Blank Indiana Financial Declaration PDF Form

Blank Indiana Financial Declaration PDF Form

The Indiana Financial Declaration form is a document used in family law cases to disclose financial information during divorce or custody proceedings. This form requires individuals to provide details about their income, expenses, assets, and liabilities. Completing the form accurately is essential for fair financial negotiations, so be sure to fill it out by clicking the button below.

The Indiana Financial Declaration form is a crucial document utilized in divorce and custody proceedings within the state. This form requires detailed disclosure of both parties' financial situations, ensuring transparency and fairness during the legal process. Key components of the form include sections for gross weekly income, monthly expenses, and a comprehensive list of assets and liabilities. Individuals must report various income sources, such as salaries, pensions, and child support, while also accounting for mandatory deductions like taxes and insurance premiums. Furthermore, the form prompts users to list all household members and their associated expenses, providing a complete financial picture. Assets are categorized by type, including real estate, vehicles, and retirement accounts, with specific instructions for valuation. The declaration also emphasizes the importance of accuracy, as individuals are required to amend the document if financial circumstances change prior to trial. Completing this form accurately is essential for ensuring that both parties are treated equitably in the division of assets and responsibilities.

Document Sample

FINANCIAL DECLARATION FORM

STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS

OF PORTER COUNTY

IN RE THE MARRIAGE OF:

Cause Number:

Petitioner,

And

Respondent

In accordance with Local Rule 18 of the Porter Superior Court and Indiana Trial Rules 26, 33, 34, 35 and 37, the undersigned, Petitioner or Respondent, hereby submits the following

VERIFIED FINANCIAL DISCLOSURE STATEMENT:

FINANCIAL DECLARATION OF

 

 

 

 

 

 

 

 

Dated:

 

I. PRELIMINARY INFORMATION:

 

 

 

 

 

 

 

 

 

Husband:

 

 

Wife:

 

Address:

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Soc. Sec. No.:

 

 

Soc. Sec No.:

 

Badge/Payroll No.:

 

 

Badge/Payroll No.:

 

Occupation:

 

 

Occupation:

 

Employer:

 

 

Employer:

 

Birth Date:

 

 

Birth Date:

 

 

 

 

 

 

Date of Marriage:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Physical Separation:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Filing:

 

 

 

 

 

 

 

 

 

 

Children:

 

 

 

 

 

Name:

 

Age:

 

DOB:

 

SSN:

Name:

 

Age:

 

DOB:

 

SSN:

Name:

 

Age:

 

DOB:

 

SSN:

1

II. HEALTH INSURANCE INFORMATION:

Name and Address of health care insurance company:

Name all persons covered under plan(s):

Weekly cost of total health insurance premium:

Weekly cost of health insurance premium for children only:

Name of the children’s health care providers:

The names of the schools and grade level for each child are:

List any extraordinary health care concerns of any family member:

List any educational concerns of any family member:

III.INCOME INFORMATION:

A.EMPLOYMENT HISTORY:

Current Employer:

Address:

Telephone No.:

 

 

 

 

Length of Employment:

 

 

 

Job Description:

 

 

 

 

 

 

 

 

 

 

Gross Income:

 

 

 

 

 

 

 

 

 

 

 

Per week

 

Bi-weekly

 

 

Per month

 

 

Yearly

Net Income:

 

 

 

 

 

 

 

 

 

 

 

Per week

 

Bi-weekly

 

 

Per month

 

 

Yearly

2

B.EMPLOYMENT HISTORY FOR LAST 5 YEARS:

Employer

 

Dates of Employment

 

Compensation (per wk/mo/yr)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C.INCOME SUMMARY:

1.GROSS WEEKLY INCOME from: Salary and wages, including commissions, bonuses, allowances, and over-time

Note: If paid monthly, determine weekly income by dividing monthly income by 4.3

Pensions & Retirement

Social Security

Disability and unemployment insurance

Public Assistance (welfare, AFDC payments, etc.)

Food Stamps

Child supports received for any child(ren) not both of the parties to this marriage

Dividends and Interest

Rents received

All other sources (specify)

TOTAL GROSS WEEKLY INCOME

2.ITEMIZED WEEKLY DEDUCTIONS: from gross income

State and Federal Income Taxes:

Social Security & Medicare Taxes:

Medical Insurance

 

 

 

Coverage:

Health

(

 

)

 

Dental

(

 

)

 

Eye Care

(

 

)

 

Psychiatric

(

 

)

3

Union or other dues:

Retirement:

Pension fund: Mandatory ( )Optional ( )

Profit sharing: Mandatory ( )Optional( )

401(K): Mandatory ( ) Optional ( )

SEP: Mandatory ( ) Optional ( )

ESOP: Mandatory ( ) Optional ( )

IRA: Mandatory ( ) Optional ( )

403 B: Mandatory ( ) Optional ( )

Child Support withheld from pay (not including this case)

Garnishments (itemize on separate sheet)

Credit Union debts

Direct Withdrawals Out of Paychecks:

Car Payments

Life Insurance

Disability Insurance

Thrift plans

Credit Union Savings

Bonds

Donations

Other (specify)

Other (specify)

TOTAL WEEKLY DEDUCTIONS:

3. WEEKLY DISPOSABLE INCOME:

(A minus B: Subtract Total Weekly Deduction from Total Weekly Gross Income)

IN ALL CASES INVOLVING CHILD SUPPORT: Prepare and attach an Indiana Child Support Guideline Worksheet (with documentation verifying your income); or, supplement with such a Worksheet within ten (10) days of the exchange of this Form.

IV. MONTHLY LIVING EXPENSES:

House

1.Rent (Mortgage)

2.2nd Mortgage

4

3.Line of Credit

4.Gas/Electric

5.Telephone

6.Water

7.Sewer

8.Sanitation (garbage)

9.Cable

10.Satellite

11.Internet

12.Taxes (real estate if not included in mortgage payment

13.Insurance (house if not included in mortgage payment)

14.Lawn Care/Snow Removal

Groceries

1.Food

2.Toiletries

3.Cleaning Products

4.Paper Products

Clothing

1.Clothes

2.Shoes

3.Uniforms

Health Care

1.Health Insurance not deducted from pay

2.Dental Insurance not deducted from pay

3.Doctor visits (non-insurance covered)

4.Dental visits (non-insurance covered)

5.Prescription Pharmaceutical (non-insurance covered)

5

6.Over-the-counter medicine

7.Glass/contact lenses

8.Other non-insurance covered health care (itemize)

Car & Travel

1.Car Payment

2.Gasoline

3.Oil/Maintenance

4.Insurance (car)

5.Car Wash

6.Tolls

7.Train/Bus

8.Parking Lot Fees

9.License Plates

Beauty Care

1.Hair Dress/Barber

2.Cosmetics

School Needs

1.Lunches

2.Books

3.Tuition/Registration

4.Uniforms

5.School Supplies

6.Extra-Curricular Activities

Infant Care

1.Diapers

2.Baby Food

6

Miscellaneous

1.Church Donations

2.Charitable Donations

3.Life Insurance

4.Babysitter

5.Newspapers & Magazines

6.Cigarettes

7.Dry Cleaning

8.Entertainment

9.Cell Phone

10.Dues/Subscriptions

11.Charge Cards

12.Other (specify)

SUB-TOTAL OF EXPENSES:

Average Weekly Expenses (multiply monthly expenses by 12 and divide by 52)

V. PROVISIONAL ARREARAGE COMPUTATIONS:

If you allege the existence of a child support, maintenance, or other arrearage, attach all records or other exhibits regarding the payment history and complete the child support arrearage.

You must attach a Child Support Guideline Worksheet to your Financial Declaration Form or one must be exchanged with the opposing party/counsel within 10 days of receipt of the other parties= Financial Declaration Form.

7

ASSETS

All property is to be listed regardless of whether it is titled in your name only or jointly of if the property you own is being held for you in the name of a third party.

VI. PROPERTY:

A. MARITAL RESIDENCE:

Description:

Location:

Date Acquired:

 

Titled:

 

Purchase Price:

 

Down Payment:

 

Source of down payment:

 

 

 

 

Current Indebtedness:

 

 

 

 

Monthly Payment:

 

 

 

 

Current Market Value:

 

 

 

 

B.OTHER REAL PROPERTY: (Complete B on a separate sheet of paper for each additional parcel of real estate owned etc.)

Description:

Location:

Date Acquired:

 

Titled:

 

Purchase Price:

 

Down Payment:

 

Source of down payment:

 

 

 

 

Current Indebtedness:

 

 

 

 

Monthly Payment:

 

 

 

 

Current Market Value:

 

 

 

 

8

C.PERSONAL PROPERTY: (motor vehicles, boats, motorcycles, furnishings, household goods, jewelry, firearms, etc. Household furnishings and household goods such as pots and pans need not

be itemized).

Description

Titled

Current Value

Indebtedness

Payment

Present User

VII. BANK ACCOUNTS:

Name

Type of Account

(Checking, Savings,

CD’s, etc.)

Owner

Account No.

Balance on Date of Filing

VIII. NON-RETIREMENT SECURITIES: (stocks, bonds, mutual funds, etc.)

Name

Type of Account

(Money Mkt, Stocks,

Bonds, Mutual Funds)

Owner

Account No.

Value on date of filing

9

IX. LIFE INSURANCE POLICIES (whole life, variable life, annuities, term)

Company

Owner

Policy #.

Beneficiary

Face Value

Loan

Amount

Cash Value

X.RETIREMENT ACCOUNTS (Pension, Profit Sharing, 401(K), SEP, IRA, KEOGH, ESOP, etc.)

Company

Type of Plan

Owner

Account #

Vested (yes/no)

Value as of date of filing

XI. OTHER PROFESSIONAL OR BUSINESS INTERESTS:

Name of Business

Type (Corp., Part., Sole Owner

% Owned

Estimated Value

XII. MARITAL BILLS, DEBTS, AND OBLIGATIONS: (list every single bill, debt and obligation regardless of whether the bill is title in your name, your spouse=s name, or jointly. Please include all mortgages, 2nd mortgages, home equity loans, charge cards, other loans, credit union loans, car payments, and unpaid medical bills, etc. Do not include monthly expenses such as utilities that are paid in full every month).

Creditor

Description

Acct. #

Monthly

Payment

Balance as of

Date of Filing

Current

Balance

10

File Specifics

Fact Name Fact Description
Purpose The Indiana Financial Declaration form is used to disclose financial information during divorce proceedings.
Governing Law This form is governed by Indiana Code Title 31, Article 15, which pertains to dissolution of marriage.
Income Reporting Petitioners must report various income sources, including wages, pensions, and child support received from prior marriages.
Expense Disclosure Monthly expenses must be itemized, including taxes, insurance, and living costs.
Assets and Liabilities The form requires disclosure of all known assets and liabilities, including real estate and retirement accounts.
Signature Requirement The declaration must be signed under penalty of perjury, affirming the accuracy of the information provided.
Supplement Duty Individuals must update the declaration if they learn that the provided information is incorrect or has changed.
Confidentiality Information disclosed is subject to confidentiality rules during court proceedings.
Children's Expenses Specific deductions for child support and healthcare expenses for children of the marriage are included.
Filing Process The completed form must be filed with the court and served to the opposing party, typically via mail or hand delivery.

How to Use Indiana Financial Declaration

Completing the Indiana Financial Declaration form is an important step in the legal process. This form requires detailed information about your income, expenses, assets, and liabilities. After filling it out, you will submit it to the court, where it will be reviewed as part of your case.

  1. Gather Necessary Documents: Collect your last three payroll stubs, bank statements, and any other financial documents that will help you accurately report your income and expenses.
  2. Fill in Personal Information: Start by entering your name, address, occupation, employer, and date of birth at the top of the form.
  3. Report Gross Weekly Income: Complete the section detailing your gross weekly income. This includes salaries, pensions, child support received, dividends, rents, business income, and any other sources of income.
  4. Calculate Weekly Available Income: Subtract any court-ordered child support, health insurance premiums, and alimony from your total gross weekly income. This will give you your weekly available income.
  5. List Monthly Expenses: Document your monthly expenses, including taxes, mortgage or rent, utilities, food, insurance, and any other recurring costs.
  6. Detail Assets and Liabilities: List all your assets, such as property, vehicles, bank accounts, and any debts. Provide as much detail as possible, including ownership and values.
  7. Sign and Date the Form: At the end of the form, sign and date it to verify that the information provided is accurate and true.
  8. Make Copies: Before submitting, make copies of the completed form for your records and for any attorneys involved in your case.
  9. Submit the Form: File the form with the appropriate court, ensuring that you meet any deadlines set by the court.

Your Questions, Answered

What is the purpose of the Indiana Financial Declaration form?

The Indiana Financial Declaration form is used to provide a comprehensive overview of an individual's financial situation during divorce or custody proceedings. It helps the court assess income, expenses, assets, and liabilities. This information is crucial for determining child support, alimony, and the division of property. Completing the form accurately is essential for fair proceedings.

Who needs to complete the Financial Declaration form?

Both spouses involved in a divorce or custody case must complete the Financial Declaration form. This includes the husband and wife, regardless of who is the petitioner or respondent. Each party must disclose their financial information, including income, expenses, and assets, to ensure transparency and fairness in the court's decisions.

How should I calculate my gross weekly income for the form?

To calculate your gross weekly income, add together all sources of income you receive weekly. This includes:

  1. Salary, wages, and commissions
  2. Pensions, retirement benefits, Social Security, disability, unemployment, and workman's compensation
  3. Child support received from prior marriages
  4. Dividends and interest
  5. Rental income
  6. Business or self-employment income
  7. Any other income sources, such as bonuses or gifts

Once you have totaled these amounts, you will have your gross weekly income to report on the form.

What should I do if my financial situation changes after submitting the form?

If your financial situation changes after you have submitted the Indiana Financial Declaration form, you are required to update the information. This includes any changes to income, expenses, or assets. You must supplement or amend the declaration prior to trial to ensure that the court has the most accurate and current information. Failing to do so may affect the court's decisions regarding support and property division.

Common mistakes

  1. Incomplete Information: Failing to fill out all required fields can lead to delays. Every section must be addressed, even if the answer is zero or "none."

  2. Incorrect Income Reporting: Misreporting income, whether by underestimating or overestimating, can affect the outcome. Always provide accurate figures, and remember to attach the necessary payroll stubs.

  3. Missing Documentation: Not attaching required documents, such as payroll stubs or calculations for business income, can result in a rejection of the form.

  4. Ignoring Assets: Omitting assets or not valuing them properly can be detrimental. Disclose all known assets, even if their value is uncertain.

  5. Neglecting Deductions: Failing to account for all deductions can lead to an inflated view of available income. Ensure that all relevant expenses are included.

  6. Inaccurate Valuation Dates: Not specifying the correct valuation date for assets can lead to complications. Always indicate the date when the petition was filed.

  7. Misunderstanding Child Support Obligations: Misreporting child support payments can have serious implications. Be precise about amounts paid and received.

  8. Failure to Update Information: Not amending the declaration if circumstances change can lead to legal issues. Update the form as necessary before trial.

  9. Not Seeking Help: Attempting to fill out the form without guidance can lead to mistakes. Consider consulting with a professional if unsure about any aspect.

Documents used along the form

The Indiana Financial Declaration form is a crucial document often used in divorce proceedings to provide a clear picture of an individual's financial situation. Alongside this form, several other documents may be required to ensure a comprehensive understanding of both parties' finances. Below is a list of commonly used forms and documents that complement the Indiana Financial Declaration.

  • Income Verification Documents: These include recent pay stubs, tax returns, and W-2 forms. They help establish the income levels of both parties.
  • Bank Statements: Recent bank statements from checking and savings accounts provide insight into the financial activities and balances of each party.
  • Asset Inventory List: This document details all assets owned by each party, including real estate, vehicles, and personal property, along with their estimated values.
  • Debt Statements: Statements outlining any debts, such as credit card balances, loans, and mortgages, help clarify financial obligations.
  • Monthly Expense Reports: A detailed account of monthly expenses assists in determining each party's financial needs and obligations.
  • Retirement Account Statements: Documents that show the current value of retirement accounts, such as 401(k)s and IRAs, are essential for assessing long-term financial stability.
  • Child Support Documentation: If applicable, this includes any existing child support orders or agreements, which are vital for understanding financial responsibilities.
  • Health Insurance Information: Details about health insurance coverage, including premiums and benefits, are important for evaluating healthcare costs.
  • Tax Returns: Copies of the last few years of tax returns provide a historical perspective on income and financial trends.

Gathering these documents can streamline the process and ensure that all financial aspects are considered fairly. By providing a complete financial picture, both parties can work towards a resolution that reflects their true financial circumstances.

Similar forms

The Indiana Financial Declaration form shares similarities with the Financial Affidavit used in family law cases in many states. Both documents require individuals to provide a detailed account of their income, expenses, assets, and liabilities. This information is crucial for determining child support, alimony, and property division during divorce proceedings. Just like the Indiana form, the Financial Affidavit typically includes sections for gross income, monthly expenses, and asset disclosures, allowing the court to assess the financial situation of each party accurately.

Another document that is comparable is the Child Support Worksheet, often used in custody and support cases. This worksheet helps calculate the amount of child support one parent may owe to the other. Similar to the Indiana Financial Declaration, it requires detailed financial information, including income and expenses. The goal is to ensure that both parents contribute fairly to the child's upbringing, taking into account their financial capabilities. The structured format of both documents aids in presenting a clear financial picture to the court.

The Statement of Net Worth is also akin to the Indiana Financial Declaration. It is commonly used in divorce cases to summarize an individual's financial standing. This document includes sections for assets, liabilities, income, and expenses, much like the Indiana form. By providing a snapshot of an individual's financial status, the Statement of Net Worth helps the court make informed decisions regarding asset division and support obligations, ensuring that all relevant financial factors are considered.

Additionally, the Financial Disclosure Statement serves a similar purpose. This document is often required in various legal proceedings, including divorce and bankruptcy. It demands a comprehensive listing of income, expenses, and assets. Like the Indiana Financial Declaration, it aims to provide transparency regarding an individual's financial situation, helping the court evaluate the case effectively. Both documents emphasize the importance of honesty and accuracy in financial reporting.

Lastly, the Income and Expense Declaration is another document that mirrors the Indiana Financial Declaration. Used primarily in family law cases, it requires parties to disclose their monthly income and expenses. This declaration is crucial for determining support obligations and ensuring that both parties are held accountable for their financial contributions. The structured approach of both documents facilitates a clear understanding of each party's financial landscape, which is essential for fair legal outcomes.

Dos and Don'ts

When filling out the Indiana Financial Declaration form, consider the following guidelines to ensure accuracy and compliance.

  • Do read the instructions carefully before starting the form.
  • Do provide complete and accurate information about your income and expenses.
  • Do attach all required documents, such as payroll stubs and tax returns.
  • Do disclose all assets, even if you are unsure of their value.
  • Don't omit any income sources, including child support or rental income.
  • Don't include non-relevant assistance, such as food stamps or general assistance.
  • Don't forget to update the form if your financial situation changes before the trial.

Misconceptions

The Indiana Financial Declaration form is an essential document used during divorce proceedings, but many misunderstand its purpose and requirements. Here are eight common misconceptions about the form, along with clarifications to help you navigate it more effectively.

  • It’s only for high-income individuals. Many believe that only those with significant income need to fill out this form. In reality, it applies to anyone going through a divorce, regardless of income level. The form helps provide a complete picture of financial circumstances.
  • All assets must be listed with exact values. Some think they need to provide precise valuations for every asset. While it's important to disclose all known assets, you can provide estimated values if exact figures are unavailable. Transparency is key.
  • Only current income is relevant. There’s a misconception that only present income matters. The form requires you to report all sources of income, including past child support or alimony received, which can influence financial assessments.
  • Monthly expenses don’t need to be detailed. Many people underestimate the importance of detailing monthly expenses. Listing all expenses accurately is crucial as it helps the court understand your financial obligations and needs.
  • It’s a one-time submission. Some individuals believe they only need to submit the form once. However, if your financial situation changes, you are obligated to update the form before the trial. Keeping it current ensures fairness in proceedings.
  • It’s only about income and expenses. The form is often seen as solely focused on income and expenses. However, it also requires disclosure of assets and debts, providing a comprehensive view of your financial situation.
  • You can skip reporting certain assets. A common misunderstanding is that some assets can be omitted if they seem insignificant. All assets, regardless of perceived value, should be reported. This includes personal property and any potential inheritances.
  • Legal assistance isn’t necessary. While some may feel confident completing the form alone, seeking guidance from a legal professional can be beneficial. They can help ensure that all information is accurately reported and compliant with legal standards.

Understanding these misconceptions can help individuals better prepare for their divorce proceedings and ensure that their financial declaration is accurate and complete. This not only aids the court in making informed decisions but also protects your interests during a challenging time.

Key takeaways

Completing the Indiana Financial Declaration form is a crucial step in legal proceedings related to family law. Here are key takeaways to keep in mind:

  • Accurate Information is Essential: Ensure all details, including income, expenses, and assets, are accurate and up-to-date. Inaccuracies can lead to legal complications.
  • Include Required Documentation: Attach necessary documents such as the last three payroll stubs and calculations for business income and expenses.
  • List All Sources of Income: Provide a comprehensive list of all income sources, including wages, pensions, and any child support received from prior marriages.
  • Detail Monthly Expenses: Clearly outline all monthly expenses. This includes taxes, housing costs, utilities, and personal expenses.
  • Declare All Assets: List all known assets, regardless of their value. This includes real estate, vehicles, and retirement accounts.
  • Be Aware of Liabilities: Identify any debts associated with your assets. This includes mortgages and loans secured by your property.
  • Update as Necessary: You are required to update the Financial Declaration if any information changes before the trial.
  • Sign and Date: The form must be signed and dated. This confirms that the information provided is truthful and complete.
  • Consult Legal Counsel: If unsure about any part of the form, seek guidance from an attorney to ensure compliance with legal requirements.

By following these guidelines, individuals can navigate the Financial Declaration process more effectively and contribute to a smoother legal experience.