner:andCo-Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg. #: Case Number:Division Courtroom CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES *****EACH PARTY MUST COMPLETE AND FILE THIS FORM WITH THE COURT***** I, the Petitioner Co-Petitioner/Respondent (check one) hereby certify that I have sent the other party the following Mandatory Disclosures as required by Rule 16.2(e)(7) of the Colorado Rules of Civil Procedure. See JDF 1125: Mandatory Disclosure – Form 35.1 for explanation on what is required by the disclosures being listed. Check those that you have furnished to the other party. (Note: Only the Sworn Financial Statement and Child Support Worksheet should be filed with the Court.)Sworn Financial Statement Retirement PlansIncome Tax Returns (most recent 3 years) Bank/Financial Institution AccountsPersonal Financial Statements (last 3 years) Income Documentation (Pay Stubs, etc.)Business Financial Statements (last 3 years) Employment and Education – Related childReal Estate Documents (Appraisal, Title, etc.) Care DocumentationPersonal Debt (Loans, Title, Credit Card Statements, etc.) Insurance DocumentationInvestments Extraordinary Children’s ExpenseEmployment Benefits DocumentationIf I have not provided information, it is because: 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.) VERIFICATION AND ACKNOWLEDGEMENT I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. JDF 1104 R8/17 CERTIFICATE OF COMPLIANCE WITH C.R.C.P. 26.2 © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 2 Executed on the ______ day of ________________, _______, at ______________________________________ (date) (month) (year) (city or other location, and state OR country_________________________________________ ____________________________________________(Printed name of Petitioner/Co-Petitioner/ Respondent) Signature of Petitioner/Co-Petitioner/Respondent) Date ____________________________________________ Attorney Signature, if any Date CERTIFICATE OF SERVICE I certify that on _______________________ (date) a true and accurate copy of the CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES was served on the other party by:Hand Delivery, E-filed, Faxed to this number ____________________, or by placing it in the United States mail, postage pre-paid, and addressed to the following:To: ___________________________________ ___________________________________ ___________________________________ (Your signature) Date