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Motion And Affidavit For Entry Of Partial Judgment In Sum Certain CAO FLE 10-1 - Idaho
| Motion And Affidavit For Entry Of Partial Judgment In Sum Certain Form. This is a Idaho form and can be used in Family Law District Court Statewide . |
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Full Name of Party Filing this Document Mailing Address (Street or Post Office Box) City, State and Zip Code Telephone Number IN THE DISTRICT COURT OF THE ____________________ JUDICIAL DISTRICT OF THE STATE OF IDAHO, IN AND FOR THE COUNTY OF _____________________ , Plaintiff, vs. , Defendant. ) ) ) ) ) ) ) Case No. MOTION AND AFFIDAVIT FOR ENTRY OF PARTIAL JUDGMENT IN A SUM CERTAIN ) : ss County of __________________) STATE OF IDAHO To obtain a partial judgment in a sum certain, I swear under oath: [ 1. ] Section One: Health Care or Work-related Child Care Expenses. The Order/Decree in this case provides for a sharing of [ ] health care expenses not paid by insurance, and/or [ ] work-related child care costs, in the following percentages: _______% to be paid by father and ______% to be paid by mother. 2. I have paid the total sum of [ ] $______________ in medical expenses and/or [ ] in work-related child care costs and, despite having submitted proof of payment to the other parent, I have not been reimbursed. 3. (name) ____________________________ owes me the sum of $___________ for his/her portion of health care expenses not paid by insurance or work-related child care expenses incurred to (date), _____________________, and a partial judgment should be entered against him/her in that amount. [ ] Section Two: Payments to Creditors. MOTION AND AFFIDAVIT FOR PARTIAL JUDGMENT IN A SUM CERTAIN CAO FLE 10-1 Revised 6/2006 Page 1 American LegalNet, Inc. www.FormsWorkFlow.com 1. The Order/Decree in this case provides for the payment of the following account/s by my former spouse: . 2. I have paid the total sum of $______________ for this/these accounts and, despite having submitted proof of payment to my former spouse, I have not been reimbursed. 3. (name) ____________________________ owes me the sum of $___________ for his/her portion of creditor payments made by me to ____________________ (date), and a partial judgment should be entered against him/her. [ ] Section Three. Request for Partial Judgment. I ask that Partial Judgment be entered against (other party's name) ________________________ in favor of (your name) ____________________________in the amount of $________________, for [ ] health care expenses [ ] work-related child care costs [ ] payments to creditors. I have attached copies of receipts reflecting the above amounts, which are true and correct amounts to the best of my knowledge and belief. amount requested.) (Attach receipts and/or any other documentation used to verify the Date: Signature SUBSCRIBED and SWORN to before me this _____ day of Notary Public for Residing at Commission Expires: CERTIFICATE OF SERVICE I certify I served a copy to: (name the other party or their attorney in the case) [ ] By Mail (Name) [ ] By fax to (number) _________________ (Street or Post Office Address) [ ] By personal delivery (City, State, and Zip Code) Date: ___________________________ , 20____. _________________________________ Signature ________________________________ Typed/printed Name of Party Signing MOTION AND AFFIDAVIT FOR PARTIAL JUDGMENT IN A SUM CERTAIN CAO FLE 10-1 Revised 6/2006 Page 2 American LegalNet, Inc. www.FormsWorkFlow.com
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