Opinion
DECIDED: May 2, 2007
The Honorable Supreme Court met pursuant to adjournment.
It is ordered that Rule 24.2 of the Uniform Superior Court Rules, involving the obligation to provide financial data in domestic relations cases, as amended, be revised to correct a clerical error in Item 2 of the Financial Affidavit — Summary of affiant's income and needs, part (b) Net monthly income, to provide (from item 3B) as follows:
In the Superior Court of ______________ County, Georgia
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
1. AFFIANT'S NAME:______________________________ Age _________
Spouse's Name: _______________________________ Age _________
Date of Marriage: _____________________ Date of Separation __________________
Names and birth dates of children for whom support is to be determined in this action:
Name Date of Birth Resides with
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Names and birth dates of affiant's other children:
Name Date of Birth Resides with
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
2. SUMMARY OF AFFIANT'S INCOME AND NEEDS
(a) Gross monthly income (from item 3A) $ ______________
(b) Net monthly income (from item 3B) ______________
(c) Average monthly expenses (item 5A) $ ______________
Monthly payments to creditors + ______________
Total monthly expenses and payments to creditors (item 5C) _______________
3. A. AFFIANT'S GROSS MONTHLY INCOME (complete this section or attach Child Support Schedule A)
(All income must be entered based on monthly average regardless of date of receipt.)
Salary or Wages ATTACH COPIES OF 2 MOST RECENT WAGE STATEMENTS $ ______________ Commissions, Fees, Tips $ ______________ Income from self-employment, partnership, close corporations, and independent contracts (gross receipts minus ordinary and necessary expenses required to produce income) ATTACH SHEET ITEMIZING YOUR CALCULATIONS $ ______________ Rental Income (gross receipts minus ordinary and necessary expenses required to produce income) ATTACH SHEET ITEMIZING YOUR CALCULATIONS $ ______________ Bonuses $ ______________ Overtime Payments $ ______________ Severance Pay $ ______________ Recurring Income from Pensions or Retirement Plans $ ______________ Interest and Dividends $ ______________ Trust Income $ ______________ Income from Annuities $ ______________ Capital Gains $ ______________ Social Security Disability or Retirement Benefits $ ______________ Workers' Compensation Benefits $ ______________ Unemployment Benefits $ ______________ Judgments from Personal Injury or Other Civil Cases $ ______________ Gifts (cash or other gifts that can be converted to cash) $ ______________ Prizes/Lottery Winnings $ ______________ Alimony and maintenance from persons not in this case $ ______________ Assets which are used for support of family $ ______________ Fringe Benefits (if significantly reduce living expenses) $ ______________ Any other income (do NOT include means-tested Public assistance, such as TANF or food stamps) $ ______________ GROSS MONTHLY INCOME $ ______________
3. B. Affiant's Net Monthly Income from employment (deducting only state and federal taxes and FICA) $ _______________
Affiant's pay period (i.e., weekly, monthly, etc.) ___________________
Number of exemptions claimed ____________
4. ASSETS
(If you claim or agree that all or part of an asset is non-marital, indicate the non-marital portion under the appropriate spouse's column and state the amount and the basis: pre-marital, gift, inheritance, source of funds, etc.).
Description Value Separate Asset Separate Asset Basis of the of the Husband of the Wife Claim Total Assets: $____________ ______________ ______________ ____________________
Cash $____________ ______________ ______________ ____________________ Stocks, bonds $____________ ______________ ______________ ____________________ CD's/Money Market Accounts Bank Accounts $____________ ______________ ______________ ____________________ (list each account): _______________ $____________ ______________ ______________ ____________________ _______________ $____________ ______________ ______________ ____________________ _______________ $____________ ______________ ______________ ____________________ Retirement Pensions, 401K, IRA, or Profit Sharing $____________ ______________ ______________ ____________________ Money owed you: $____________ ______________ ______________ ____________________ Tax Refund owed you: $____________ ______________ ______________ ____________________ Real Estate: home: $ ___________ ______________ ______________ ____________________ debt owed: $ ___________ other: $ ___________ ______________ ______________ ____________________ debt owed: $ ____________ Automobiles/Vehicles: Vehicle 1: $____________ ______________ ______________ ____________________ debt owed: $ ___________ Vehicle 2: $____________ ______________ ______________ ____________________ debt owed: $____________ Life Insurance (net cash value): $____________ ______________ ______________ ____________________ Furniture/furnishings: $____________ ______________ ______________ ____________________ Jewelry: $____________ ______________ ______________ ____________________ Collectibles: $____________ ______________ ______________ ____________________ Other Assets: $____________ ______________ ______________ ____________________ _______________ $____________ ______________ ______________ ____________________ _______________ $____________ ______________ ______________ ____________________ _______________ _______________ $____________ ______________ ______________ ____________________5. A. AVERAGE MONTHLY EXPENSES HOUSEHOLD AUTOMOBILE OTHER VEHICLES (boats, trailers, RVs, etc.)
Mortgage or rent payments $ __________ Cable TV $ __________ Property taxes $ __________ Misc. household and grocery Items $ __________ Homeowner/Renter Insurance $ __________ Meals outside the home $ __________ Electricity $ __________ Other $ __________ Water $ __________ Garbage and Sewer $ __________ Gasoline and oil $ __________ Telephone: Repairs $ __________ residential line: $ __________ Auto tags and license $ __________ cellular telephone: $ __________ Insurance $ __________ Gas $ __________ Repairs and maintenance: $ __________ Gasoline and oil $__________ Lawn Care $ __________ Repairs $__________ Pest Control $ __________ Tags and license $__________ Insurance $__________CHILDREN'S EXPENSES AFFIANT'S OTHER EXPENSES
Child care (total monthly cost) $__________ Dry cleaning/laundry $__________ School tuition $__________ Clothing $__________ Tutoring $__________ Medical, dental, prescription (out of pocket/uncovered expenses) $__________ Private lessons (e.g., music, dance) $__________ Affiant's gifts (special holidays) $__________ School supplies/expenses $__________ Entertainment $__________ Lunch Money $__________ Recreational Expenses (e.g., fitness) $__________ Other Educational Expenses (list) Vacations $__________ ____________________ $__________ Travel Expenses for Visitation $__________ ____________________ $__________ Publications $__________ Allowance $__________ Dues, clubs $__________ Clothing $__________ Religious and charities $__________ Diapers $__________ Pet expenses $__________ Medical, dental, prescription (out of pocket/uncovered expenses) $__________ Alimony paid to former spouse $__________ Grooming, hygiene $__________ Child support paid for other children $__________ Gifts from children to others $__________ Date of initial order: __________ Entertainment $__________ Other (attach sheet) $__________ Activities (including extra-curricular, school, religious, cultural, etc.) $__________ Summer Camps $__________OTHER INSURANCE TOTAL ABOVE EXPENSES $__________ B. PAYMENTS TO CREDITORS To Whom: Balance Monthly Joint Plaintiff Due Payment
Health Child(ren)'s portion: $__________ $__________ Dental Child(ren)'s portion: $__________ $__________ Vision Child(ren)'s portion: $__________ $__________ Life Relationship of Beneficiary: $__________ ____________ Disability $__________ Other(specify): $__________ (please check one) Defendant TOTAL MONTHLY PAYMENTS TO CREDITORS: $ ___________________C. TOTAL MONTHLY EXPENSES: $ ______________________
This ______________________ day of ___________, 20________.
_____________________________________ _____________________________________
Notary Public Affiant
I hereby certify that the above is a true extract from the minutes of the Supreme Court of Georgia Witness my signature and the seal of said court hereto affixed the day and year last above written.