FINANCIAL DISCLOSURE DECLARATION
CASE INFORMATION
Case No.: [CASE NUMBER]
Court: [COURT NAME]
County: [COUNTY]
State: [STATE]
I. PERSONAL INFORMATION
A. DECLARANT INFORMATION
Full Legal Name: [FULL LEGAL NAME]
Date of Birth: [DATE OF BIRTH]
Current Address: [STREET ADDRESS, CITY, STATE, ZIP CODE]
Telephone Number: [TELEPHONE NUMBER]
Email Address: [EMAIL ADDRESS]
Occupation: [OCCUPATION]
Employer: [EMPLOYER NAME]
B. SPOUSE/PARTNER INFORMATION
Full Legal Name: [FULL LEGAL NAME]
Date of Birth: [DATE OF BIRTH]
Current Address: [STREET ADDRESS, CITY, STATE, ZIP CODE]
Telephone Number: [TELEPHONE NUMBER]
Email Address: [EMAIL ADDRESS]
Occupation: [OCCUPATION]
Employer: [EMPLOYER NAME]
C. MARRIAGE/PARTNERSHIP DETAILS
Date of Marriage/Domestic Partnership: [DATE]
Date of Separation (if applicable): [DATE]
Length of Marriage/Domestic Partnership: [YEARS/MONTHS]
D. CHILDREN INFORMATION
-
Child's Full Name: [FULL NAME]
Date of Birth: [DATE OF BIRTH]
Age: [AGE]
-
Child's Full Name: [FULL NAME]
Date of Birth: [DATE OF BIRTH]
Age: [AGE]
-
Child's Full Name: [FULL NAME]
Date of Birth: [DATE OF BIRTH]
Age: [AGE]
(Add additional children as necessary)
II. INCOME INFORMATION
A. EMPLOYMENT INCOME
-
Current Employment
- Employer Name: [EMPLOYER NAME]
- Position/Title: [POSITION/TITLE]
- Employment Start Date: [DATE]
- Gross Monthly Salary/Wages: $[AMOUNT]
- Net Monthly Income: $[AMOUNT]
- Frequency of Pay: [WEEKLY/BI-WEEKLY/MONTHLY]
- Year-to-Date Gross Income: $[AMOUNT] (as of [DATE])
-
Additional Employment Compensation
- Annual Bonuses: $[AMOUNT]
- Commissions: $[AMOUNT]
- Overtime Pay: $[AMOUNT]
- Profit Sharing: $[AMOUNT]
- Other Compensation: $[AMOUNT] (Describe: [DESCRIPTION])
-
Employment Benefits
- Health Insurance: $[AMOUNT]/month
- Retirement Contributions by Employer: $[AMOUNT]/month
- Stock Options/RSUs: [DESCRIPTION AND VALUE]
- Other Benefits: [DESCRIPTION AND VALUE]
Note: Pay stubs for the last 6 months are attached as Exhibit A.
B. SELF-EMPLOYMENT INCOME
-
Business Information
- Business Name: [BUSINESS NAME]
- Business Address: [BUSINESS ADDRESS]
- Type of Business Entity: [SOLE PROPRIETORSHIP/LLC/CORPORATION/PARTNERSHIP]
- Ownership Percentage: [PERCENTAGE]%
- Nature of Business: [DESCRIPTION]
- Date Business Established: [DATE]
-
Business Income
- Gross Monthly Business Income: $[AMOUNT]
- Monthly Business Expenses: $[AMOUNT]
- Net Monthly Business Income: $[AMOUNT]
- Annual Business Income (Previous Year): $[AMOUNT]
- Annual Business Income (Year Before Last): $[AMOUNT]
Note: Business tax returns for the past 3 years and current profit and loss statements are attached as Exhibit B.
C. INVESTMENT INCOME
-
Interest Income
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
-
Dividend Income
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
-
Capital Gains
- Source: [SOURCE]
- Amount (Last Calendar Year): $[AMOUNT]
-
Rental Property Income
- Property Address: [ADDRESS]
- Gross Monthly Rental Income: $[AMOUNT]
- Monthly Expenses: $[AMOUNT]
- Net Monthly Rental Income: $[AMOUNT]
-
Other Investment Income
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
Note: Investment account statements showing this income are attached as Exhibit C.
D. RETIREMENT INCOME
-
Pension Income
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
-
Social Security Benefits
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
-
IRA/401(k) Distributions
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
-
Other Retirement Income
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
E. GOVERNMENT BENEFITS
-
Unemployment Benefits
- Monthly Amount: $[AMOUNT]
- Duration of Benefits: [DURATION]
- Expiration Date: [DATE]
-
Disability Payments
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Nature of Disability: [DESCRIPTION]
- Duration of Benefits: [TEMPORARY/PERMANENT]
-
Workers' Compensation
- Monthly Amount: $[AMOUNT]
- Nature of Claim: [DESCRIPTION]
- Duration of Benefits: [DURATION]
-
Public Assistance
- Type of Assistance: [TYPE]
- Monthly Amount: $[AMOUNT]
-
Other Government Benefits
- Type of Benefit: [TYPE]
- Monthly Amount: $[AMOUNT]
F. OTHER INCOME SOURCES
-
Alimony/Spousal Support (from previous relationships)
- Payor Name: [NAME]
- Monthly Amount: $[AMOUNT]
- Duration of Obligation: [DURATION]
- Termination Date (if applicable): [DATE]
-
Child Support (from previous relationships)
- Payor Name: [NAME]
- Monthly Amount: $[AMOUNT]
- Number of Children: [NUMBER]
- Duration of Obligation: [DURATION]
- Termination Date (if applicable): [DATE]
-
Trust Income
- Name of Trust: [NAME]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
- Terms of Trust: [DESCRIPTION]
-
Royalties
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
-
Gifts or Allowances
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
-
Other Income
- Source: [SOURCE]
- Monthly Amount: $[AMOUNT]
- Annual Amount: $[AMOUNT]
G. TAX RETURNS
Complete copies of personal and business tax returns for the past 5 years, including all schedules and attachments, are attached as Exhibit D.
III. ASSETS
A. REAL ESTATE
-
Primary Residence
- Property Address: [ADDRESS]
- Title Holders: [NAMES]
- Form of Ownership: [INDIVIDUAL/JOINT TENANTS/TENANTS IN COMMON/COMMUNITY PROPERTY]
- Purchase Date: [DATE]
- Purchase Price: $[AMOUNT]
- Current Market Value: $[AMOUNT] (as of [DATE])
- Basis for Valuation: [APPRAISAL/COMPARATIVE MARKET ANALYSIS/ESTIMATE]
- Outstanding Mortgage Balance: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Secondary/Vacation Property
- Property Address: [ADDRESS]
- Title Holders: [NAMES]
- Form of Ownership: [INDIVIDUAL/JOINT TENANTS/TENANTS IN COMMON/COMMUNITY PROPERTY]
- Purchase Date: [DATE]
- Purchase Price: $[AMOUNT]
- Current Market Value: $[AMOUNT] (as of [DATE])
- Basis for Valuation: [APPRAISAL/COMPARATIVE MARKET ANALYSIS/ESTIMATE]
- Outstanding Mortgage Balance: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Rental/Investment Property
- Property Address: [ADDRESS]
- Title Holders: [NAMES]
- Form of Ownership: [INDIVIDUAL/JOINT TENANTS/TENANTS IN COMMON/COMMUNITY PROPERTY]
- Purchase Date: [DATE]
- Purchase Price: $[AMOUNT]
- Current Market Value: $[AMOUNT] (as of [DATE])
- Basis for Valuation: [APPRAISAL/COMPARATIVE MARKET ANALYSIS/ESTIMATE]
- Outstanding Mortgage Balance: $[AMOUNT]
- Equity: $[AMOUNT]
- Monthly Rental Income: $[AMOUNT]
- Monthly Expenses: $[AMOUNT]
- Net Monthly Income: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Undeveloped Land/Other Real Estate
- Property Address/Description: [ADDRESS/DESCRIPTION]
- Title Holders: [NAMES]
- Form of Ownership: [INDIVIDUAL/JOINT TENANTS/TENANTS IN COMMON/COMMUNITY PROPERTY]
- Purchase Date: [DATE]
- Purchase Price: $[AMOUNT]
- Current Market Value: $[AMOUNT] (as of [DATE])
- Basis for Valuation: [APPRAISAL/COMPARATIVE MARKET ANALYSIS/ESTIMATE]
- Outstanding Mortgage Balance: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Deeds, mortgage statements, property tax bills, and recent appraisals for all real estate are attached as Exhibit E.
B. BANK ACCOUNTS
-
Checking Accounts
- Financial Institution: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holders: [NAMES]
- Current Balance: $[AMOUNT] (as of [DATE])
- Average Balance (last 6 months): $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Savings Accounts
- Financial Institution: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holders: [NAMES]
- Current Balance: $[AMOUNT] (as of [DATE])
- Interest Rate: [PERCENTAGE]%
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Money Market Accounts
- Financial Institution: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holders: [NAMES]
- Current Balance: $[AMOUNT] (as of [DATE])
- Interest Rate: [PERCENTAGE]%
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Certificates of Deposit
- Financial Institution: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holders: [NAMES]
- Principal Amount: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Interest Rate: [PERCENTAGE]%
- Maturity Date: [DATE]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Bank statements for the last 3 months for all accounts are attached as Exhibit F.
C. INVESTMENT ACCOUNTS
-
Brokerage Accounts
- Financial Institution: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holders: [NAMES]
- Current Value: $[AMOUNT] (as of [DATE])
- Major Holdings: [DESCRIPTION]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Individual Stocks
- Company Name: [NAME]
- Number of Shares: [NUMBER]
- Purchase Date: [DATE]
- Purchase Price per Share: $[AMOUNT]
- Current Value per Share: $[AMOUNT] (as of [DATE])
- Total Current Value: $[AMOUNT]
- Registered Owners: [NAMES]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Bonds
- Issuer: [NAME]
- Face Value: $[AMOUNT]
- Purchase Date: [DATE]
- Purchase Price: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Maturity Date: [DATE]
- Interest Rate: [PERCENTAGE]%
- Registered Owners: [NAMES]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Mutual Funds/ETFs
- Fund Name: [NAME]
- Financial Institution: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Number of Shares/Units: [NUMBER]
- Purchase Date: [DATE]
- Purchase Price per Share/Unit: $[AMOUNT]
- Current Value per Share/Unit: $[AMOUNT] (as of [DATE])
- Total Current Value: $[AMOUNT]
- Registered Owners: [NAMES]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Investment account statements for the last 3 months are attached as Exhibit G.
D. RETIREMENT ACCOUNTS
-
401(k)/403(b) Accounts
- Employer/Plan Administrator: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holder: [NAME]
- Current Value: $[AMOUNT] (as of [DATE])
- Vested Amount: $[AMOUNT]
- Loan Balance (if any): $[AMOUNT]
- Beneficiary Designation: [NAME(S)]
- Date Plan Participation Began: [DATE]
- Pre-Marital Value (if applicable): $[AMOUNT] (as of [DATE])
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Individual Retirement Accounts (IRAs)
- Financial Institution: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Type of IRA: [TRADITIONAL/ROTH/SEP/SIMPLE]
- Account Holder: [NAME]
- Current Value: $[AMOUNT] (as of [DATE])
- Beneficiary Designation: [NAME(S)]
- Date Account Established: [DATE]
- Pre-Marital Value (if applicable): $[AMOUNT] (as of [DATE])
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Pension Plans
- Employer/Plan Administrator: [NAME]
- Plan Name: [NAME]
- Type of Plan: [DEFINED BENEFIT/DEFINED CONTRIBUTION]
- Account Holder: [NAME]
- Date Employment Began: [DATE]
- Years of Service: [NUMBER]
- Vested Percentage: [PERCENTAGE]%
- Current Value/Projected Monthly Benefit: $[AMOUNT]
- Survivor Benefits: [DESCRIPTION]
- Beneficiary Designation: [NAME(S)]
- Pre-Marital Value/Service (if applicable): [DESCRIPTION]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Profit-Sharing Plans
- Employer/Plan Administrator: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holder: [NAME]
- Current Value: $[AMOUNT] (as of [DATE])
- Vested Amount: $[AMOUNT]
- Beneficiary Designation: [NAME(S)]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Retirement account statements for the last 3 months are attached as Exhibit H.
E. BUSINESS INTERESTS
-
Ownership in Privately Held Business
- Business Name: [NAME]
- Business Address: [ADDRESS]
- Type of Entity: [SOLE PROPRIETORSHIP/LLC/CORPORATION/PARTNERSHIP]
- Date Established/Acquired: [DATE]
- Ownership Percentage: [PERCENTAGE]%
- Position/Title: [POSITION/TITLE]
- Nature of Business: [DESCRIPTION]
- Book Value: $[AMOUNT] (as of [DATE])
- Estimated Market Value: $[AMOUNT] (as of [DATE])
- Method of Valuation: [DESCRIPTION]
- Annual Gross Revenue (Previous Year): $[AMOUNT]
- Annual Net Income (Previous Year): $[AMOUNT]
- Pre-Marital Value (if applicable): $[AMOUNT] (as of [DATE])
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Professional Practice
- Practice Name: [NAME]
- Practice Address: [ADDRESS]
- Type of Entity: [SOLE PROPRIETORSHIP/LLC/CORPORATION/PARTNERSHIP]
- Date Established/Acquired: [DATE]
- Ownership Percentage: [PERCENTAGE]%
- Nature of Practice: [DESCRIPTION]
- Book Value: $[AMOUNT] (as of [DATE])
- Estimated Market Value: $[AMOUNT] (as of [DATE])
- Method of Valuation: [DESCRIPTION]
- Annual Gross Revenue (Previous Year): $[AMOUNT]
- Annual Net Income (Previous Year): $[AMOUNT]
- Pre-Marital Value (if applicable): $[AMOUNT] (as of [DATE])
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Ownership in Publicly Traded Company
- Company Name: [NAME]
- Position/Title: [POSITION/TITLE]
- Number of Shares Owned: [NUMBER]
- Current Value per Share: $[AMOUNT] (as of [DATE])
- Total Current Value: $[AMOUNT]
- Stock Options/RSUs: [DESCRIPTION AND VALUE]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Business tax returns, profit and loss statements, balance sheets, and business valuations for the past 3 years are attached as Exhibit I.
F. LIFE INSURANCE POLICIES
-
Term Life Insurance
- Insurance Company: [NAME]
- Policy Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Insured: [NAME]
- Owner: [NAME]
- Beneficiary: [NAME(S)]
- Face Value/Death Benefit: $[AMOUNT]
- Annual Premium: $[AMOUNT]
- Issue Date: [DATE]
- Expiration/Renewal Date: [DATE]
-
Permanent Life Insurance (Whole Life/Universal Life)
- Insurance Company: [NAME]
- Policy Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Insured: [NAME]
- Owner: [NAME]
- Beneficiary: [NAME(S)]
- Face Value/Death Benefit: $[AMOUNT]
- Cash Surrender Value: $[AMOUNT] (as of [DATE])
- Annual Premium: $[AMOUNT]
- Issue Date: [DATE]
- Loan Balance (if any): $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Life insurance policy statements showing current values are attached as Exhibit J.
G. VEHICLES
-
Automobiles/Trucks
- Make: [MAKE]
- Model: [MODEL]
- Year: [YEAR]
- VIN (last 4 digits): XXXX-[LAST 4 DIGITS]
- Registered Owner(s): [NAME(S)]
- Current Value: $[AMOUNT] (as of [DATE])
- Source of Valuation: [KELLEY BLUE BOOK/NADA/OTHER]
- Outstanding Loan Balance: $[AMOUNT]
- Lender: [NAME]
- Monthly Payment: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Motorcycles
- Make: [MAKE]
- Model: [MODEL]
- Year: [YEAR]
- VIN (last 4 digits): XXXX-[LAST 4 DIGITS]
- Registered Owner(s): [NAME(S)]
- Current Value: $[AMOUNT] (as of [DATE])
- Source of Valuation: [KELLEY BLUE BOOK/NADA/OTHER]
- Outstanding Loan Balance: $[AMOUNT]
- Lender: [NAME]
- Monthly Payment: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Boats/Watercraft
- Make: [MAKE]
- Model: [MODEL]
- Year: [YEAR]
- Hull ID (last 4 digits): XXXX-[LAST 4 DIGITS]
- Registered Owner(s): [NAME(S)]
- Current Value: $[AMOUNT] (as of [DATE])
- Source of Valuation: [NADA/OTHER]
- Outstanding Loan Balance: $[AMOUNT]
- Lender: [NAME]
- Monthly Payment: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Recreational Vehicles (RVs)
- Make: [MAKE]
- Model: [MODEL]
- Year: [YEAR]
- VIN (last 4 digits): XXXX-[LAST 4 DIGITS]
- Registered Owner(s): [NAME(S)]
- Current Value: $[AMOUNT] (as of [DATE])
- Source of Valuation: [NADA/OTHER]
- Outstanding Loan Balance: $[AMOUNT]
- Lender: [NAME]
- Monthly Payment: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Aircraft
- Make: [MAKE]
- Model: [MODEL]
- Year: [YEAR]
- Registration Number: [NUMBER]
- Registered Owner(s): [NAME(S)]
- Current Value: $[AMOUNT] (as of [DATE])
- Source of Valuation: [SOURCE]
- Outstanding Loan Balance: $[AMOUNT]
- Lender: [NAME]
- Monthly Payment: $[AMOUNT]
- Equity: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Vehicle titles, registration documents, loan statements, and value estimates are attached as Exhibit K.
H. PERSONAL PROPERTY
-
Household Furnishings
- Description: [DESCRIPTION]
- Location: [LOCATION]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Electronics
- Description: [DESCRIPTION]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Jewelry
- Description: [DESCRIPTION]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Insurance Coverage (if any): [DESCRIPTION]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Artwork
- Description/Artist: [DESCRIPTION/ARTIST]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Insurance Coverage (if any): [DESCRIPTION]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Collectibles
- Description: [DESCRIPTION]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Insurance Coverage (if any): [DESCRIPTION]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Antiques
- Description: [DESCRIPTION]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Insurance Coverage (if any): [DESCRIPTION]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Sporting Equipment
- Description: [DESCRIPTION]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Tools/Equipment
- Description: [DESCRIPTION]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [APPRAISAL/ESTIMATE/PURCHASE PRICE]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Appraisals or other documentation for items valued over $1,000 are attached as Exhibit L.
I. INTELLECTUAL PROPERTY
-
Patents
- Patent Number: [NUMBER]
- Description: [DESCRIPTION]
- Date Issued: [DATE]
- Expiration Date: [DATE]
- Owner(s): [NAME(S)]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [DESCRIPTION]
- Annual Income Generated: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Trademarks
- Registration Number: [NUMBER]
- Description: [DESCRIPTION]
- Date Registered: [DATE]
- Renewal Date: [DATE]
- Owner(s): [NAME(S)]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [DESCRIPTION]
- Annual Income Generated: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Copyrights
- Registration Number: [NUMBER]
- Description: [DESCRIPTION]
- Date Registered: [DATE]
- Owner(s): [NAME(S)]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [DESCRIPTION]
- Annual Income Generated: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Royalty Agreements
- Description: [DESCRIPTION]
- Parties to Agreement: [NAMES]
- Date of Agreement: [DATE]
- Terms of Agreement: [DESCRIPTION]
- Annual Income Generated: $[AMOUNT]
- Estimated Future Value: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Documentation related to intellectual property rights and royalty agreements is attached as Exhibit M.
J. INHERITANCE AND GIFTS
-
Inheritance Received
- Decedent's Name: [NAME]
- Relationship to Declarant: [RELATIONSHIP]
- Date of Death: [DATE]
- Date Inheritance Received: [DATE]
- Description of Inherited Assets: [DESCRIPTION]
- Value at Time of Receipt: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION]
-
Expected Inheritance
- Potential Source: [NAME]
- Relationship to Declarant: [RELATIONSHIP]
- Estimated Value: $[AMOUNT]
- Likelihood and Timing: [DESCRIPTION]
-
Substantial Gifts Received During Marriage
- Donor's Name: [NAME]
- Relationship to Recipient: [RELATIONSHIP]
- Date Gift Received: [DATE]
- Description of Gift: [DESCRIPTION]
- Value at Time of Receipt: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Recipient: [NAME]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Documentation related to inheritances and substantial gifts is attached as Exhibit N.
K. DIGITAL ASSETS
-
Cryptocurrency Holdings
- Type of Cryptocurrency: [TYPE]
- Number of Units/Coins: [NUMBER]
- Date Acquired: [DATE]
- Purchase Price: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Storage Method: [EXCHANGE/WALLET/COLD STORAGE]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Domain Names
- Domain Name: [NAME]
- Registrar: [NAME]
- Registration Date: [DATE]
- Renewal Date: [DATE]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [DESCRIPTION]
- Annual Income Generated: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Online Businesses/Accounts with Monetary Value
- Description: [DESCRIPTION]
- Platform/Website: [NAME]
- Date Established: [DATE]
- Estimated Value: $[AMOUNT]
- Basis for Valuation: [DESCRIPTION]
- Annual Income Generated: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
-
Digital Media Libraries
- Description: [DESCRIPTION]
- Platform: [NAME]
- Estimated Value: $[AMOUNT]
- Separate Property Claim (if any): [DESCRIPTION AND BASIS]
Note: Documentation related to digital assets is attached as Exhibit O.
IV. DEBTS AND LIABILITIES
A. MORTGAGES
-
Primary Residence Mortgage
- Property Address: [ADDRESS]
- Lender: [NAME]
- Loan Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Type of Loan: [FIXED/ADJUSTABLE]
- Maturity Date: [DATE]
- Names on Loan: [NAMES]
-
Second Mortgage/Home Equity Line of Credit
- Property Address: [ADDRESS]
- Lender: [NAME]
- Loan Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Type of Loan: [FIXED/ADJUSTABLE/HELOC]
- Maturity Date: [DATE]
- Names on Loan: [NAMES]
-
Other Real Estate Mortgages
- Property Address: [ADDRESS]
- Lender: [NAME]
- Loan Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Type of Loan: [FIXED/ADJUSTABLE]
- Maturity Date: [DATE]
- Names on Loan: [NAMES]
Note: Mortgage statements for all properties are attached as Exhibit P.
B. CREDIT CARD DEBT
- Credit Card Accounts
- Creditor: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Account Holders: [NAMES]
- Current Balance: $[AMOUNT] (as of [DATE])
- Credit Limit: $[AMOUNT]
- Minimum Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Primary User of Account: [NAME]
- Purpose of Debt: [DESCRIPTION]
Note: Credit card statements for the last 3 months are attached as Exhibit Q.
C. AUTO LOANS
- Vehicle Loans
- Vehicle Description: [YEAR, MAKE, MODEL]
- Lender: [NAME]
- Loan Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Maturity Date: [DATE]
- Names on Loan: [NAMES]
- Primary User of Vehicle: [NAME]
Note: Vehicle loan statements are attached as Exhibit R.
D. STUDENT LOANS
- Student Loans
- Lender/Servicer: [NAME]
- Loan Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Type of Loan: [FEDERAL/PRIVATE]
- Repayment Plan: [DESCRIPTION]
- Borrower: [NAME]
- Purpose: [UNDERGRADUATE/GRADUATE/PROFESSIONAL]
- Date Incurred: [BEFORE MARRIAGE/DURING MARRIAGE]
Note: Student loan statements are attached as Exhibit S.
E. PERSONAL LOANS
-
Bank/Financial Institution Loans
- Lender: [NAME]
- Loan Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Maturity Date: [DATE]
- Names on Loan: [NAMES]
- Purpose of Loan: [DESCRIPTION]
-
Family/Friend Loans
- Lender Name: [NAME]
- Relationship to Borrower: [RELATIONSHIP]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Repayment Terms: [DESCRIPTION]
- Interest Rate (if any): [PERCENTAGE]%
- Written Agreement: [YES/NO]
- Borrower: [NAME]
- Purpose of Loan: [DESCRIPTION]
Note: Loan agreements and statements for personal loans are attached as Exhibit T.
F. BUSINESS DEBTS
-
Business Loans
- Business Name: [NAME]
- Lender: [NAME]
- Loan Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Original Loan Amount: $[AMOUNT]
- Date of Loan: [DATE]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Maturity Date: [DATE]
- Personal Guarantee: [YES/NO]
- Names on Guarantee: [NAMES]
- Purpose of Loan: [DESCRIPTION]
-
Business Lines of Credit
- Business Name: [NAME]
- Lender: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Credit Limit: $[AMOUNT]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Personal Guarantee: [YES/NO]
- Names on Guarantee: [NAMES]
-
Business Credit Cards
- Business Name: [NAME]
- Creditor: [NAME]
- Account Number (last 4 digits): XXXX-[LAST 4 DIGITS]
- Credit Limit: $[AMOUNT]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Interest Rate: [PERCENTAGE]%
- Personal Guarantee: [YES/NO]
- Names on Guarantee: [NAMES]
Note: Business loan agreements and statements are attached as Exhibit U.
G. TAX LIABILITIES
-
Federal Tax Liabilities
- Tax Year(s): [YEAR(S)]
- Amount Owed: $[AMOUNT]
- Filing Status: [SINGLE/MARRIED FILING JOINTLY/MARRIED FILING SEPARATELY]
- Payment Plan: [YES/NO]
- Monthly Payment (if applicable): $[AMOUNT]
- Interest and Penalties: $[AMOUNT]
- Estimated Payoff Date: [DATE]
-
State Tax Liabilities
- State: [STATE]
- Tax Year(s): [YEAR(S)]
- Amount Owed: $[AMOUNT]
- Filing Status: [SINGLE/MARRIED FILING JOINTLY/MARRIED FILING SEPARATELY]
- Payment Plan: [YES/NO]
- Monthly Payment (if applicable): $[AMOUNT]
- Interest and Penalties: $[AMOUNT]
- Estimated Payoff Date: [DATE]
-
Local Tax Liabilities
- Jurisdiction: [JURISDICTION]
- Tax Year(s): [YEAR(S)]
- Amount Owed: $[AMOUNT]
- Payment Plan: [YES/NO]
- Monthly Payment (if applicable): $[AMOUNT]
- Interest and Penalties: $[AMOUNT]
- Estimated Payoff Date: [DATE]
Note: Tax bills, notices, and payment plan agreements are attached as Exhibit V.
H. MEDICAL DEBTS
- Medical Bills
- Provider: [NAME]
- Patient: [NAME]
- Date of Service: [DATE]
- Original Amount: $[AMOUNT]
- Current Balance: $[AMOUNT] (as of [DATE])
- Monthly Payment: $[AMOUNT]
- Payment Plan: [YES/NO]
- Insurance Coverage Pending: [YES/NO]
- Collection Status: [YES/NO]
Note: Medical bills and statements are attached as Exhibit W.
I. JUDGMENTS AND LIENS
-
Court Judgments
- Case Number: [NUMBER]
- Court: [COURT]
- Plaintiff: [NAME]
- Defendant: [NAME]
- Date of Judgment: [DATE]
- Original Amount: $[AMOUNT]
- Current Balance: $[AMOUNT] (as of [DATE])
- Interest Rate: [PERCENTAGE]%
- Payment Plan: [YES/NO]
- Monthly Payment (if applicable): $[AMOUNT]
-
Tax Liens
- Type of Tax: [INCOME/PROPERTY/OTHER]
- Taxing Authority: [NAME]
- Date Filed: [DATE]
- Original Amount: $[AMOUNT]
- Current Balance: $[AMOUNT] (as of [DATE])
- Property Affected: [DESCRIPTION]
- Status: [ACTIVE/RELEASED]
-
Mechanic's Liens
- Claimant: [NAME]
- Date Filed: [DATE]
- Original Amount: $[AMOUNT]
- Current Balance: $[AMOUNT] (as of [DATE])
- Property Affected: [DESCRIPTION]
- Status: [ACTIVE/RELEASED]
Note: Documentation related to judgments and liens is attached as Exhibit X.
V. MONTHLY EXPENSES
A. HOUSING EXPENSES
- Mortgage/Rent Payment: $[AMOUNT]/month
- Property Taxes (if not included in mortgage): $[AMOUNT]/month
- Homeowners/Renters Insurance (if not included in mortgage): $[AMOUNT]/month
- Homeowners Association (HOA) Fees: $[AMOUNT]/month
- Home Maintenance and Repairs: $[AMOUNT]/month
- Lawn Care/Landscaping: $[AMOUNT]/month
- Pest Control: $[AMOUNT]/month
- Security System: $[AMOUNT]/month
- Other Housing Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
B. UTILITY EXPENSES
- Electricity: $[AMOUNT]/month
- Gas: $[AMOUNT]/month
- Water/Sewer: $[AMOUNT]/month
- Trash Collection: $[AMOUNT]/month
- Telephone (Landline): $[AMOUNT]/month
- Cell Phone: $[AMOUNT]/month
- Internet: $[AMOUNT]/month
- Cable/Satellite TV: $[AMOUNT]/month
- Streaming Services: $[AMOUNT]/month
- Other Utility Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
C. FOOD AND HOUSEHOLD EXPENSES
- Groceries: $[AMOUNT]/month
- Dining Out/Takeout: $[AMOUNT]/month
- Household Supplies: $[AMOUNT]/month
- Personal Care Items: $[AMOUNT]/month
- Dry Cleaning/Laundry: $[AMOUNT]/month
- Other Food/Household Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
D. TRANSPORTATION EXPENSES
- Car Payment(s): $[AMOUNT]/month
- Auto Insurance: $[AMOUNT]/month
- Gasoline: $[AMOUNT]/month
- Car Maintenance and Repairs: $[AMOUNT]/month
- Public Transportation: $[AMOUNT]/month
- Parking and Tolls: $[AMOUNT]/month
- Vehicle Registration/License: $[AMOUNT]/month
- Other Transportation Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
E. HEALTHCARE EXPENSES
- Health Insurance Premiums (if not deducted from pay): $[AMOUNT]/month
- Dental Insurance Premiums (if not deducted from pay): $[AMOUNT]/month
- Vision Insurance Premiums (if not deducted from pay): $[AMOUNT]/month
- Out-of-Pocket Medical Expenses: $[AMOUNT]/month
- Prescription Medications: $[AMOUNT]/month
- Dental Expenses: $[AMOUNT]/month
- Vision Care: $[AMOUNT]/month
- Therapy/Counseling: $[AMOUNT]/month
- Other Healthcare Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
F. CHILD-RELATED EXPENSES
- Childcare/Daycare: $[AMOUNT]/month
- School Tuition: $[AMOUNT]/month
- School Supplies and Fees: $[AMOUNT]/month
- School Lunches: $[AMOUNT]/month
- Children's Clothing: $[AMOUNT]/month
- Children's Allowances: $[AMOUNT]/month
- Extracurricular Activities: $[AMOUNT]/month
- Sports and Recreation: $[AMOUNT]/month
- Summer Camps: $[AMOUNT]/month
- Tutoring: $[AMOUNT]/month
- College Savings Contributions: $[AMOUNT]/month
- Other Child-Related Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
G. INSURANCE EXPENSES
- Life Insurance Premiums: $[AMOUNT]/month
- Disability Insurance Premiums: $[AMOUNT]/month
- Long-Term Care Insurance Premiums: $[AMOUNT]/month
- Umbrella Policy Premiums: $[AMOUNT]/month
- Other Insurance Premiums: $[AMOUNT]/month (Describe: [DESCRIPTION])
H. ENTERTAINMENT AND RECREATION
- Gym/Health Club Memberships: $[AMOUNT]/month
- Entertainment (Movies, Events, etc.): $[AMOUNT]/month
- Hobbies: $[AMOUNT]/month
- Subscriptions and Memberships: $[AMOUNT]/month
- Vacation/Travel: $[AMOUNT]/month
- Pet Expenses: $[AMOUNT]/month
- Other Entertainment/Recreation Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
I. DEBT PAYMENTS
- Credit Card Payments (minimum required): $[AMOUNT]/month
- Student Loan Payments: $[AMOUNT]/month
- Personal Loan Payments: $[AMOUNT]/month
- Other Debt Payments: $[AMOUNT]/month (Describe: [DESCRIPTION])
J. OTHER EXPENSES
- Charitable Contributions: $[AMOUNT]/month
- Religious Contributions: $[AMOUNT]/month
- Gifts: $[AMOUNT]/month
- Professional Dues: $[AMOUNT]/month
- Professional Services (Accounting, Legal, etc.): $[AMOUNT]/month
- Education/Continuing Education: $[AMOUNT]/month
- Child Support (from previous relationships): $[AMOUNT]/month
- Alimony/Spousal Support (from previous relationships): $[AMOUNT]/month
- Tax Payments (not withheld from pay): $[AMOUNT]/month
- Retirement Contributions (not deducted from pay): $[AMOUNT]/month
- Other Expenses: $[AMOUNT]/month (Describe: [DESCRIPTION])
K. TOTAL MONTHLY EXPENSES
TOTAL MONTHLY EXPENSES: $[AMOUNT]/month
VI. SEPARATE PROPERTY CLAIMS
A. PRE-MARITAL PROPERTY
-
Description of Property: [DESCRIPTION]
- Date Acquired: [DATE]
- Value at Time of Marriage: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
-
Description of Property: [DESCRIPTION]
- Date Acquired: [DATE]
- Value at Time of Marriage: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
B. INHERITED PROPERTY
-
Description of Property: [DESCRIPTION]
- Date Inherited: [DATE]
- Value at Time of Inheritance: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
-
Description of Property: [DESCRIPTION]
- Date Inherited: [DATE]
- Value at Time of Inheritance: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
C. GIFTS RECEIVED INDIVIDUALLY
-
Description of Property: [DESCRIPTION]
- Date Received: [DATE]
- Donor: [NAME]
- Value at Time of Gift: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
-
Description of Property: [DESCRIPTION]
- Date Received: [DATE]
- Donor: [NAME]
- Value at Time of Gift: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
D. POST-SEPARATION ACQUISITIONS
-
Description of Property: [DESCRIPTION]
- Date Acquired: [DATE]
- Source of Funds: [DESCRIPTION]
- Purchase Price: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
-
Description of Property: [DESCRIPTION]
- Date Acquired: [DATE]
- Source of Funds: [DESCRIPTION]
- Purchase Price: $[AMOUNT]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
E. PROPERTY COVERED BY PRENUPTIAL OR POSTNUPTIAL AGREEMENT
-
Description of Property: [DESCRIPTION]
- Agreement Date: [DATE]
- Relevant Provision: [DESCRIPTION]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
-
Description of Property: [DESCRIPTION]
- Agreement Date: [DATE]
- Relevant Provision: [DESCRIPTION]
- Current Value: $[AMOUNT] (as of [DATE])
- Documentation: [DESCRIPTION OF DOCUMENTATION]
- Current Location/Status: [DESCRIPTION]
Note: Documentation supporting separate property claims is attached as Exhibit Y.
VII. VALUATION DATES
In accordance with the laws of [STATE/JURISDICTION], the following valuation dates have been used for the assets and liabilities listed in this Financial Disclosure Declaration:
- Date of Separation: [DATE]
- Date of Filing: [DATE]
- Current Date: [DATE]
For specific assets or liabilities where a different valuation date has been used, the specific date is noted in the relevant section.
VIII. DISCLOSURE UPDATES
I understand and acknowledge that I have a continuing duty to update this Financial Disclosure Declaration if there are any significant changes to my financial situation during the pendency of this action. Significant changes include, but are not limited to:
- Changes in employment status or income
- Acquisition or disposition of assets valued at $1,000 or more
- Incurring new debts of $1,000 or more
- Receipt of lump sum payments (e.g., bonuses, inheritances, settlements)
- Changes in retirement benefits or accounts
I agree to provide updated information within 30 days of any such change by filing a Supplemental Financial Disclosure Declaration with the court and serving a copy on the opposing party.
IX. COMPLETENESS CERTIFICATION
I hereby certify that I have made a complete and thorough search of all my records and have made honest and consistent inquiry to ascertain all material facts relating to this Financial Disclosure Declaration. I further certify that the information provided in this Financial Disclosure Declaration and the attached supporting documentation represents a complete and accurate disclosure of my income, expenses, assets, and liabilities to the best of my knowledge and belief.
I understand that this Financial Disclosure Declaration will be relied upon by the court and the opposing party in this action, and that any intentional or reckless omission or misstatement of material information may result in sanctions, including but not limited to monetary fines, adverse evidentiary determinations, or other appropriate remedies as determined by the court.
X. PENALTIES OF PERJURY STATEMENT
I declare under penalty of perjury under the laws of the State of [STATE] that the foregoing is true and correct to the best of my knowledge, information, and belief.
XI. JURISDICTION-SPECIFIC REQUIREMENTS
In addition to the information provided above, I have included all additional information and documentation required by the laws and rules of [STATE/JURISDICTION], including but not limited to:
- [JURISDICTION-SPECIFIC REQUIREMENT]
- [JURISDICTION-SPECIFIC REQUIREMENT]
- [JURISDICTION-SPECIFIC REQUIREMENT]
XII. SUPPORTING DOCUMENTATION
The following supporting documentation is attached to this Financial Disclosure Declaration:
- Exhibit A: Pay stubs for the last 6 months
- Exhibit B: Business tax returns and profit and loss statements
- Exhibit C: Investment account statements
- Exhibit D: Personal and business tax returns for the past 5 years
- Exhibit E: Real estate documentation
- Exhibit F: Bank statements for the last 3 months
- Exhibit G: Investment account statements for the last 3 months
- Exhibit H: Retirement account statements for the last 3 months
- Exhibit I: Business documentation
- Exhibit J: Life insurance policy statements
- Exhibit K: Vehicle documentation
- Exhibit L: Personal property appraisals
- Exhibit M: Intellectual property documentation
- Exhibit N: Inheritance and gift documentation
- Exhibit O: Digital asset documentation
- Exhibit P: Mortgage statements
- Exhibit Q: Credit card statements for the last 3 months
- Exhibit R: Vehicle loan statements
- Exhibit S: Student loan statements
- Exhibit T: Personal loan documentation
- Exhibit U: Business loan documentation
- Exhibit V: Tax liability documentation
- Exhibit W: Medical debt documentation
- Exhibit X: Judgment and lien documentation
- Exhibit Y: Separate property claim documentation
- Exhibit Z: [OTHER DOCUMENTATION]
SIGNATURE PAGE
Executed on this _____ day of ________________, [YEAR].
[FULL LEGAL NAME]
Declarant
Attorney for Declarant (if applicable)
[ATTORNEY NAME]
[BAR NUMBER]
[LAW FIRM]
[ADDRESS]
[TELEPHONE NUMBER]
[EMAIL ADDRESS]