Financial Affidavit
  • Affidavit Details
    • Who is Affiant?
    • Income & Assets
    • Deductions
    • Household Expenses
    • General Information
  • Complete the Document
    • Format & Signatures

Who is Affiant?

  • Indicate the full name of an affiant (a person, who issues this affidavit):

  • Indicate the affiant's current residential address:

  • The Affiant is:

  • Describe the nature and scope of the affiant’s self-employed business activities:

  • Indicate the affiant's current job title or positions:

  • Provide the full legal name of the business or organization where the affiant is currently employed:

  • Describe the steps the affiant has taken to seek employment during his or her period of unemployment:

Income & Assets

  • List all sources of the affiant’s monthly income and specify the amount received from each source in USD:

  • The Affiant:

  • Indicate the Affiant's home value (in USD):

  • Indicate the Affiant's TOTAL amount of all cash savings (in USD):

  • Does the Affiant owns any other assets or property?

  • List all the assets the Affiant owns as well as their approximate value in USD:

  • Indicate the TOTAL amount of the Affiant's monthly income (in USD):

Deductions

  • Indicate the amount of taxes the Affiant pays each month (in USD):

  • Does the Affiant pay monthly child support payments?

  • Indicate the amount of a monthly child support payments (in USD):

  • Does the Affiant pay monthly alimony payments (e.g., for ex-wife or ex-husband)?

  • Indicate the amount of monthly alimony payments (in USD):

  • Does the Affiant pay monthly health insurance premium?

  • Indicate the amount of monthly health insurance premium payments (in USD):

  • Does the Affiant have any other additional expenses (excluding household expenses such as bills, mortgage payments etc.)?

  • List all additional monthly expenses incurred by the Affiant and their amounts (in USD):

Household Expenses

  • Indicate the amount of monthly mortgage payments (in USD):

  • Indicate the amount of a monthly property tax (in USD):

  • Indicate the amount of a monthly rental payments (in USD):

  • Indicate the amount of monthly utility bills (in USD):

  • Indicate the amount of Internet and mobile bills (in USD):

  • Does the Affiant own a car?

  • Indicate the amount of a monthly car insurance payments (in USD):

  • Indicate the amount of monthly car loan payments (in USD):

  • Indicate the amount of monthly food expenses (in USD):

  • Indicate the Affiant's monthly amount of the total deductions and expenses (in USD):

General Information

  • Specify the type of identification document the Affiant presents to the notary to verify their identity:

  • Describe the reason the Affiant is executing this document:

  • Indicate the name of the county where the Affiant currently resides:

  • Select the state, where the Affiant currently resides:

  • Do you want to add a signature?

  • Affiant's signature:

Select a template's format:

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