Affidavit Regarding Direct Payments {Law 422} | Pdf Fpdf Doc Docx | Florida

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Affidavit Regarding Direct Payments {Law 422} | Pdf Fpdf Doc Docx | Florida

Affidavit Regarding Direct Payments {Law 422}

This is a Florida form that can be used for Family Law within Local County, Brevard.

Alternate TextLast updated: 3/8/2017

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OBLIGOR/OBLIGEE AFFIDAVIT REGARDING DIRECT PAYMENTS CASE NUMBER 05 - XXXX-XX I, _____________________________________________, the above named penalty of perjury, do hereby swear and/or affirm that I on the dates indicated: PAYMENT DATE PAYMENT AMOUNT received Obligor Obligee, under paid direct the following payments The total amount $_______________. received paid (as evidenced by copies of cancelled checks) through direct payment is Neither of the parties hereto have previously received any AFDC monies. Dated this __________ day of _________________________, 20_____. Affiant's Signature Printed Name Sworn to and subscribed before me this __________ day of _________________________, 20_____. Notary Public/Deputy Clerk LAW 422 Rev. 06/2005 American LegalNet, Inc. www.FormsWorkFlow.com

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