Financial Disclosure Affirmation {4-17}

Form 4-17 - FINANCIAL DISCLOSURE AFFIRMATION. You are required to attach to this form the following documents: • Current and representative paycheck stub(s); • Copies of your most recently filed state and federal income tax returns, including all forms; • A copy of the W-2 wage and tax statement(s) submitted with the returns OR, if you did not file tax returns, a copy of your W-2 form for the most recent year for which you filed tax returns; • Information relating to health insurance plans available to you for the provision of insurance, health care, dental care, optical care, prescription drug and other pharmaceutical and health-related benefits for the child(ren) for whom support is sought, including the costs for adding the child(ren) to such plans; and • Information relating to accident and life insurance plans. www.FormsWorkflow.com