Please fill in the following completely:


This part is about where the case is located and some information which helps this program create the header for you.


Within which judicial circuit is your case being held?
What county in Florida (ie: Volusia, Flagler) has jurisdiction over your housing case?
What is the case number for your case?

This next part is about you.


What is your full legal name?
Are you the Petitioner (top name) or the Respondent (bottom name)?
How old are you?
What is your current street address?
What city do you live in?
What state do you live in?
What is your zip code?
What is your phone number?
What is a good email address for you?
What do you do for a living (ie: carpenter, electrician, doctor)?
Are you employed?

Fill in this part IF YOU SELECTED EMPLOYED above.

What is your employer's full name?
What is your employer's current street address?
What is your employer's city?
What is your employer's state?
What is your employer's zip code?
What is your employer's phone number?
What is your pay rate at this employer?
Is that weekly, bi-weekly, twice a month, monthly, or other?
If you are expecting to become unemployed or change jobs soon, describe the change you expect and why and how it will affect your income:
(COMING SOON) CLICK HERE TO SUBMIT INFORMATION ABOUT OTHER EMPLOYEES! (COMING SOON)

Fill in this part IF YOU SELECTED UNEMPLOYED above.

Describe your efforts to find employment, how soon you expect to be employed, and the pay you expect to receive:

Fill in this part IF YOU SELECTED RETIRED above.

When did you retire?
What is your employer's full name from whom you retired?
What is your last employer's current street address?
What is your last employer's city?
What is your last employer's state?
What is your last employer's zip code?
What is your last employer's phone number?

This part is concerned about last year's income for both parties. If you filed jointly (as a married couple) then the numbers should be the same. If you filed individually, then the numbers are likely different. That may or may not mean that your liability is impacted in your family law case. See Publication 504, Divorced or Separated Individuals for the IRS for more information.

What was last years gross income for you; or if you were married the combined gross income of both parties?
What was your individual income last year?
What was the other party's income last year? Leave this blank if you do not know.

For this part, you need to input values for the month. Yearly, quarterly, or other periodic values will create problems in the calculations of your financial affidavit which may impact your case.


Here we will work on your PRESENT MONTHLY GROSS INCOME. If you do not have income under certain categories, enter $0.00.

If you need to convert values from one period to another (ie: yearly to monthly), click this button and keep this calculator handy for that purpose.

What is your average monthly gross salary or wages?
What is your average monthly bonuses, commissions, allowances, overtime, tips, and similar payments?
What is your average 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.)
What is your monthly disability benefits/SSI?
What is your average monthly Workers’ Compensation
What is your average monthly Unemployment Compensation
What is your average monthly pension, retirement, or annuity payments
What is your average monthly Social Security benefits
Breaking down your alimony income (if any), how much is from this case:
Breaking down your alimony income (if any), how much is from other case(s):
What is your average monthly interest and dividends
What is your average monthly rental income (gross receipts minus ordinary and necessary expenses required to produce income) (Attach sheet itemizing such income and expense items.)
What is your average monthly income from royalties, trusts, or estates
What is your average monthly reimbursed expenses and in-kind payments to the extent that they reduce personal living expenses (Attach sheet itemizing each item and amount.)
What is your average monthly gains derived from dealing in property (not including nonrecurring gains)
Any other income of a recurring nature (identify source)


Here we will work on your PRESENT MONTHLY DEDUCTIONS. If you do not have deductions under certain categories, enter $0.00.

If you need to convert values from one period to another (ie: yearly to monthly), click this button and keep this calculator handy for that purpose.

How much do you pay on average for monthly federal, state, and local income tax (corrected for filing status and allowable dependents and income tax liabilities)
What is your filing status?
How many dependents did you claim?
How much do you pay on average for monthly FICA or self-employment taxes
How much do you pay on average for monthly Medicare payments
How much do you pay on average for monthly mandatory union dues
How much do you pay on average for monthly mandatory retirement payments
How much do you pay on average for monthly health insurance payments (including dental insurance), excluding portion paid for any minor children of this relationship
How much do you pay on average for monthly court-ordered child support actually paid for children from another relationship
Breaking down your alimony payments (if any), how much is from this case:
Breaking down your alimony payments (if any), how much is from other case(s):

Here we will work on your AVERAGE MONTHLY EXPENSES. If you do not have expenses under certain categories, enter $0.00.

If you need to convert values from one period to another (ie: yearly to monthly), click this button and keep this calculator handy for that purpose.

HOUSEHOLD EXPENSES
How much do you pay on average for monthly mortgage or rent payments
How much do you pay on average for monthly property taxes (if not included in mortgage)
How much do you pay on average for monthly insurance on residence (if not included in mortgage)
How much do you pay on average for monthly condominium maintenance fees and homeowner’s association fees
How much do you pay on average for monthly electricity
How much do you pay on average for monthly water, garbage, and sewer
How much do you pay on average for monthly telephone
How much do you pay on average for monthly fuel, oil, or natural gas
How much do you pay on average for monthly repairs and maintenance
How much do you pay on average for monthly lawn care
How much do you pay on average for monthly pool maintenance
How much do you pay on average for monthly pest control
How much do you pay on average for monthly misc. household
How much do you pay on average for monthly food and home supplies
How much do you pay on average for monthly meals outside home
How much do you pay on average for monthly cable t.v.
How much do you pay on average for monthly alarm service contract
How much do you pay on average for monthly service contracts on appliances
How much do you pay on average for monthly maid service
Other:




AUTOMOBILE:
How much do you pay on average for monthly gasoline and oil
How much do you pay on average for monthly repairs
How much do you pay on average for monthly auto tags and emission testing
How much do you pay on average for monthly insurance
How much do you pay on average for monthly payments (lease or financing)
How much do you pay on average for monthly rental/replacements
How much do you pay on average for monthly alternative transportation (bus, rail, car pool, etc.)
How much do you pay on average for monthly tolls and parking

MONTHLY EXPENSES FOR CHILDREN COMMON TO BOTH PARTIES:
How much do you pay on average for monthly nursery, babysitting, or day care
How much do you pay on average for monthly school tuition
How much do you pay on average for monthly school supplies, books, and fees
How much do you pay on average for monthly after school activities
How much do you pay on average for monthly lunch money
How much do you pay on average for monthly private lessons or tutoring
How much do you pay on average for monthly allowances
How much do you pay on average for monthly clothing and uniforms
How much do you pay on average for monthly entertainment (movies, parties, etc.)
How much do you pay on average for monthly health insurance
How much do you pay on average for monthly medical, dental, prescriptions (nonreimbursed only)
How much do you pay on average for monthly psychiatric/psychological/counselor
How much do you pay on average for monthly orthodontic
How much do you pay on average for monthly vitamins
How much do you pay on average for monthly beauty parlor/barber shop
How much do you pay on average for monthly nonprescription medication
How much do you pay on average for monthly cosmetics, toiletries, and sundries
How much do you pay on average for monthly gifts from child(ren) to others (other children, relatives, teachers, etc.)
How much do you pay on average for monthly camp or summer activities
How much do you pay on average for monthly clubs (Boy/Girl Scouts, etc.)
How much do you pay on average for monthly time-sharing expenses
How much do you pay on average for monthly miscellaneous
MONTHLY EXPENSES FOR CHILD(REN) FROM ANOTHER RELATIONSHIP
(other than court-ordered child support)



MONTHLY INSURANCE:
How much do you pay on average for health insurance (if not listed on lines 23 or 45)
How much do you pay on average for life insurance
How much do you pay on average for dental insurance.
Other:


OTHER MONTHLY EXPENSES NOT LISTED ABOVE:
How much do you pay on average for monthly dry cleaning and laundry
How much do you pay on average for monthly clothing
How much do you pay on average for monthly medical, dental, and prescription (unreimbursed only)
How much do you pay on average for monthly psychiatric, psychological, or counselor (unreimbursed only)
How much do you pay on average for monthly non-prescription medications, cosmetics, toiletries, and sundries
How much do you pay on average for monthly grooming
How much do you pay on average for monthly gifts
How much do you pay on average for monthly pet expenses
How much do you pay on average for monthly club dues and membership
How much do you pay on average for monthly sports and hobbies
How much do you pay on average for monthly entertainment
How much do you pay on average for monthly periodicals/books/tapes/CDs
How much do you pay on average for monthly vacations
How much do you pay on average for monthly religious organizations
How much do you pay on average for monthly bank charges/credit card fees
How much do you pay on average for monthly education expenses




MONTHLY PAYMENTS TO CREDITORS: (only when payments are currently made by you on outstanding balances). List only last 4 digits of account numbers.














Next, let's talk about the stuff you own. These are your "assets."


How much cash do you have on average every month in your wallet or purse?
Do you want the judge in your case to award this to you?
Did you get this cash outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much cash do you have on average in your banks?
Do you want the judge in your case to award this to you?
Did you get this cash outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much do you own in stocks and bonds?
Do you want the judge in your case to award this to you?
Did you get these stocks and bonds outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much money is owed to you in writing?
Do you want the judge in your case to award this to you?
Were these notes obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much money is owed to you but not in writing?
Do you want the judge in your case to award this to you?
Were these debts owed to you obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list any real estate by address along with the current value of the property. If you own multiple real properties, list them individually on one line and place their individual value in parenthesis next to them. ie: 123 Anywhere Lane; Daytona Beach, FL 12345 ($100,000).
What is the total amount of the real estate owned by you worth?
Do you want the judge in your case to award this/these to you?
Were these properties obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list any business entities you own along with the current value of the property. If you own multiple business entities, list them individually on one line and place their individual value in parenthesis next to them. ie: Acme Knitting Company ($100,000).
What is the total amount your business entities are worth?
Do you want the judge in your case to award this/these to you?
Were these businesses obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list any automobiles, boats, or other vehicles along with the current value of the property. If you own multiple vehicles, list them individually on one line and place their individual value in parenthesis next to them. ie: 2018 Ford F-150 ($35,000).
What is the total amount your vehicles are worth?
Do you want the judge in your case to award this/these to you?
Were these vehicles obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list any retirement plans along with the current value of the plans. If you have plans, list them individually on one line and place their individual value in parenthesis next to them. ie: Work IRA ($10,000).
What is the total amount your retirement plans are worth?
Do you want the judge in your case to award this/these to you?
Were these plans obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much is the furniture and furnishings in the home worth?
Do you want the judge in your case to award this to you?
Were these furnishings owned by you obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much is the furniture and furnishings outside the home worth?
Do you want the judge in your case to award this to you?
Were these furnishings owned by you obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much are the collections you own worth?
Do you want the judge in your case to award this to you?
Were these collections owned by you obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
How much is the jewelry you own worth?
Do you want the judge in your case to award this to you?
Was this jewelry owned by you obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
What is the cash surrender value of any life insurance policy you own?
Do you want the judge in your case to award this to you?
Was this life insurance obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
What is the value of the sporting and entertainment equipment you own?
Do you want the judge in your case to award this to you?
Was this equipment obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list any other asset not described above along with the current value of the property. If you own multiple unlisted assets, list them individually on one line and place their individual value in parenthesis next to them. ie: 1968 Presidential License Plate ($80,000).
What is the total amount your other assets are worth?
Do you want the judge in your case to award this/these to you?
Were these other assets obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?

Next, let's talk about the stuff you owe. These are your "liabilities."


Please list mortgages which are on any of your above listed real properties along with the current value of the property. If you have multiple mortgages on your properties, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: 123 Anywhere Lane, Daytona Beach, FL 12345 ($71,000).
What is the total amount of your mortgages on all of your properties?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list back rents which you owe to any current or prior landlord. If you have multiple such rental delinquencies, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: 123 Anywhere Lane, Daytona Beach, FL 12345 ($4,000).
What is the total amount of your back rent due?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list all credit or charge cards upon which you owe any balance. If you have multiple such delinquencies, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: CapitalOne Mastercard ($10,000).
What is the total amount of your charge and credit cards owed?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list all vehicle loans upon which you owe any balance. If you have multiple such loans, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: Harley Davidson ($18,000).
What is the total amount of these vehicle loans?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list all bank/credit union loans upon which you owe any balance. If you have multiple such loans, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: Space Coast Credit Union ($18,000).
What is the total amount of these loans?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list all money loans you owe which is not evidences by a written document. If you have multiple such loans, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: Loan from Mother ($20,000).
What is the total amount of these loans?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list any judgments (court orders) under which you owe. If you have multiple such judgments, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: Doe v. Smith, 2018 AB 123456 (Fla. Orange Cty.) ($25,000).
What is the total amount of these loans?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?
Please list any other liability under which you owe. If you have multiple such liabilities, list them individually on one line and place their individual amount owed by you in parenthesis next to them. ie: Hospital Bill ($600,000).
What is the total amount of these loans?
Do you want the judge in your case to award this/these to you?
Were these liabilities obtained by you outside of the marital relationship (after seperation, an inheritance, prior to the marriage)?

Next, let's talk about the stuff you might own in the future. These are your "contingent assets."


Please list any asset which you do not have yet but anticipate obtaining sometime in the future. (income potential, accrued vacation or sick leave, bonuses, inheritance, etc.) If you own multiple such assets, list them individually on one line and place their individual value in parenthesis next to them. ie: Inheritance from rich uncle ($1,000,000).
What is the total amount your other assets are worth?
Do you want the judge in your case to award this/these to you?

Next, let's talk about the stuff you might owe in the future. These are your "contingent liabilities."


Please list any liability which you do not have yet but anticipate obtaining sometime in the future. (possible lawsuits, future unpaid taxes, contingent tax liabilities, debts assumed by another, etc.) If multiple such liabilities exist, list them individually on one line and place their amount in parenthesis next to them. ie: IRS Audit ($2,000,000).
What is the total amount of these liabilities?
Do you want the judge in your case to award this/these to you?

Let's talk about children."


Are there minor or dependent children common to you and the other person?

This next part is about the other person in this case.


What is the other parent's full name?
What is the other parent's current street address?
What city does the other parent live in?
What state does the other parent live in?
What is the other parent's zip code?
What is the other parent's phone number?
What is a good email address for the other parent? (We will not be emailing that person)


The section is about the other parent's attorney, if any. If there is no attorney representing the other parent, you can skip this portion.

What is the attorney's full name?
What is the attorney's current street address?
What city does the attorney live in?
What state does the attorney live in?
What is the attorney's zip code?
What is the attorney's phone number?
What is a good email address for the attorney? (We will not be emailing that person)

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DISCLAIMER

No employee or agent is authorized to conclude any binding agreement on behalf of Hallisky Davis and Associates, LLC ("HDA") with another party by email or otherwise without express written confirmation by the company signed by the managing members. HDA accepts no liability for the content of any communication with any agent, or for the consequences of any actions taken on the basis of the information provided, unless that information is subsequently confirmed in a writing signed by all parties.No advice or information provided should be construed as acting to create or modify any attorney-client relationship between the recipient and HDA or any attorney(s) working for the business. The use of this website will be governed solely by the end-user license agreement and the terms of service.

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