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Printable Florida Financial Affidavit Short 12.902(b) Form in PDF

The Florida Financial Affidavit Short 12.902(b) form is a crucial document used in family law cases to disclose an individual's financial situation. This form simplifies the process of providing necessary financial information during divorce or child support proceedings. Understanding its requirements can help ensure compliance and promote fair outcomes in legal matters.

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Printable Florida Financial Affidavit Short 12.902(b) Form in PDF

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INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.902(b), FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) (01/15)

When should this form be used?

This form should be used when you are involved in a family law case which requires a financial affidavit and your individual gross income is UNDER $50,000 per year unless:

(1)You are filing a simplified dissolution of marriage under rule 12.105 and both parties have waived the filing of a financial affidavit;

(2)You have no minor children, no support issues, and have filed a written settlement agreement disposing of all financial issues; or

(3)The court lacks jurisdiction to determine any financial issues.

This form should be typed or printed in black ink. After completing this form, you should sign the form before a notary public or deputy clerk. You should file the original with the clerk of the circuit court in the county where the petition was filed and keep a copy for your records.

What should I do next?

A copy of this form must be served on the other party in your case within 45 days of being served with the petition, if it is not served on him or her with your initial papers. Service must be in accordance with Florida Rule of Judicial Administration 2.516.

Where can I look for more information?

Before proceeding, you should read “General Information for Self-Represented Litigants” found at the beginning of these forms. The words that are in “bold underline” in these instructions are defined there. For further information, see Florida Family Law Rule of Procedure 12.285.

Special notes...

If you want to keep your address confidential because you are the victim of sexual battery, aggravated child abuse, aggravated stalking, harassment, aggravated battery, or domestic violence, do not enter the address, telephone, and fax information at the bottom of this form. Instead, file Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h).

The affidavit must be completed using monthly income and expense amounts. If you are paid or your bills are due on a schedule which is not monthly, you must convert those amounts. Hints are provided below for making these conversions.

Instructions to Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

Hourly - If you are paid by the hour, you may convert your income to monthly as follows:

Hourly amount	x	Hours worked per week =		Weekly amount
Weekly amount	x	52 Weeks per year	=	Yearly amount
Yearly amount	÷	12 Months per year	=	Monthly Amount

Daily - If you are paid by the day, you may convert your income to monthly as follows:

Daily amount	x	Days worked per week	=	Weekly amount
Weekly amount	x	52 Weeks per year	=	Yearly amount
Yearly amount	÷	12 Months per year	=	Monthly Amount

Weekly - If you are paid by the week, you may convert your income to monthly as follows:

Weekly amount	x	52 Weeks per year	=	Yearly amount
Yearly amount	÷	12 Months per year	=	Monthly Amount

Bi-weekly - If you are paid every two weeks, you may convert your income to monthly as follows:

Bi-weekly amount	x	26	=	Yearly amount
Yearly amount	÷	12 Months per year	=	Monthly Amount

Semi-monthly - If you are paid twice per month, you may convert your income to monthly as follows:

Semi-monthly amount x

Monthly Amount

Expenses may be converted in the same manner.

Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete.

Instructions to Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

IN THE CIRCUIT COURT OF THE					JUDICIAL CIRCUIT,
IN AND FOR				COUNTY, FLORIDA
			Case No.: ______________________
			Division: _______________________
	,
Petitioner,
and
		,
Respondent.

FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM)

(Under $50,000 Individual Gross Annual Income)


I, {full legal name}				, being sworn, certify that the following
information is true:
My Occupation:			Employed by: ___________________________
Business Address: ________________________________________________________________
Pay rate: $	( ) every week (	) every other week ( ) twice a month ( ) monthly
( ) other: ____________

___ Check here if unemployed and explain on a separate sheet your efforts to find employment.

SECTION I. PRESENT MONTHLY GROSS INCOME:

All amounts must be MONTHLY. See the instructions with this form to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under “other” should be listed separately with separate dollar amounts.

1.$______ Monthly gross salary or wages

2.______ Monthly bonuses, commissions, allowances, overtime, tips, and similar payments

3._______Monthly business income from sources such as self-employment, partnerships, close corporations, and/or independent contracts (gross receipts minus ordinary and necessary expenses required to produce income) (Attach sheet itemizing such income and expenses.)

4._______Monthly disability benefits/SSI

5._______Monthly Workers’ Compensation

6._______Monthly Unemployment Compensation

7._______Monthly pension, retirement, or annuity payments

8._______Monthly Social Security benefits

9.______ Monthly alimony actually received (Add 9a and 9b)

9a. From this case: $ _______

9b. From other case(s): _______

10._______ Monthly interest and dividends

11._______Monthly rental income (gross receipts minus ordinary and necessary expenses

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

required to produce income) (Attach sheet itemizing such income and expense items.)

12._______ Monthly income from royalties, trusts, or estates

13._______ Monthly reimbursed expenses and in-kind payments to the extent that they reduce personal living expenses

14._______ Monthly gains derived from dealing in property (not including nonrecurring gains)

15._______ Any other income of a recurring nature (list source) _________________________

16.__________________________________________________________________________

17.$ _______ TOTAL PRESENT MONTHLY GROSS INCOME (Add lines 1–16)

PRESENT MONTHLY DEDUCTIONS:

18.$______Monthly federal, state, and local income tax (corrected for filing status and allowable dependents and income tax liabilities)

a.Filing Status ____________

b.Number of dependents claimed _______

19._______ Monthly FICA or self-employment taxes

20._______ Monthly Medicare payments

21._______ Monthly mandatory union dues

22._______ Monthly mandatory retirement payments

23._______ Monthly health insurance payments (including dental insurance), excluding portion paid for any minor children of this relationship

24._______ Monthly court-ordered child support actually paid for children from another relationship

25._______Monthly court-ordered alimony actually paid (Add 25a and 25b)

25a. from this case: $ _______

25b. from other case(s):$ _______

26.$_______ TOTAL DEDUCTIONS ALLOWABLE UNDER SECTION 61.30, FLORIDA STATUTES (Add lines 18 through 25).

27.$_______ PRESENT NET MONTHLY INCOME (Subtract line 26 from line 17)

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form)(01/15)

SECTION II. AVERAGE MONTHLY EXPENSES

Proposed/Estimated Expenses. If this is a dissolution of marriage case and your expenses as listed below do not reflect what you actually pay currently, you should write “estimate” next to each amount that is estimated.

A. HOUSEHOLD:
Mortgage or rent	$ _______
Property taxes	$_______
Utilities	$_______
Telephone	$ _______
Food	$ _______
Meals outside home	$_______
Maintenance/Repairs	$ _______
Other: __________	$_______
B. AUTOMOBILE
Gasoline	$ _______
Repairs	$_______
Insurance	$_______

C.CHILD(REN)’S EXPENSES

Day care	$ _______
Lunch money	$_______
Clothing	$ _______
Grooming	$_______
Gifts for holidays	$ _______
Medical/Dental (uninsured)	$ _______
Other: ______________	$ _______

D.INSURANCE Medical/Dental (if not listed on

lines 23 or 45)			$ _______
Child(ren)’s medical/dental			$ _______
Life			$ _______
Other:			$ _______

E. OTHER EXPENSES NOT LISTED ABOVE

Clothing	$ _______
Medical/Dental (uninsured)	$_______
Grooming	$ _______
Entertainment	$_______
Gifts	$_______
Religious organizations	$_______
Miscellaneous	$_______
Other: ______________	$ _______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
F. PAYMENTS TO CREDITORS
CREDITOR:	MONTHLY
	PAYMENT
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______
____________________	$_______

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

28. $_______ TOTAL MONTHLY EXPENSES (add ALL monthly amounts in A through F above)

SUMMARY

29.$_______ TOTAL PRESENT MONTHLY NET INCOME (from line 27 of SECTION I. INCOME)

30.$_______ TOTAL MONTHLY EXPENSES (from line 28 above)

31.$_______ SURPLUS (If line 29 is more than line 30, subtract line 30 from line 29. This is the amount of your surplus. Enter that amount here.)

32.($_______) (DEFICIT) (If line 30 is more than line 29, subtract line 29 from line 30. This is the amount of your deficit. Enter that amount here.)

SECTION III. ASSETS AND LIABILITIES

Use the nonmarital column only if this is a petition for dissolution of marriage and you believe an item is “nonmarital,” meaning it belongs to only one of you and should not be divided. You should indicate to whom you believe the item(s) or debt belongs. (Typically, you will only use this column if property/debt was owned/owed by one spouse before the marriage. See the “General Information for Self-Represented Litigants” found at the beginning of these forms and section 61.075(1), Florida Statutes, for definitions of “marital” and “nonmarital” assets and liabilities.)

A. ASSETS:

DESCRIPTION OF ITEM(S). List a description of each separate item		Current	Nonmarital
owned by you (and/or your spouse, if this is a petition for dissolution		Current	(check correct
of marriage). LIST ONLY LAST 4 DIGITS OF ACCOUNT NUMBERS. Check		Fair	column)
the line next to any asset(s) which you are requesting the judge		Market
award to you.		Value
award to you.			husband	wife
			husband	wife
	Cash (on hand)	$
	Cash (in banks or credit unions)
	Stocks, Bonds, Notes
	Real estate: (Home)
	(Other)
	Automobiles
	Other personal property
	Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)
	Other






	____Check here if additional pages are attached.
Total Assets (add next column)		$

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

B. LIABILITIES:

DESCRIPTION OF ITEM(S). List a description of each separate debt		Current	Nonmarital
		Current	(check correct
owed by you (and/or your spouse, if this is a petition for dissolution		Amount	column)
of marriage). LIST ONLY LAST 4 DIGITS OF ACCOUNT NUMBERS. Check		Owed	column)
the line next to any debt(s) for which you believe you should be
responsible.			husband	wife
	Mortgages on real estate: First mortgage on home	$
	Second mortgage on home
	Other mortgages

	Auto loans

	Charge/credit card accounts



	Other



	____Check here if additional pages are attached.
Total Debts (add next column)		$

C. CONTINGENT ASSETS AND LIABILITIES:

INSTRUCTIONS: If you have any POSSIBLE assets (income potential, accrued vacation or sick leave, bonus, inheritance, etc.) or POSSIBLE liabilities (possible lawsuits, future unpaid taxes, contingent tax liabilities, debts assumed by another), you must list them here.

		Contingent Assets		Possible	Nonmarital
				Possible	(check correct
	Check the line next to any contingent asset(s) which you are requesting the			Value	column)
					column)
	judge award to you.				husband	wife
					husband	wife
			$

Total Contingent Assets			$


		Contingent Liabilities			Nonmarital
				Possible	(check correct
	Check the line next to any contingent debt(s) for which you believe you			Amount	column)
	should be responsible.			Owed	husband	wife
	should be responsible.


			$

Total Contingent Liabilities			$

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

SECTION IV. CHILD SUPPORT GUIDELINES WORKSHEET

(Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet, MUST be filed with the court at or prior to a hearing to establish or modify child support. This requirement cannot be waived by the parties.)

[Check one only]

____ A Child Support Guidelines Worksheet IS or WILL BE filed in this case. This case involves the

establishment or modification of child support.

____ A Child Support Guidelines Worksheet IS NOT being filed in this case. The establishment or

modification of child support is not an issue in this case.

I certify that a copy of this document was [check all used]: ( ) e-mailed ( ) mailed ( ) faxed

( ) hand delivered to the person(s) listed below on {date} ________________________________.

Other party or his/her attorney:

Name: _____________________________

Address: ____________________________

City, State, Zip: _______________________

Fax Number: _________________________

E-mail Address(es): _____________________

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this affidavit and that the punishment for knowingly making a false statement includes fines and/or imprisonment.

Dated:

Signature of Party

Printed Name: ________________________________

Address: ___________________________________

City, State, Zip: ______________________________

Fax Number: ________________________________

E-mail Address(es): ____________________________

STATE OF FLORIDA

COUNTY OF

Sworn to or affirmed and signed before me on		by	.
	________________________________
		NOTARY PUBLIC or DEPUTY CLERK
	________________________________
		[Print, type, or stamp commissioned
		name of notary or deputy clerk.]
____ Personally known
____ Produced identification
Type of identification produced

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:

[fill in all blanks] This form was prepared for the: {choose only one} (	) Petitioner ( ) Respondent
This form was completed with the assistance of:
{name of individual}		,

{name of business} ___________________________________________________________________,
{address}	________________________________,
{city}	________,{state} ________ {telephone number}	.

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (01/15)

Documents used along the form

The Florida Financial Affidavit Short 12.902(b) form is commonly used in family law cases, particularly during divorce proceedings. It provides a snapshot of an individual's financial situation. Alongside this form, several other documents are often required to ensure a complete financial disclosure. Below is a list of documents frequently associated with the Florida Financial Affidavit Short.

Financial Affidavit Long 12.902(a): A more detailed version of the financial affidavit that includes extensive financial information, suitable for cases requiring deeper financial scrutiny.
Income Verification Documents: These may include recent pay stubs, tax returns, and W-2 forms to verify income sources and amounts.
Bank Statements: Recent statements from all bank accounts help illustrate the financial status and spending habits of the individual.
Debt Statements: Documentation of any outstanding debts, such as credit card statements or loan agreements, to provide a complete picture of financial obligations.
Property Valuation Documents: These include appraisals or tax assessments for real estate owned, giving insight into asset values.
Retirement Account Statements: Statements from retirement accounts like 401(k)s or IRAs, which are important for understanding long-term financial assets.
Proof of Expenses: Documentation of monthly expenses, such as bills and receipts, to establish a clear budget and financial needs.
Operating Agreement (New York) - This document is essential for LLCs in New York, outlining management structure and operational procedures. For more information, you can refer to the nypdfforms.com/operating-agreement-form.
Child Support Guidelines Worksheet: A form used to calculate child support obligations based on income and expenses, ensuring fair support arrangements.
Marital Settlement Agreement: A document outlining the terms of the divorce settlement, including asset division and support arrangements.

These documents are essential for providing a comprehensive view of financial circumstances during divorce proceedings. Properly preparing and submitting these forms can help facilitate a smoother legal process.

Similar forms

The Florida Financial Affidavit Short 12.902(b) form serves as a crucial document for individuals involved in family law matters, particularly during divorce proceedings. This form provides a concise overview of an individual's financial situation. Several other documents share similarities with this form, each serving a specific purpose in financial disclosure and assessment. Below is a list of eight documents that are comparable to the Florida Financial Affidavit Short 12.902(b):

Florida Financial Affidavit Long 12.902(a): This document is more detailed than the short version and requires a comprehensive breakdown of financial assets, liabilities, income, and expenses.
Income and Expense Declaration (California): Similar in purpose, this document requires individuals to disclose their income and expenses, helping courts assess financial needs in family law cases.
Affidavit of Financial Support (New York): This form is used to outline an individual’s financial situation to determine child support obligations, much like the Florida form.
New York Durable Power of Attorney: This essential document allows one individual to handle another's financial and legal affairs, even if they become incapacitated. Understanding its significance is vital, particularly for those interested in a Durable Power of Attorney.
Financial Disclosure Statement (Illinois): This document requires a thorough listing of income, assets, and debts, similar to the Florida Financial Affidavit, ensuring transparency in financial matters.
Statement of Net Worth (New Jersey): This form helps parties in divorce proceedings present their financial standing, paralleling the financial overview provided by the Florida form.
Financial Affidavit (Texas): This document serves to disclose financial information relevant to divorce and child support, akin to the Florida Financial Affidavit.
Financial Statement (Massachusetts): This form requires individuals to outline their financial circumstances, providing a basis for court decisions regarding support and division of assets.
Affidavit of Financial Condition (Pennsylvania): This document is utilized in family law cases to present an individual’s financial status, similar to the Florida Financial Affidavit Short.

Each of these documents plays a vital role in ensuring that financial matters are handled fairly and transparently in family law cases. By providing necessary financial information, they help courts make informed decisions that affect the lives of individuals and families.

Misconceptions

Understanding the Florida Financial Affidavit Short 12.902(b) form is crucial for anyone navigating financial disclosures in legal matters. However, several misconceptions often cloud the process. Here are four common misunderstandings:

The form is only for divorce cases. Many believe that the 12.902(b) form is exclusively used in divorce proceedings. In reality, this form can also be relevant in other family law matters, such as child custody and support cases, where financial information is necessary.
Filling out the form is optional. Some individuals think that completing the financial affidavit is not mandatory. This is misleading. In many cases, the court requires this form to ensure transparency and fairness in financial matters. Failing to submit it could lead to complications or delays in the legal process.
Only income needs to be reported. A common misconception is that the affidavit only requires disclosure of income. However, the form asks for a comprehensive overview of financial situations, including assets, liabilities, and expenses. Omitting any of these details can lead to serious repercussions.
Once submitted, the information cannot be changed. Some believe that the information provided on the affidavit is set in stone. This is not true. If financial circumstances change, individuals can amend their affidavit to reflect new information. Keeping the court updated is essential for maintaining accuracy in financial disclosures.

Clarifying these misconceptions can help individuals better prepare for their legal proceedings and ensure compliance with court requirements.

Understanding Florida Financial Affidavit Short 12.902(b)

What is the Florida Financial Affidavit Short 12.902(b) form?
The Florida Financial Affidavit Short 12.902(b) form is a legal document used in family law cases, particularly in divorce proceedings. It provides a simplified overview of an individual's financial situation, including income, expenses, assets, and liabilities.
Who needs to complete this form?
This form is typically required for individuals involved in divorce, child support, or alimony cases. Both parties may need to submit their financial affidavits to ensure transparency regarding their financial circumstances.
What information is required on the form?
The form requires detailed information about your income, monthly expenses, assets such as bank accounts and property, and liabilities like debts or loans. It is important to provide accurate and complete information.
How do I fill out the form?
To fill out the form, start by gathering all necessary financial documents, such as pay stubs, bank statements, and bills. Then, complete each section of the form with the relevant information. Ensure that all figures are accurate and reflect your current financial situation.
Is there a specific format for submitting the form?
The completed form should be submitted to the court as part of your case filing. It may need to be filed electronically or in person, depending on the court's requirements. Always check with your local court for specific submission guidelines.
What happens if I do not submit this form?
Failure to submit the Florida Financial Affidavit Short 12.902(b) form may result in delays in your case or even dismissal of your petition. The court relies on this information to make informed decisions regarding support and asset division.
Can I amend the form after submission?
Yes, if your financial situation changes or if you discover an error after submitting the form, you can amend it. You will need to complete a new form and submit it to the court, along with an explanation of the changes.
Is this form confidential?
The information on the Florida Financial Affidavit Short 12.902(b) form is generally considered part of the court record and may be accessible to the public. However, sensitive information can sometimes be redacted or sealed upon request. Consult with your attorney for guidance on confidentiality options.
Where can I obtain the form?
The Florida Financial Affidavit Short 12.902(b) form can be obtained from the Florida State Courts website or your local courthouse. Ensure you are using the most current version of the form.
Do I need legal assistance to complete the form?
While it is not mandatory to have legal assistance, consulting with an attorney can help ensure that you complete the form correctly and understand the implications of the information you provide. Legal guidance can be particularly beneficial if your financial situation is complex.