FA Long Form

All amounts must be MONTHLY. Attach more paper if needed. Items included under “Other” should be listed separately with separate dollar amounts.

All amounts must be MONTHLY.

25. Monthly court-ordered alimony actually paid

Proposed/Estimated: If this is a dissolution of marriage case and your expenses as listed below do not reflect what you actually pay currently, you should write “estimate” next to each amount that is estimated.

HOUSEHOLD:

AUTOMOBILE:

MONTHLY EXPENSES FOR CHILDREN COMMON TO BOTH PARTIES:

MONTHLY EXPENSES FOR CHILD(REN) FROM ANOTHER RELATIONSHIP: (other than court ordered child support)

MONTHLY INSURANCE:

OTHER MONTHLY EXPENSE NOT LISTED ABOVE:

MONTHLY PAYMENTS TO CREDITORS: (only when payments are currently made by you on outstanding balances)

NAME OF CREDITOR(s):

SUMMARY

A. ASSETS (This is where you list what you OWN)

INSTRUCTIONS:

STEP 1: In Column A, list a description of each separate item owned by you (and/or your spouse, if this is a petition for dissolution of marriage). Blank spaces are provided if you need to list more than one of an item.

STEP 2: If this is a petition for dissolution of marriage, check the box in Column A next to any item that you are requesting the Judge award to you.

STEP 3: In Column B, write what you believe to be the current fair market value of all items listed.

STEP 4: Use Column C only if this is a petition for dissolution of marriage and you believe an item is “non-martial”, meaning it belongs to only one of you and should not be divided. You should indicate to whom you believe the item belongs. (Typically, you will only use Column C if property was owned by one spouse before the marriage.)

INSTRUCTIONS:

STEP 1: In Column A, list a description of each separate debt owed by you (and/or your spouse, if this is a petition for dissolution of marriage). Blank spaces are provided if you need to list more than one of an item.

STEP 2: If this is a petition for dissolution of marriage, check the box in Column A next to any debt(s) for which you believe you should be responsible.

STEP 3: In Column B, write what you believe to be the current amount owed for all items listed.

STEP 4: Use Column C only if this is a petition for dissolution of marriage and you believe an item is “non-martial”, meaning the debt belongs to only one of you and should not be divided. You should indicate to whom you believe the debt belongs. (Typically, you will only use Column C if the debt was owed by one spouse before the marriage.)

INSTRUCTIONS: If you have any POSSIBLE assets (income potential, accrued vacation or sick leave, bonus, inheritance, etc.) or POSSIBLE liabilities (possible lawsuits, future unpaid taxes, contingent tax liabilities, debts assumed by another), you must list them here.

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet, MUST be filed with the court at or prior to a hearing to establish or modify child support. this requirement cannot be waived by the parties.

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this affidavit and that the punishment for knowingly making a false statement includes fines and/or imprisonment.