Missouri > Local Circuit Courts > 38th Circuit > Dissolution
Statement Of Property (Sample And Form) 3 - Missouri
| Statement Of Property (Sample And Form) Form. This is a Missouri form and can be used in Dissolution 38th Circuit Local Circuit Courts . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
FORM 3 IN THE CIRCUIT COURT OF (COUNTY NAME) COUNTY, MISSOURI In Re: ) ) ) Petitioner, ) ) vs. ) Case No. ) ) Respondent. ) STATEMENT OF PROPERTY OF PETITIONER/RESPONDENT (MODIFICATION/PATERNITY) SOCIAL SECURITY NUMBER: Instructions: This form must be completed in full. If additional space is required, add a page indicating the section number and supply all information requested. Show only dollar amounts, rounding to the nearest dollar. STATEMENT IS TO BE CURRENT WITHIN 15 DAYS OF HEARING. Failure to submit this form may result in the prohibition of the presentation of affirmative evidence of the information recited herein. PROPERTY OF PETITIONER/RESPONDENT A. Real Estate - List interest in real estate owned by you, including Present Amount Owed leaseholds. Include street address. Fair Market Value B. Motor Vehicles. Include all automobiles, boats, trailers, aircraft, Present Amount Owed recreational vehicles and campers in which you have an interest. Fair Market Value List year, make, model, and vehicle identification number. th 38 Circuit Form 3 (Rev. 1-1-2000) 1 <<<<<<<<<********>>>>>>>>>>>>> 2 C. Bank Accounts. List all checking and savings accounts, time Present Amount Owed deposits, money market certificates, etc., held in your name, alone or Fair Market Value with another person. Give the name of the institution, the names on the account and the account number. D. Cash on Hand held by you or under your control, directly or indirectly. E. Securities. List all stocks, including both public and closely held Present Amount Owed corporations, bonds, promissory notes, mortgages, money market Fair Market Value funds and all other such property in which you have an interest. Give the names in which the securities are held. F. Life Insurance. List the type of policy, name of issuing company, Present Amount Owed insured, beneficiaries, face value and cash value of any policy in Fair Market Value which you have an interest. G. Retirement Pension and/or Profit Sharing. List name of the Present Amount Owed company, and the present total value of any plan in which you hold Fair Market Value an interest. th 38 Circuit Form 3 (Rev. 1-1-2000) 2 <<<<<<<<<********>>>>>>>>>>>>> 3 H. Interest in trust. List any interest which you hold in a trust. Present Amount Owed Fair Market Value I. Interest in contracts made and not performed held by you. List Present Amount Owed the parties to the contract, your interest to the contract and the Fair Market Value expected date of performance, if any. J. Interest in pending litigation or suit not yet filed held by you. Present Amount Owed Fair Market Value K. Interest in farm equipment, crops, animals. List the nature of the Present Amount Owed property held by you. Fair Market Value L. Debts owed to you by others. List the name of the debtor, any Present Amount Owed security, date of loan and due date, if any, of any debts owed to you. Fair Market Value th 38 Circuit Form 3 (Rev. 1-1-2000) 3 <<<<<<<<<********>>>>>>>>>>>>> 4 M. Interests in sole proprietorships, partnerships or joint ventures Present Amount Owed held by you. List the names of all other persons who share an Fair Market Value interest in this business with you and the percent interest you hold O. Other Assets. List all assets below not already listed herein in Present Amount Owed which you hold any interest. Fair Market Value th 38 Circuit Form 3 (Rev. 1-1-2000) 4 <<<<<<<<<********>>>>>>>>>>>>> 5 Liabilities: List all loans from any bank, credit union, savings and loan association or other lending institution for which you have any liability. Indicate who signed the loan, the date of the loan, purpose of the loan, actual disposition of the proceeds and state the name and address of the lender. so, list all credit card balancesAl and store charges. State whose name is on the credit card. Also, list all other ibtndeedness and give the name and address of the creditor. Name of Creditor Current Balance Secured? By Required What? Monthly Payment th 38 Circuit Form 3 (Rev. 1-1-2000) 5 <<<<<<<<<********>>>>>>>>>>>>> 6 IN THE CIRCUIT COURT OF COUNTY, MISSOURI In Re: ) ) ) Petitioner, ) ) vs. ) Case No. ) ) Respondent. ) STATEMENT OF PROPERTY OF SOCIAL SECURITY NUMBER: PROPERTY OF PETITIONER/RESPONDENT A. Real Estate Present Amount Owed Fair Market Value B. Motor Vehicles. Present Amount Owed Fair Market Value C. Bank Accounts. Present Amount Owed Fair Market Value th 38 Circuit Form 3 (Rev. 1-1-2000) 1 <<<<<<<<<********>>>>>>>>>>>>> 7 D. Cash on Hand held by you or under your control, directly or indirectly. E. Securities. Present Amount Owed Fair Market Value F. Life Insurance. Present Amount Owed Fair Market Value G. Retirement Pension and/or Profit Sharing. Present Amount Owed Fair Market Value H. Interest in trust. Present Amount Owed Fair Market Value th 38 Circuit Form 3 (Rev. 1-1-2000) 2 <<<<<<<<<********>>>>>>>>>>>>> 8 I. Interest in contracts made and not performed held by you. Present Amount Owed Fair Market Value J. Interest in pending litigation or suit not yet filed held by you. Present Amount Owed Fair Market Value K. Interest in farm equipment, crops, animals. Present Amount Owed Fair Market Value L. Debts owed to you by others. Present Amount Owed Fair Market Value M. Interests in sole proprietorships, partnerships or joint ventures Present Amount Owed held by you. Fair Market Value th 38 Circuit Form 3 (Rev. 1-1-2000) 3 <<<<<<<<<********>>>>>>>>>>>>> 9 O. Other Assets. Present Amount Owed Fair Market Value Liabilities: Name of Creditor Current Balance Secured? By Required What? Monthly Payment th 38 Circuit Form 3 (Rev. 1-1-2000) 4 <<<<<<<<<********>>>>>>>>>>>>> 10 th 38 Circuit Form 3 (Rev. 1-1-2000) 5
|
|||||||
