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Domestic Relations Information Form - Washington
| Domestic Relations Information Form Form. This is a Washington form and can be used in General Superior Court Kitsap Local County . |
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Exhibit E (KCLSPR 94.04) DOMESTIC RELATIONS INFORMATION FORM Date: ____________________________ Husband Petitioner Cause No.: _______________________ Wife Respondent PARTIES : HUSBAND/FATHER WIFE/MOTHER Name: Age: Name Age: Address: Address: Date of Marriage: Date of Separation: DEPENDENT CHILDREN: Percent Residential Time This Prior Name Age Since Marriage Marriage Father % Mother % CHILD SUPPORT: 1. NET INCOME SUPPORT Husband/Father: $ Wife/Mother: $ 2. Tax Exemptions allocated as follows: ___________________________________________________________ 3. Exceptional support considerations: _________ ___________________________________________________ _________________________________________________________________________________________ 4. Child Support presently being paid $___________ ___ per month; since ________________________________ Domestic Relations Information Form (Rev. 9/01) - 1 - <<<<<<<<<********>>>>>>>>>>>>> 2Exhibit E (KCLSPR 94.04) 5. Summary of proposed residential arrangements for the children: ______________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ YOU MUST ATTACH: 1. Propos ed Child Support Order, Support Works heets and current pay stubs . Form WPF DR 01-050. 2. Completed Financial Declaration. Form WP F DR 01-055 3. Propos ed Parenting Plan, if disputed. MAINTENANCE: 1. Requested: $_________________ per month, duration: ____________________________________ 2. Presently being paid: $_________________ per month, for __________________________________ months. HUSB AND/FATHER INCOME: Employer/Other Source Length Gross Income Net Income Total Income WIFE/MOTHER INCOME: Employer/Other Source Length Gross Income Net Income Total Income FACTORS RE L ATING TO AWAR D OF MAINTENANCE: ______________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ IF ATTORNEY FEES A R E AT ISSUE: 1. Incurred to Date $ Paid To Date $ 2. Ordered to Date $ Paid to Date $ 3. Requested to Date $ Estimate to Trial $ Domestic Relations Information Form (Rev. 9/01) - 2 - <<<<<<<<<********>>>>>>>>>>>>> 3Exhibit E (KCLSPR 94.04) PROPERTY DIVISION: ASSETS: Fair Market Value Debt Owed Net to Husband Net to Wife Real Estate: Home $ $ $ $ Other Real Property $ $ $ $ $ $ $ $ Vehicles (Year/Make): $ $ $ $ $ $ $ $ Household Goods $ $ $ $ Tools/E quipment $ $ $ $ Recreational/Hobby Equipment $ $ $ $ Business/Profession: Husband $ $ $ $ Wife $ $ $ $ Investments $ $ $ $ Life Insurance Cash Value $ $ $ $ Retirement: Husband $ $ $ $ Wife $ $ $ $ IRAs, TSPs, 401-Ks, etc.: Husband $ $ $ $ Wife $ $ $ $ Receivables $ $ $ $ Other Assets: $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Debts: ($ ) ($ ) ($ ) ($ ) TOTALS $ $ $ $ Equalization: $ - $ divided by two (2) = $ Proposed Percentage Division: ________ % to Husband _________ % to Wife Effects of Proposed Division: $_________ to Husband $__________ to Wife Domestic Relations Information Form (Rev. 9/01) - 3 -
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