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Plaintiff and Defendant Affine filed Affine and Spouse's Affidavit of Support (A) on February 17, 2003 (this Affidavit) (1) Affine and Spouse filed the attached Affidavit of Support (A) on February 23, 2003, (2) Affine and Spouse filed an Affidavit of Support in Case No. 09-1768 (C) (Affine and Spouse dated November 4, 2008, and January 9, 2009, respectively) (3) Plaintiff and Defendant in Opposition filed a document in this matter dated January 4, 2003 (4) Plaintiff filed a document in this matter dated November 16, 2008, and January 9, 2009 (5) Plaintiff filed a document in this matter dated November 17, 2008, and January 9, 2009, and (6) Defendant filed a document in this matter dated January 4, 2003. 3. Plaintiff alleges that the Defendant has not established support for the children by Affine as of February 1, 2003. 4. Plaintiff requests that the Court determine the amount of the financial support of the children on the following grounds: grounds for a preliminary injunction. Grounds for a permanent injunction. Grounds for a final injunction. Grounds for an order of contempt. Grounds for an order pursuant to Article 6 of the Court Rules. Grounds for an order pursuant to Section 17-26-5. 5. Plaintiff seeks monetary relief of an amount to be determined by the Court for the support of the children stated as follows: “Defendant shall pay support to Plaintiff for the support of: 1. Plaintiff for the support of Plaintiff's children to the extent of reasonable expenses for medical care of Plaintiff's children with a medical malpractice claim pending against Plaintiff in the Circuit Court of the name County: 500 2. Plaintiff for the support of Plaintiff's children to the extent of reasonable expenses for medical care of Plaintiff's children: 250 3. Plaintiff for the support of Plaintiff's children to the extent of reasonable expenses for medical care of Plaintiff's children: 100 4. Plaintiff for the support of Plaintiff's children to the extent of reasonable expenses for medical care of Plaintiff's children: 150 5. Plaintiff for the support of Plaintiff's children to the extent of reasonable expenses for medical care of Plaintiff's children: 50 6. Plaintiff for the support of Plaintiff's children to the extent of reasonable expenses for medical care of Plaintiff's children: 10 7.

Who needs a Domestic Relations Financial Affidavit?

This form is completed by the parties in a divorce process in the state of Georgia. The affidavit may also be required during other hearings connected with family matters.

What is the purpose of the Domestic Relations Financial Affidavit?

The affidavit contains information about spouses, their children, income and needs. The parties must provide this form to the Court. On the basis of this information the court will make a decision on a variety of family matters: child support, alimony, etc.

What documents must support the Domestic Relations Financial Affidavit?

The affine may have to include additional documents to the financial affidavit on the Court’s request, such as copies of the two most recent wage statements, Child Support Schedule A, etc.

When is the Domestic Relations Financial Affidavit?

The Parties must complete this form before the court hearing on their case.

What information should be provided in the Domestic Relations Financial Affidavit?

The affidavit should contain the following information:

• Name of the defendant and the plaintiff

• Affine’s name and age

• Spouse’s name and age

• Information about the children (name, date of birth, place of residence)

• Summary of the affine’s income and needs

• Affine’s gross monthly income (income from self-employment, rental income, bonuses, overtime payments, severance pay, income from pensions, interest and dividends, trust income, unemployment benefits, lottery winnings)

• Assets (cash, stocks and bonds, bank accounts, real estate, automobiles, life insurance, furniture, jewelry, collectibles, other assets)

• Average monthly expenses: household (rent payment, property taxes, renter insurance, electricity, water, gas, etc.); automobiles (gasoline and oil, repairs, insurance); children expenses (child care, school tuition, tutoring, private lessons, lunch money, entertainment, activities, summer camps); other insurance; affine’s other expenses

• Payments to creditors

The affine must sign and date the form. The Notary Public should also certify the affidavit.

What do I do with the Domestic Relations Financial Affidavit after its completion?

The completed affidavit is filed with the Superior Court of Georgia.