Family Law Financial Affidavit (Short Form) With Instructions {12.902(b)}

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.902(b), FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (01/15) When should this form be used? This form should be used when you are involved in a family law case which requires a financial affidavit and your individual gross income is UNDER $50,000 per year unless: (1) You are filing a simplified dissolution of marriage under rule 12.105 and both parties have waived the filing of a financial affidavit; (2) You have no minor children, no support issues, and have filed a written settlement agreement disposing of all financial issues; or (3) The court lacks jurisdiction to determine any financial issues. This form should be typed or printed in black ink. After completing this form, you should sign the form before a notary public or deputy clerk. You should file the original with the clerk of the circuit court in the county where the petition was filed and keep a copy for your records. What should I do next? A copy of this form must be served on the other party in your case within 45 days of being served with the petition, if it is not served on him or her with your initial papers. Service must be in accordance with Florida Rule of Judicial Administration 2.516. Where can I look for more information? Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. The words that are in "bold underline" in these instructions are defined there. For further information, see Florida Family Law Rule of Procedure 12.285. Special notes... If you want to keep your address confidential because you are the victim of sexual battery, aggravated child abuse, aggravated stalking, harassment, aggravated battery, or domestic violence, do not enter the address, telephone, and fax information at the bottom of this form. Instead, file Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h). The affidavit must be completed using monthly income and expense amounts. If you are paid or your bills are due on a schedule which is not monthly, you must convert those amounts. Hints are provided below for making these conversions. Instructions to Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15) American LegalNet, Inc. www.FormsWorkFlow.com Hourly - If you are paid by the hour, you may convert your income to monthly as follows: Hourly amount x Hours worked per week = Weekly amount Weekly amount x 52 Weeks per year = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Daily - If you are paid by the day, you may convert your income to monthly as follows: Daily amount x Days worked per week = Weekly amount Weekly amount x 52 Weeks per year = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Weekly - If you are paid by the week, you may convert your income to monthly as follows: Weekly amount x 52 Weeks per year = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Bi-weekly - If you are paid every two weeks, you may convert your income to monthly as follows: Bi-weekly amount x 26 = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Semi-monthly - If you are paid twice per month, you may convert your income to monthly as follows: Semi-monthly amount x 2 = Monthly Amount Expenses may be converted in the same manner. Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete. Instructions to Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15) American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: ______________________ Division: _______________________ , Petitioner, and , Respondent. FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (Under $50,000 Individual Gross Annual Income) I, {full legal name} information is true: My Occupation: , being sworn, certify that the following Employed by: ___________________________ Business Address: ________________________________________________________________ Pay rate: $ ( ) every week ( ) every other week ( ) twice a month ( ) monthly ( ) other: ____________ ___ Check here if unemployed and explain on a separate sheet your efforts to find employment. SECTION I. PRESENT MONTHLY GROSS INCOME: All amounts must be MONTHLY. See the instructions with this form to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under "other" should be listed separately with separate dollar amounts. 1. $______ Monthly gross salary or wages 2. ______ Monthly bonuses, commissions, allowances, overtime, tips, and similar payments 3. _______Monthly business income from sources such as self-employment, partnerships, close corporations, and/or independent contracts (gross receipts minus ordinary and necessary expenses required to produce income) (Attach sheet itemizing such income and expenses.) 4. _______Monthly disability benefits/SSI 5. _______Monthly Workers' Compensation 6. _______Monthly Unemployment Compensation 7. _______Monthly pension, retirement, or annuity payments 8. _______Monthly Social Security benefits 9. ______ Monthly alimony actually received (Add 9a and 9b) 9a. From this case: $ _______ 9b. From other case(s): _______ 10. _______ Monthly interest and dividends 11. _______Monthly rental income (gross receipts minus ordinary and necessary expenses Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15) American LegalNet, Inc. www.FormsWorkFlow.com 12. 13. 14. 15. 16. 17. required to produce income) (Attach sheet itemizing such income and expense items.) _______ Monthly income from royalties, trusts, or estates _______ Monthly reimbursed expenses and in-kind payments to the extent that they reduce personal living expenses _______ Monthly gains derived from dealing in property (not including nonrecurring gains) _______ Any other income of a recurring nature (list source) _________________________ _____________