Opinion
1:20-CV-474
05-05-2021
CONDRA L. SMITH, Plaintiff, v. U.S. DEPARTMENT OF EDUCATION, PIONEER CREDIT RECOVERY, INC., and GENERAL REVENUE, Defendants.
FINANCIAL AFFIDAVIT
1. Are you employed?
No__.
Yes, and my gross earnings (before deductions for taxes, etc.) are: $__ per month.
2. Are you married?
No__ .
Yes, and my spouse's gross earnings (before deductions for taxes, etc.) are: $__ per month.
3. Have you (and your spouse, if married) received any money from any other source, other than employment, in the past 12 months?
No__ .
If your answer is yes, state the source of income, how often you received it, and how much you received:
4. If you have no income listed above, explain how you (and your spouse, if married) obtain food, clothing, shelter, and other necessities of basic living:
5. Do you (or your spouse, if married) expect to receive any money or income from any other sources, other than employment, in the next 12 months?
No __.
If your answer is yes, state the source of income, how often you expect to receive it, and how much you expect to receive:
6. How much money do you (and your spouse, if married) have (include cash on hand and deposits in savings and checking accounts)? $ __.
7. What is the approximate value of your (and your spouse's) real estate, cars, jewelry, stocks, bonds, and other valuable property or investments? $ __.
8. How many children under the age of 18 do you (and your spouse, if married) support? __.
9. Please provide any other information that should be considered:
I declare under penalty of perjury that all of my statements in this affidavit are true.
Condra L. Smith