Nevada > County > Washoe > District Court > Family
Schedule Of Arrearages 3912 - Nevada
| Schedule Of Arrearages Form. This is a Nevada form and can be used in Family District Court Washoe County . |
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1 CODE 3912 2 3 4 5 6 IN THE FAMILY DIVISION 7 OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA 8 IN AND FOR THE COUNTY OF WASHOE 9 ________________________________, 10 Plaintiff, 11 vs. Case No.12 ________________________________, Dept. No. 13 Defendant. __________________________________/ 14 15 SCHEDULE OF ARREARAGES 16 STATE OF NEVADA ) ) ss. 17 COUNTY OF WASHOE. ) 18 I, ______________________________, being first sworn deposes and says:19 I am owed and entitled to receive certain periodic monthly payments from,20 _____________________________________, pursuant to the following order filed with the21 Court on ______ day of _______________________, _______. A copy of the order is attached22 to this schedule. _________________________, has failed to make all of the payments when23 due as set forth herein on page 2. The following schedule is a true and accurate statement of all payments, due dates and of any payments received by me during the months noted.24 ______________________________25 AFFIANT SUBSCRIBED AND SWORN to before me 26 this ______ day of ________________, 20____. 27 ____________________________________ 28 NOTARY PUBLIC JUD 113 (Rev 8/99) <<<<<<<<<********>>>>>>>>>>>>> 2 1 DUE DATE SET AMOUNT DUE DATE PAYMENT AMOUNT OF TOTAL BY COURT THIS PAYMENT RECEIVED THIS PAYMENT ARREARAGE 2 DECREE/ORDER MONTH RECEIVED THIS MONTH 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 - 2 -
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