COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS HAMILTON COUNTY, OHIOPlaintiff / PetitionerDate:Case No.-vs/and-File No.CSEA No.Defendant / PetitionerProperty StatementNOTICE OF SCHEDULING CONFERENCE A HEARING WILL BE HELD ONThe day of , 20 , at .M. before Magistrate , Room , Domestic Relations Court, 800 Broadway, Cincinnati, Ohio 45202-1332. ----------------------------------------------------------------------------------------------MOTION FOR FINAL DETERMINATION OF ISSUES (Check and Sign if Applicable)Plaintiff represents to the Court that the issues to be decided are limited. In the event that Defendant fails to answer or appear for the scheduling conference, Plaintiff requests that the Court make all such final orders including parenting/visitation orders, child support, spousal support, attorney fees and costs, and a division of property as are necessary and appropriate to the resolution of this matter on the above date and time. Plaintiff further represents that all requisite discovery will be completed prior to the hearing date.Plaintiff/Attorney for Plaintiff ----------------------------------------------------------------------------------------------INSTRUCTIONS Pursuant to O.R.C. §3105.171 (B) every asset and liability, both marital and separate property, is subject to the jurisdiction of the Court. Therefore, every asset and liability of either party must be listed. Pursuant to O.R.C. §3105.171 (A) (2) during the marriage for purposes of identifying marital property is defined as from the date of marriage to the date of final hearing unless it would be inequitable to use such dates. For purpose of this property statement during the marriage is defined as the following dates: (date of marriage). (other) to(date of separation),(date of filing complaint).(other specify)(date of final hearing)Date of Valuation used for purpose of this statement 1: REAL ESTATEAppraisal/Source of Address/TitleMarital/SeparateEquityValuationMixedMarket ValueComment:2: HOUSEHOLD GOODS (Please attach inventory of property claimed to be separate as well as marital property for which you request an individual award. If all household goods are to be divided equally, please so indicate.) Comment:Pg. 1DR 4.1TP (Oct. 1999)2001 © American LegalNet, Inc.3: AUTOMOBILESAppraisalYear & Makeor Current Market PriceMarital/Separate MixedSource of ValuationEquityDescription/TitleComment:4: FUNDS ON DEPOSITMarital/Separate MixedDescription/TitleType of AccountNumberComment:5: STOCKS AND BONDSAppraisalDescription/Numberor Current Market PriceSource of ValuationMarital/Separate MixedLocation/TitleComment:6: RETIREMENT SAVINGS PLANS/PENSIONS/PROFIT SHARINGYear of EmploymentMarital/Separate MixedName of Plan/EmployerYears in PlanVested?AmountH:W:Comment:7: TAX REFUNDS YearMarital/Separate MixedDate of ReceiptSourcePresent ValueH: W:J:How many tax exemptions are you presently claiming, including yourself? 8: LIFE INSURANCE Name of CompanyMarital/Separate MixedCashValueFaceAmountPolicy No.BeneficiaryOwnerInsuredComment:9: EXPECTANCIES AND INHERITANCES OF THE PARTIESMarital/Separate MixedSource of ValuationLocation/TitledDate of ValuationValue of FundPg. 2DR 4.1TP (Oct. 1999)2001 © American LegalNet, Inc.Comment:10: OTHER ASSETS List location, title, valueof item including date and source of valuation, including whether this property is claimed to bemarital, separate, or mixed.$$$$LIABILITIESWho is Liable: Husband, WifeMarital/Sep/ MixedName of CreditorEncumbranceBal. DueAs of1:2:3:4:5:6:7:8:Comment:Total Asset Value minus Total Liabilities equals Total EquitySTATE OF OHIO} }S.S. COUNTY OF HAMILTON}, being first duly cautioned and sworn, deposes and states that the facts set forth in the foregoing Property Statement are true as he / she verily believes.Sworn to and subscribed in my presence this day of 20 .Notary PublicPROOF OF SERVICEupon, been served by20day ofI hereby certify that a copy of the foregoing property statement has thisService has been requested through the Clerk of Courts.Attorney forPg. 3DR 4.1TP (Oct. 1999)2001 © American LegalNet, Inc.
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