COURT OF COMMON PLEAS COUNTY, OHIO Case No. Plaintiff/Petitioner 1 Judge v./and Magistrate Defendant/Petitioner 2 Instructions: Check local court rules to determine when this form must be filed. This affidavit is used to make complete disclosure of income, expenses and money owed. It is used to determine child and not know exact spousal support amounts. Do not leave any category blank. Write “none” where appropriate. If you do figures for any item, give your best estimate and If you need more space, add additional pages. put “EST.” AFFIDAVIT OF INCOME AND EXPENSES Affidavit of (Print Your Name) Date of marriage Date of separation SECTION I - INCOME ___________________ Your Name Name ________________Spouse’s Employed Yes No Yes No Employer Payroll address Payroll city, state, zip Scheduled paychecks per year 12 24 26 52 12 24 26 52 A. YEARLY INCOME, OVERTIME, COMMISSIONS AND BONUSES FOR PAST THREE YEARS ___________________ Your Name Name _______________Spouse’s $ 3 years ago 20 $ Base yearly income $ 2 years ago 20 $ $ Last year 20 $ $ 3 years ago 20 $ Yearly overtime, commissions $ 2 years ago 20 $ and/or bonuses $ Last year 20 $
COURT OF COMMON PLEAS COUNTY, OHIO Case No. Plaintiff/Petitioner 1 Judge v./and Magistrate Defendant/Petitioner 2 Instructions: Check local court rules to determine when this form must be filed. This affidavit is used to make complete disclosure of income, expenses and money owed. It is used to determine child and spousal support amounts. Do not leave any category blank. Write “none” where appropriate. If you do not know exact figures for any item, give your best estimate and put “EST.” If you need more space, add additional pages. AFFIDAVIT OF INCOME AND EXPENSES Affidavit of (Print Your Name) Date of marriage Date of separation SECTION I - INCOME ___________________ Your Name ________________Spouse’s Name Employed Yes No Yes No Employer Payroll address Payroll city, state, zip Scheduled paychecks per year 12 24 26 52 12 24 26 52 A. YEARLY INCOME, OVERTIME, COMMISSIONS AND BONUSES FOR PAST THREE YEARS ___________________ Your Name _______________Spouse’s Name Base yearly income $ 3 years ago 20 $ $ 2 years ago 20 $ $ Last year 20 $ Yearly overtime, commissions and/or bonuses $ 3 years ago 20 $ $ 2 years ago 20 $ $ Last year 20 $
Affidavit1_2016.docx