Ga. R. Super. Ct. 24.2
Except as noted below, at least 5 days before any temporary or final hearing in any action for temporary or permanent child support, alimony, equitable division of property, modification of child support or alimony or attorney's fees, all parties shall serve upon the opposing party the affidavit specifying his or her financial circumstances in the form set forth herein. In cases involving child support, the worksheet(s) and schedules required by OCGA § 19-6-15 and only as promulgated by the Georgia Child Support Commission shall be completed and served upon the opposing party contemporaneously with the filing of the affidavit required above. In emergency actions, the affidavit, worksheet(s) and schedules may be served on or before the date of the hearing or at any other time as the Court orders.
In cases filed with complete separation agreements or consent orders resolving all issues but the issue of divorce, the parties are not required to serve financial affidavits, unless otherwise ordered by the Court. In cases involving child support, the parties must attach to the proposed final judgment a completed worksheet or worksheets and any applicable schedules. In addition, the separation agreement must include the parties' gross and adjusted incomes.
The Office of Child Support Services is exempt from filing financial affidavits.
Notice of the date of any temporary hearing shall be served upon the adverse party at least 15 days before the date of the hearing, unless otherwise ordered by the Court.
The parties shall serve upon each other the affidavit and worksheet(s) and schedules (where applicable) at least 5 days prior to any mediation or other alternative dispute resolution proceeding.
In any case in which a party has previously served the affidavit, worksheet(s) and schedules and thereafter amends the affidavit or worksheet(s) and schedules, any such amendments shall be served upon the opposing party at least 5 days prior to final hearing or trial.
On the request of either party, and upon good cause shown to the Court, the affidavits, worksheets, schedules, and any other financial information may be sealed, upon order of the Court.
Only the last four digits of social security numbers, tax identification numbers, or financial account numbers shall be included in any document served or filed with the Court pursuant to this rule. No birth date should be included, only the year of birth. See also OCGA § 9-11-7.1.
A Certificate of Service shall be filed with the Clerk of Court certifying proper service of the affidavit required above and worksheet(s) and schedules (where applicable). Each party shall submit to the Court the original affidavit and worksheet(s) and schedules (where applicable) at the time of hearing or trial.
Failure of any party to furnish the above financial information may subject the offending party, in the discretion of the Court, to the penalties of contempt and may result in continuance of the hearing until the required financial information is furnished and may result in other sanctions or remedies deemed appropriate in the Court's discretion.
Notwithstanding the time limits contained in this rule, the Court may decide a matter without strict adherence to a time limitation, if the financial information was known or reasonably available to the other party, or if a continuance would result in a manifest injustice to a party.
The affidavit shall be under oath and in substantially the following form:
In the Superior Court of
______________ County, Georgia
)
______________________, Plaintiff )
)
vs.
Civil Action No. ___________
)
______________________, Defendant )
)
DOMESTIC RELATIONS FINANCIAL AFFIDAVIT
Spouse's Name: _______________________________ Age _________
Date of Marriage: _____________________ Date of Separation __________________
Names and birth dates of children for whom support is to be determined in this action:
| Name | Date of Birth | Resides with |
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Names and birth dates of affiant's other children:
| Name | Date of Birth | Resides with |
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
| 2. SUMMARY OF AFFIANT'S INCOME AND NEEDS | |
| (a) Gross monthly income (from item 3A) | $ ______________ |
| (b) Net monthly income (from item 3B) | ______________ |
| (c) Average monthly expenses (item 5A) | $ ______________ |
| Monthly payments to creditors | + ______________ |
| Total monthly expenses and | |
| payments to creditors (item 5C) | _______________ |
| 3. A. AFFIANT'S GROSS MONTHLY INCOME (complete this section or attach Child Support Schedule A) | |
| (All income must be entered based on monthly average regardless of date of receipt.) | |
| Salary or Wages | $ ______________ |
| ATTACH COPIES OF 2 MOST RECENT WAGE STATEMENTS | |
| Commissions, Fees, Tips | $ ______________ |
| Income from self-employment, partnership, close corporations, and independent contracts | $ ______________ |
| (gross receipts minus ordinary and necessary expenses required to produce income) | |
| ATTACH SHEET ITEMIZING YOUR CALCULATIONS | |
| Rental Income (gross receipts minus ordinary and necessary | $ ______________ |
| expenses required to produce income) | |
| ATTACH SHEET ITEMIZING YOUR CALCULATIONS | |
| Bonuses | $ ______________ |
| Overtime Payments | $ ______________ |
| Severance Pay | $ ______________ |
| Recurring Income from Pensions or Retirement Plans | $ ______________ |
| Interest and Dividends | $ ______________ |
| Trust Income | $ ______________ |
| Income from Annuities | $ ______________ |
| Capital Gains | $ ______________ |
| Social Security Disability or Retirement Benefits | $ ______________ |
| Workers' Compensation Benefits | $ ______________ |
| Unemployment Benefits | $ ______________ |
| Judgments from Personal Injury or Other Civil Cases | $ ______________ |
| Gifts (cash or other gifts that can be converted to cash) | $ ______________ |
| Prizes/Lottery Winnings | $ ______________ |
| Alimony and maintenance from persons not in this case | $ ______________ |
| Assets which are used for support of family | $ ______________ |
| Fringe Benefits (if significantly reduce living expenses) | $ ______________ |
| Any other income (do NOT include means-tested Public | $ ______________ |
| assistance, such as TANF or food stamps) | |
| GROSS MONTHLY INCOME | $ ______________ |
| B. Affiant's Net Monthly Income from employment | $ ______________ |
| deducting only state and federal taxes and FICA) | |
| Affiant's pay period (i.e., weekly, monthly, etc.) | _______________ |
| Number of exemptions claimed | _______________ |
(If you claim or agree that all or part of an asset is non-marital, indicate the non-marital portion under the appropriate spouse's column and state the amount and the basis: pre-marital, gift, inheritance, source of funds, etc.).
Separate Asset
| Description | Value | Separate Asset | Separate Asset | Basis of |
| of the Husband | of the Wife | the Claim | ||
| Cash | $________ | ________ | ________ | ________ |
| Stocks, bonds | $________ | ________ | ________ | ________ |
| CD's/Money Market Accounts | $________ | ________ | ________ | ________ |
| Bank Accounts (list each account): | ||||
| ________ | $________ | ________ | ________ | ________ |
| ________ | $________ | ________ | ________ | ________ |
| ________ | $________ | ________ | ________ | ________ |
| Retirement Pensions, 401K, IRA, or Profit Sharing | $________ | ________ | ________ | ________ |
| Money owed you: | $________ | ________ | ________ | ________ |
| Tax Refund owed you: | $________ | ________ | ________ | ________ |
| Real Estate: | ||||
| home: | $________ | ________ | ________ | ________ |
| debt owed: | $________ | ________ | ________ | ________ |
| other: | $________ | ________ | ________ | |
| debt owed: | $________ | ________ | ________ | ________ |
| Automobiles/Vehicles: | ||||
| Vehicle 1: | $________ | ________ | ________ | ________ |
| debt owed: | $________ | ________ | ________ | ________ |
| Vehicle 2: | ||||
| debt owed: | $________ | ________ | ________ | ________ |
| Life Insurance (net cash value): | $________ | ________ | ________ | ________ |
| Furniture/furnishings: | $________ | ________ | ________ | ________ |
| Jewelry: | $________ | ________ | ________ | ________ |
| Collectibles: | $________ | ________ | ________ | ________ |
| Other Assets: | $________ | ________ | ________ | ________ |
| ______________ | $________ | ________ | ________ | ________ |
| ______________ | $________ | ________ | ________ | ________ |
| ______________ | $________ | ________ | ________ | ________ |
| Total Assets: | $________ | ________ | ________ | ________ |
| 5. A. AVERAGE MONTHLY EXPENSES | |
| HOUSEHOLD | |
| Mortgage or rent payments | $ __________ |
| Property taxes | $ __________ |
| Homeowner/Renter Insurance | $ __________ |
| Electricity | $ __________ |
| Water | $ __________ |
| Garbage and Sewer | $ __________ |
| Telephone: | $ __________ |
| Residential line: | $ __________ |
| Cellular telephone: | $ __________ |
| Gas | $ __________ |
| Repairs and maintenance | $ __________ |
| Lawn Care | $ __________ |
| Pest Control | $ __________ |
| Cable TV | $ __________ |
| Misc. household and grocery items | $ __________ |
| Meals outside the home | $ __________ |
| Other | $ __________ |
| AUTOMOBILE | |
| Gasoline and oil | $ __________ |
| Repairs | $ __________ |
| Auto tags and license | $ __________ |
| Insurance | $ __________ |
| OTHER VEHICLES (boats, trailers, RVs, etc.) | |
| Gasoline and oil | $ __________ |
| Repairs | $ __________ |
| Tags and license | $ __________ |
| Insurance | $ __________ |
| CHILDREN'S EXPENSES | |
| Child care (total monthly cost) | $ __________ |
| School tuition | $ __________ |
| Tutoring | $ __________ |
| Private lessons (e.g., music, dance) | $ __________ |
| School supplies/expenses | $ __________ |
| Lunch Money | $ __________ |
| Other Educational Expenses (list) | $ __________ |
| ______________ | $ __________ |
| ______________ | $ __________ |
| Allowance | $ __________ |
| Clothing | $ __________ |
| Diapers | $ __________ |
| Medical, dental, prescription (out of pocket/uncovered expenses) | $ __________ |
| Grooming, hygiene | $ __________ |
| Gifts from children to others | $ __________ |
| Entertainment | $ __________ |
| Activities (including extra-curricular, school, religious, cultural, etc.) | $ __________ |
| Summer Camps | $ __________ |
| AFFIANT'S OTHER EXPENSES | |
| Dry cleaning/laundry | $ __________ |
| Entertainment | $ __________ |
| Clothing | $ __________ |
| Medical, dental, prescription (out of pocket/uncovered expenses) | $ __________ |
| Affiant's gifts (special holidays) | $ __________ |
| Entertainment | $ __________ |
| Recreational Expenses (e.g., fitness) | $ __________ |
| Vacations | $ __________ |
| Travel Expenses for Visitation | $ __________ |
| Publications | $ __________ |
| Dues, clubs | $ __________ |
| Religious and charities | $ __________ |
| Pet expenses | $ __________ |
| Alimony paid to former spouse | $ __________ |
| Child support paid for other children | $ __________ |
| Date of initial order: __________ | |
| Other (attach sheet) | $ __________ |
| OTHER INSURANCE | |
| Health | $ __________ |
| Child(ren)'s portion: | $ __________ |
| Dental | $ __________ |
| Child(ren)'s portion: | $ __________ |
| Vision | $ __________ |
| Child(ren)'s portion: | $ __________ |
| Life | $ __________ |
| Relationship of Beneficiary: ____________ | |
| Disability | $ __________ |
| Other (specify): | $ __________ |
| TOTAL ABOVE EXPENSES | $ __________ |
| B. PAYMENTS TO CREDITORS | ||||
| (please check one) | ||||
| To Whom: | Balance Due | Monthly Payment | Joint Plaintiff | Defendant |
| ____________________________________________________________________________________________________ | ||||
| ____________________________________________________________________________________________________ | ||||
| ____________________________________________________________________________________________________ | ||||
| ____________________________________________________________________________________________________ | ||||
| ____________________________________________________________________________________________________ | ||||
| TOTAL MONTHLY PAYMENTS TO CREDITORS: | $ ___________________ | |||
| C. TOTAL MONTHLY EXPENSES: | $ ___________________ | |||
Personally appeared before me, an officer authorized to administer oaths, the undersigned affiant, who upon being sworn, swears that he/she is legally competent to make this affidavit, that the affidavit is based upon personal knowledge, and that the contents of the affidavit are true.
___________________
Affiant
Sworn to and subscribed
before me, this ________ day of ________, 20__.
____________________
Notary Public
My commission expires:_____
Ga. R. Super. Ct. 24.2