Tennessee > Local County > Shelby > Chancery Court
Adoption Affidavit To Establish Financial Ability - Tennessee
| Adoption Affidavit To Establish Financial Ability Form. This is a Tennessee form and can be used in Chancery Court Shelby Local County . |
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IN THE CHANCERY COURT OF TENNESSEE FOR THE THIRTIETH JUDICIAL DISTRICT AT MEMPHIS IN RE: ADOPTION OF ____________________________________ ____________________________________ and NO. ____________________ ____________________________________ , Petitioner(s) AFFIDAVIT TO ESTABLISH FINANCIADOPTION AL ABILITY ________________________Husbands Monthly Income: Gross: __________________ ; Net: Source: ________________________________ ________________________Wifes Monthly Income: Gross: __________________ ; Net: Source: ________________________________ Other: _________________________________ __________________Total Income: Gross: __________________ ; Net : ______ Bank Accounts: Checking and Savings (Present Balances) : ___________________________ ___________________________ Monthly Expenses: _________ Rent or House Note: ______Utilities/Phone, etc.: ______________________________ Groceries: ____ Automobile Note: __________Automobile Gasoline, Insurance & Maintenance ______________ Doctor, Dentist, Health Insurance, etc. ______________Miscellaneous: Laundry/Dry Cleaning; Haircuts/Beauty Parlor; Lunches; Enterntainment; etc. ______________Charge Accounts: ______________Total Monthly Expenses: ______________ I/We _______________________ and _______________________ make each oath that the information provided in this affidavit is true and correct. _______________________________ Petitioner _______________________________ Petitioner Sworn to and subscribed before me this ____ day of ________ , ______ . _______________________________ Notary Public My commission expires: ___________________________
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