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Affidavit Of Income And Property (Two Pages) - Tennessee
| Affidavit Of Income And Property (Two Pages) Form. This is a Tennessee form and can be used in Trial And General Sessions Courts Statewide . |
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____________ Court AFFIDAVIT OF INCOME Case Number ______________County AND PROPERTY ________________Tennessee Page 1 of 2 ____________________________________________________ vs. _______________ _______________________________ Comes now the Defendant(s) and, subject to the penalty of perjury, makes oath and says that the following facts are true and that there is NO OTHER source of income or property other than that described below: 6. List all monthly household expenses: 1. Full name: Rent/Mortgage: $ Address: Utilities: $ Phone # Health Insurance: $ Soc. Sec. No. Transportation Cost: $ Food: $ Clothing: $ Employer: Other: $ Phone # $ 2. List all dependents: $ Name Age Relationship $ TOTAL $ 7. List all land/house/real estate/property you own: DESCRIBE VALUE 3. List all income from any source: $ $ per/wk /mo , $ from : $ $ per/wk /mo , $ from : 8. List all personal property/cars/trucks/ $ per/wk /mo , furniture/stocks/bonds/tools/equipment you own and its total from : value: I receive CHILD SUPPORT in the sum of DESCRIBE VALUE $ per . Cars $ Trucks $ 4. List all bank accounts: Other $ ACCOUNT BANK/SOURCE BALANCE $ Checking $ $ Savings $ $ Other: $ Other: $ 9. List all assets/property sold or transferred in the last six months: DESCRIBE VALUE $ $ $ $ 5. List all debts: CREDITOR/ADDRESS BALANCE $ $ $ $ $ $ <<<<<<<<<********>>>>>>>>>>>>> 2 ____________ Court AFFIDAVIT OF INCOME Case Number ______________County AND PROPERTY ________________Tennessee Page 2 of 2 ____________________________________________________ vs. _______________ _______________________________ 10. The last income tax I filed was for and it reflected an income of $ and I attach a copy hereto or will file the same within seven days. LIST ALL PROPERTY YOU CLAIM TO BE EXEMPT PURSUANT TO LAW: All clothing for myself and my family; all receptacles for said clothing; family portraits; family Bible; school books; and VERIFICATION AND OATH: Comes now the Petitioner(s) / Defendant(s) and makes oath, subject to the penalty of perjury, that the information in this Motion for Installment Payment is true to the best of Petitioners knowledge, information and belief. Defendant(s) Sworn to and subscribed before me on ____________________ Clerk/Deputy Clerk/Notary Public Commission Expires:
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