Affidavit Of Property {DR-502}

DR-502 Page 1 of 7 COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION CLERMONT COUNTY, OHIO Plaintiff Case Number: vs. Defendant Instructions : Check local court rules to determine when this form must be filed. List ALL OF YOUR PROPERTY AND DEBTS, the property and debts of your spouse, and any joint property or debts. Do not leave any category blank. For each item, if none, put 223NONE.224 If you do not know exact figures for any item, give your best estimate, and put 223EST.224 If more space is needed, add additional pages. AFFIDAVIT OF PROPERTY Affidavit of ( Print Your Name) I. REAL ESTATE INTERESTS Address Present Fair Market Value Titled In Mortgage Balance Equity (as of date) 1. $ Your name Spouse222s name Both $ $ 2. $ Your name Spouse222s name Both $ $ TOTAL SECTION I: REAL ESTATE INTERESTS $ American LegalNet, Inc. www.FormsWorkFlow.com DR-502 Page 2 of 7 II.OTHER ASSETS Category Description (List who has possession) Titled In Value/Date of Value A. Vehicles and Other Certificate of Title Property (Include model and year of automobiles, trucks, motorcycles, boats, motors, motor homes, etc.) 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ 3. Your name Spouse222s name Both $ 4. Your name Spouse222s name Both $ 5. Your name Spouse222s name Both $ 6. Your name Spouse222s name Both $ B. Financial Accounts (Include checking, savings, CDs, POD a ccounts, money market accounts, etc.) 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ 3. Your name Spouse222s name Both $ 4. Your name Spouse222s name Both $ American LegalNet, Inc. www.FormsWorkFlow.com DR-502 Page 3 of 7 Category Description (List who has possession) Titled In Value/Date of Value C. Pensions & Retirement plans (Include profit - sharing, IRAs, 401k plans, etc.; Describe each type of plan) 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ 3. Your name Spouse222s name Both $ 4. Your name Spouse222s name Both $ D. Publicly Held Stocks, Bonds, Securities & Mutual Funds 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ 3. Your name Spouse222s name Both $ 4. Your name Spouse222s name Both $ Category Description (List who has possession) Titled In Value/Date of Value E. Closely Held Stocks & Other Business Interests and Name of Company (Type of ownership and number) 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ American LegalNet, Inc. www.FormsWorkFlow.com DR-502 Page 4 of 7 F. Life Insurance Type (Term/Whole Life) ( A ny cash value or loans) (Insured party & value upon death) 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ 3. Your name Spouse222s name Both $ 4. Your name Spouse222s name Both $ Category Description Who Has Possession Value/Date of Value G. Furniture & Appliances (Estimate value of those in your possession, and value of those in your spouse222s possession) 1. You Spouse Both $ 2. You Spouse Both $ 3. You Spouse Both $ 4. You Spouse Both $ H. Safe Deposit Box (Give location and describe contents) Titled In 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ American LegalNet, Inc. www.FormsWorkFlow.com DR-502 Page 5 of 7 I. Transfer of Assets Explanation: List the name and address of any person (other than creditors listed on your Affidavit) who has received money or property from you exceeding $300 in value in the past 12 months and the reason for each transfer. 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ 3. Your name Spouse222s name Both $ 4. Your name Spouse222s name Both $ Category Description (Also list who has possession) Titled In Value/Date of Value J . All Other Assets Not Listed Above Explanation: List any item you have not listed above that is considered an asset. 1. Your name Spouse222s name Both $ 2. Your name Spouse222s name Both $ TOTAL SECTION II: OTHER ASSETS $ III.SEPARATE PROPERTY CLAIMS: Pre-marital assets, gifts to one spouse only, inheritances Separate property as defined in R.C. 3105.171 is real or personal property that was inherited, acquired by one spouse prior to the date of marriage, acquired after a decree of legal separation under R.C. 3107.17, excluded by a valid antenuptial agreement, compensation for personal injury, except for loss of marital earnings and compensation for expenses paid from marital assets, or any gift of property that was given to only one spouse. Description Why do you claim this as a separate property? Present Fair Market Value Date of Marriage Market Value 1. $ 2. $ 3. $ 4. $ 5. $ TOTAL SECTION III: SEPARATE PROPERTY CLAIMS $ American LegalNet, Inc. www.FormsWorkFlow.com DR-502 Page 6 of 7 IV.DEBT List ALL OF YOUR DEBTS, the debts of your spouse, and any joint debts. Do not leave any category blank. For each item, if none, put 223NONE.224 If you don222t know exact figures for any item, give your best estimate, and put 223EST.224 If more space is needed to explain, please attach an additional page with the explanation and identify which question you are answering. Type Name of Creditor/Purpose of Debt Account Name Name(s) on Account Total Debt Due Monthly Payment A. Secured Debt (Mortgages, Car, etc.) 1. Your name Spouse222s name Joint $ $ 2. Your name Spouse222s name Joint $ $ 3. Your name Spouse222s name Joint $ $ 4. Your name Spouse222s name Joint $ $ 5. Your name Spouse222s name Joint $ $ B. Unsecured Debt, including credit cards 1. Your name Spouse222s name Joint $ $ 2. Your name Spouse222s name Joint $ $ 3. Your name Spouse222s name Joint $ $ 4. Your name Spouse222s name Joint $ $ 5. Your name Spouse222s name Joint $ $ TOTAL SECTION IV: DEBT $ American LegalNet, Inc. www.FormsWorkFlow.com DR-502 Page 7 of 7 Rev V. BANKRUPTCY Filed by: Date of Filing: Case Number Date of Discharge or Relief from Stay Type of Case (Ch. 7, 11, 12, 13) Current Monthly Payments 1. You Spouse Both $ 2. You Spouse Both $ TOTAL SECTION V: BANKRUPTCY $ OATH (Do Not Sign Until Notary is Present) I, (print your name) swear or affirm that I have read this document and , to the best o f my knowledge and belief, the facts and information stated in this document are true, accurate and complete. I understand that if I do not tell the truth, I may be subject to penalties for perjury. Your S ignature Sworn before me and signed in my presence this day of , . Notary Public My Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com