Fill and Sign the Preliminary Declaration Montana Form

Petitioner’s Preliminary Disclosure Statement 1 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28                   Telephone: (406)       Attorney for Petitioner MONTANA       JUDICIAL DISTRICT COURT,       COUNTY IN RE THE MARRIAGE OF: * * Dept. No       * Petitioner * * Cause No. And * *       * Respondent * PETITIONER'S PRELIMINARY * * * * * * * * * * * * * * * * * * * * * DISCLOSURE STATEMENT 1. Petitioner's Preliminary Asset Disclosure Exhibit attached sets forth the identity of all assets in which Petitioner has or may have an interest regardless of the characterization of the asset. These assets include, but are not limited to, any real or personal property of any nature, however and whenever acquired, whether the property is tangible or intangible, whether the property is currently existing or contingent, and whether the title is in the name of husband or wife or both. Petitioner's percentage of ownership in each asset is set forth in Exhibit A when property is not solely owned by one or both of the parties. 2. Petitioner's Preliminary Liability Disclosure Exhibit attached sets forth the identity of all liabilities for which Petitioner may be liable, regardless of the characterization of the liability. These liabilities include, but are not limited to, any debt or obligation, however and whenever Petitioner’s Preliminary Disclosure Statement 2 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 acquired, whether the debt or obligation is currently existing or contingent or is in the name of the husband or wife or both. 3. Petitioner's Preliminary Income Declaration Exhibit attached sets forth the income of Petitioner. Petitioner's income includes earnings and accumulations from any source. 4. Petitioner's Preliminary Personal Living Expense Disclosure Exhibit attached sets forth the personal living expenses of Petitioner. DATED:       . ______________________________________       Attorney for Petitioner STATE OF MONTANA ) )ss. County of       ) Petitioner,       , being first duly sworn, states under penalty of perjury that the facts and matters contained in this Preliminary Disclosure Statement are true, accurate, and complete to the best of my knowledge. I understand that in addition to any other civil or criminal remedy available under law for perjury, the court may set aside the judgment, or part of the judgment, if the court discovers that a party has committed perjury in a Preliminary Declaration of Disclosure. ______________________________________       Petitioner Petitioner’s Preliminary Disclosure Statement 3 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 SUBSCRIBED AND SWORN to before me       on this       day of       . _____________________________________ NOTARY PUBLIC for the State of Montana Residing at       My commission expires on       Petitioner’s Preliminary Disclosure Statement 4 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 PETITIONER'S PRELIMINARY ASSET DISCLOSURE EXHIBIT Item Percentage of Ownership Market Value Checking Account:                                     Savings Accounts                                     Cash on Hand                                     Stocks, Bonds, CDs                                                       Real Estate:                   Automobiles/RVs                                                       Retirement Accounts                   Cash Value of Life Insurance                                     Business Fixtures, Equipment and Goodwill                                                                                                                                                                                                                                                             Petitioner’s Preliminary Disclosure Statement 5 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Household                                                                                                                                                                                                                                           PROPERTY TOTAL       PETITIONER'S PRELIMINARY LIABILITY DISCLOSURE EXHIBIT Creditor Percentage of Debt Current Balance Debt Secured by Real Estate:                   Other Secured Debt:                                                       Credit Cards                                                       Other Unsecured Debt                                                                                                                                                                                                                                           Petitioner’s Preliminary Disclosure Statement 6 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 LIABILITY TOTAL       PETITIONER'S PRELIMINARY INCOME DECLARATION EXHIBIT Description Average Monthly Amount Income from Wages Salary, Commission, Bonuses       Self-Employment Income       Pensions, Social Security       Capital Gains Income       Interest       Earned Income Credit       Other Taxable Income       Other Non-taxable Income       Income from Public Assistance TANF       Food Stamps       SSI       Other Public Assistance       Value of Employment Fringe Benefits Company Car       Free or reduced rent/housing       Food       Utilities       Vehicle Expense Reimbursement       TOTAL GROSS AVERAGE MONTHLY INCOME       Mandatory Deductions from Income Court Ordered Child Support       Court Ordered Maintenance       Court Ordered Health Insurance for Children       Federal Income Tax       State Income Tax       Social Security/Medicare       Retirement Contributions       Petitioner’s Preliminary Disclosure Statement 7 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Requirement Employment Expense       Old Fund Liability Tax       Dependent Care Expense for children not of this marriage       Other mandatory deductions from income       TOTAL MANDATORY DEDUCTIONS FROM INCOME       NET AVERAGE MONTHLY INCOME       PETITIONER'S PERSONAL LIVING EXPENSES DISCLOSURE EXHIBIT Description Average Monthly Amount Housing Rent       Mortgage       Maintenance       Utilities Heat       Electricity       Telephone       Cable TV       Water       Food Groceries       Dining       Transportation Gas/oil       Maintenance       Registration       Car Payment/lease       Clothing Purchases       Laundry/dry cleaning       Insurance Life       Health       Disability       Auto       Petitioner’s Preliminary Disclosure Statement 8 -1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Unreimbursed Medical Expenses Self       Children for whom support calculated       Other Expenses Entertainment                               TOTAL PERSONAL LIVING EXPENSES (including children's expenses)