COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN THE COURT OF COMMON PLEAS, ASHLAND COUNTY, OHIO DOMESTIC RELATIONS DIVISION,Case No. Plaintiff / Petitioner 1,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vs. ,FINANCIAL AFFIDAVIT OF Defendant / Petitioner 2.THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:STATE OF OHIO, COUNTY OF ASHLAND, ss: Now comes the after being duly sworn and cautioned under law and states that the following is a true and accurate accounting of the financial assets, liabilities and expenses of the parties. The affiant also states as follows: Information about Marriage:Date of this marriage:Place of Marriage:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableDate of Separation:,Wife is pregnant:Yes No located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomCheck here, if noneMinor and/or Dependent Children of this Marriage (Names & DOB's):Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Information about Parties:WIFEHUSBAND, one of the Justices of theCourt in Witness, Honorableday of, 20 County,Job Title Name of EmployerPayroll Address(Attorney must sign above and type name below)Insurance available through employmentAttorney(s) forInsurance company Address of Insurance CompanyMarginal Insurance Cost per pay for dependentsCOBRA conversion cost for spouse coverageOffice and P.O. AddressPaychecks per Year Year-to-Date Income LOCAL TAX RATETelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)GROSS MONTHLY INCOMEWIFETYPE OF INCOMEHUSBANDEmployment Income Unemployment Comp.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOWorker's Comp Disability Benefits Interest/Dividends Pension/Social SecurityPublic AssistanceGREETINGS:Child Support Spousal SupportWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,Tax Refund Other Incomelocated at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room$GROSS MONTHLY INCOME$DEDUCTIONS FROM GROSS MONTHLY INCOMEYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.WIFETYPE OF DEDUCTIONSHUSBANDTaxes, one of the Justices of theSocial Security/Pension/MedicareCourt in Witness, Honorableday of, 20 County,401K Deduction Insurance Premiums(Attorney must sign above and type name below)Attorney(s) forChild Support Spousal Support Business Deductions$$TOTAL DEDUCTIONSOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:$$NET MONTHLY INCOMEMobile Tel. No.:2American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.MONTHLY BUDGET INSTRUCTIONS: (1) Expenses should be listed in the weekly, annually, or monthly columns, as they are paid. IT IS NOT NECESSARY TO LIST EVERY EXPENSE IN ALL THREE COLUMNS. (2) The total weekly expenses should be multiplied by 52 and divided by 12 to arrive at a monthly figure. This amount should be put on the total weekly expense line in the monthly column. The total annual expenses should be divided by 12 and the result should be placed in the monthly column on that line. (4) The monthly column should be totaled, including the total weekly and annual expenses lines.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)TYPE OF EXPENSEWEEKLY COSTANNUAL COSTMONTHLY COST. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) for[Column 1 x 52 ÷12 = Column 3]Rent or Mortgage Property Taxes Property Insurance Gas/Fuel Oil/Propane ElectricWater/Sewer Trash Disposal Basic Telephone Service Cable Television Home Maintenance Automobile Loan Payment(s) Gasoline for automobiles Maintenance for automobiles Car Insurance GroceriesPersonal Hygiene ClothingOther Insurance not deducted from wages and not listed for home or car Uninsured health expenses Educational expenses EntertainmentChild Care Credit card payments Loan payments not listed for home or car Other:Other: TOTAL WEEKLY EXPENSES$$Office and P.O. Address[Column 2 ÷ 12 = Column 3]TOTAL ANNUAL EXPENSES$$Add annual, monthly and weekly expenses as all computed on a monthly basisTOTAL MONTHLY EXPENSESTelephone No.: Facsimile No.: E-Mail Address:$Mobile Tel. No.:3American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.ASSETS OF THE PARTIES (Attach additional sheets if ne
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