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Motor Vehicle 1
Value
Make & Year
Model
Registration #
Motor Vehicle 2
Value
Make & Year
Model
Registration #
Other Assets
Value
6. State every person, business, or organization owing you of your spouse money, and the amount owed.
Person owing you
or your spouse
Amount owed to you
Amount owed to your spouse
7. State the persons who rely on you or your spouse for support.
Name
Relationship
Age
8. Estimate the average monthly expenses of you and your family. Show separately the amounts paid by your spouse. Adjust any payments that are made weekly, biweekly, quarterly, semiannually, or annually to show the monthly are.
Rent or home-mortgage payment (include lot rented for mobile home)
· Are real estate taxes included? Yes / No
· Is property insurance included? Yes / No
You
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