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The Indiana Financial Declaration Form serves as a crucial document in divorce and custody proceedings, particularly within Porter County's Circuit and Superior Courts. This form is designed to provide a comprehensive overview of the financial circumstances of both parties involved in a marriage dissolution. It includes sections for preliminary information about the husband and wife, such as their addresses, Social Security numbers, occupations, and details about their children. Health insurance information is also a key component, detailing coverage providers and associated costs. The form requires an extensive breakdown of income, encompassing current employment history, past employment over the last five years, and a summary of gross and net income. Additionally, it highlights weekly deductions from income, which can include taxes, insurance premiums, and other mandatory or optional contributions. To ensure a complete financial picture, the form also prompts individuals to list their monthly living expenses across various categories, including housing, groceries, healthcare, and more. This structured approach not only aids in the fair assessment of financial obligations, such as child support but also ensures that all relevant financial details are accurately disclosed to the court.

Sample - Indiana Financial Form

FINANCIAL DECLARATION FORM

STATE OF INDIANA: CIRCUIT AND SUPERIOR COURTS

OF PORTER COUNTY

IN RE THE MARRIAGE OF:

Cause Number:

Petitioner,

And

Respondent

In accordance with Local Rule 18 of the Porter Superior Court and Indiana Trial Rules 26, 33, 34, 35 and 37, the undersigned, Petitioner or Respondent, hereby submits the following

VERIFIED FINANCIAL DISCLOSURE STATEMENT:

FINANCIAL DECLARATION OF

 

 

 

 

 

 

 

 

Dated:

 

I. PRELIMINARY INFORMATION:

 

 

 

 

 

 

 

 

 

Husband:

 

 

Wife:

 

Address:

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Soc. Sec. No.:

 

 

Soc. Sec No.:

 

Badge/Payroll No.:

 

 

Badge/Payroll No.:

 

Occupation:

 

 

Occupation:

 

Employer:

 

 

Employer:

 

Birth Date:

 

 

Birth Date:

 

 

 

 

 

 

Date of Marriage:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Physical Separation:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Filing:

 

 

 

 

 

 

 

 

 

 

Children:

 

 

 

 

 

Name:

 

Age:

 

DOB:

 

SSN:

Name:

 

Age:

 

DOB:

 

SSN:

Name:

 

Age:

 

DOB:

 

SSN:

1

II. HEALTH INSURANCE INFORMATION:

Name and Address of health care insurance company:

Name all persons covered under plan(s):

Weekly cost of total health insurance premium:

Weekly cost of health insurance premium for children only:

Name of the children’s health care providers:

The names of the schools and grade level for each child are:

List any extraordinary health care concerns of any family member:

List any educational concerns of any family member:

III.INCOME INFORMATION:

A.EMPLOYMENT HISTORY:

Current Employer:

Address:

Telephone No.:

 

 

 

 

Length of Employment:

 

 

 

Job Description:

 

 

 

 

 

 

 

 

 

 

Gross Income:

 

 

 

 

 

 

 

 

 

 

 

Per week

 

Bi-weekly

 

 

Per month

 

 

Yearly

Net Income:

 

 

 

 

 

 

 

 

 

 

 

Per week

 

Bi-weekly

 

 

Per month

 

 

Yearly

2

B.EMPLOYMENT HISTORY FOR LAST 5 YEARS:

Employer

 

Dates of Employment

 

Compensation (per wk/mo/yr)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C.INCOME SUMMARY:

1.GROSS WEEKLY INCOME from: Salary and wages, including commissions, bonuses, allowances, and over-time

Note: If paid monthly, determine weekly income by dividing monthly income by 4.3

Pensions & Retirement

Social Security

Disability and unemployment insurance

Public Assistance (welfare, AFDC payments, etc.)

Food Stamps

Child supports received for any child(ren) not both of the parties to this marriage

Dividends and Interest

Rents received

All other sources (specify)

TOTAL GROSS WEEKLY INCOME

2.ITEMIZED WEEKLY DEDUCTIONS: from gross income

State and Federal Income Taxes:

Social Security & Medicare Taxes:

Medical Insurance

 

 

 

Coverage:

Health

(

 

)

 

Dental

(

 

)

 

Eye Care

(

 

)

 

Psychiatric

(

 

)

3

Union or other dues:

Retirement:

Pension fund: Mandatory ( )Optional ( )

Profit sharing: Mandatory ( )Optional( )

401(K): Mandatory ( ) Optional ( )

SEP: Mandatory ( ) Optional ( )

ESOP: Mandatory ( ) Optional ( )

IRA: Mandatory ( ) Optional ( )

403 B: Mandatory ( ) Optional ( )

Child Support withheld from pay (not including this case)

Garnishments (itemize on separate sheet)

Credit Union debts

Direct Withdrawals Out of Paychecks:

Car Payments

Life Insurance

Disability Insurance

Thrift plans

Credit Union Savings

Bonds

Donations

Other (specify)

Other (specify)

TOTAL WEEKLY DEDUCTIONS:

3. WEEKLY DISPOSABLE INCOME:

(A minus B: Subtract Total Weekly Deduction from Total Weekly Gross Income)

IN ALL CASES INVOLVING CHILD SUPPORT: Prepare and attach an Indiana Child Support Guideline Worksheet (with documentation verifying your income); or, supplement with such a Worksheet within ten (10) days of the exchange of this Form.

IV. MONTHLY LIVING EXPENSES:

House

1.Rent (Mortgage)

2.2nd Mortgage

4

3.Line of Credit

4.Gas/Electric

5.Telephone

6.Water

7.Sewer

8.Sanitation (garbage)

9.Cable

10.Satellite

11.Internet

12.Taxes (real estate – if not included in mortgage payment

13.Insurance (house – if not included in mortgage payment)

14.Lawn Care/Snow Removal

Groceries

1.Food

2.Toiletries

3.Cleaning Products

4.Paper Products

Clothing

1.Clothes

2.Shoes

3.Uniforms

Health Care

1.Health Insurance not deducted from pay

2.Dental Insurance not deducted from pay

3.Doctor visits (non-insurance covered)

4.Dental visits (non-insurance covered)

5.Prescription Pharmaceutical (non-insurance covered)

5

6.Over-the-counter medicine

7.Glass/contact lenses

8.Other non-insurance covered health care (itemize)

Car & Travel

1.Car Payment

2.Gasoline

3.Oil/Maintenance

4.Insurance (car)

5.Car Wash

6.Tolls

7.Train/Bus

8.Parking Lot Fees

9.License Plates

Beauty Care

1.Hair Dress/Barber

2.Cosmetics

School Needs

1.Lunches

2.Books

3.Tuition/Registration

4.Uniforms

5.School Supplies

6.Extra-Curricular Activities

Infant Care

1.Diapers

2.Baby Food

6

Miscellaneous

1.Church Donations

2.Charitable Donations

3.Life Insurance

4.Babysitter

5.Newspapers & Magazines

6.Cigarettes

7.Dry Cleaning

8.Entertainment

9.Cell Phone

10.Dues/Subscriptions

11.Charge Cards

12.Other (specify)

SUB-TOTAL OF EXPENSES:

Average Weekly Expenses (multiply monthly expenses by 12 and divide by 52)

V. PROVISIONAL ARREARAGE COMPUTATIONS:

If you allege the existence of a child support, maintenance, or other arrearage, attach all records or other exhibits regarding the payment history and complete the child support arrearage.

You must attach a Child Support Guideline Worksheet to your Financial Declaration Form or one must be exchanged with the opposing party/counsel within 10 days of receipt of the other parties= Financial Declaration Form.

7

ASSETS

All property is to be listed regardless of whether it is titled in your name only or jointly of if the property you own is being held for you in the name of a third party.

VI. PROPERTY:

A. MARITAL RESIDENCE:

Description:

Location:

Date Acquired:

 

Titled:

 

Purchase Price:

 

Down Payment:

 

Source of down payment:

 

 

 

 

Current Indebtedness:

 

 

 

 

Monthly Payment:

 

 

 

 

Current Market Value:

 

 

 

 

B.OTHER REAL PROPERTY: (Complete B on a separate sheet of paper for each additional parcel of real estate owned etc.)

Description:

Location:

Date Acquired:

 

Titled:

 

Purchase Price:

 

Down Payment:

 

Source of down payment:

 

 

 

 

Current Indebtedness:

 

 

 

 

Monthly Payment:

 

 

 

 

Current Market Value:

 

 

 

 

8

C.PERSONAL PROPERTY: (motor vehicles, boats, motorcycles, furnishings, household goods, jewelry, firearms, etc. Household furnishings and household goods such as pots and pans need not

be itemized).

Description

Titled

Current Value

Indebtedness

Payment

Present User

VII. BANK ACCOUNTS:

Name

Type of Account

(Checking, Savings,

CD’s, etc.)

Owner

Account No.

Balance on Date of Filing

VIII. NON-RETIREMENT SECURITIES: (stocks, bonds, mutual funds, etc.)

Name

Type of Account

(Money Mkt, Stocks,

Bonds, Mutual Funds)

Owner

Account No.

Value on date of filing

9

IX. LIFE INSURANCE POLICIES (whole life, variable life, annuities, term)

Company

Owner

Policy #.

Beneficiary

Face Value

Loan

Amount

Cash Value

X.RETIREMENT ACCOUNTS (Pension, Profit Sharing, 401(K), SEP, IRA, KEOGH, ESOP, etc.)

Company

Type of Plan

Owner

Account #

Vested (yes/no)

Value as of date of filing

XI. OTHER PROFESSIONAL OR BUSINESS INTERESTS:

Name of Business

Type (Corp., Part., Sole Owner

% Owned

Estimated Value

XII. MARITAL BILLS, DEBTS, AND OBLIGATIONS: (list every single bill, debt and obligation regardless of whether the bill is title in your name, your spouse=s name, or jointly. Please include all mortgages, 2nd mortgages, home equity loans, charge cards, other loans, credit union loans, car payments, and unpaid medical bills, etc. Do not include monthly expenses such as utilities that are paid in full every month).

Creditor

Description

Acct. #

Monthly

Payment

Balance as of

Date of Filing

Current

Balance

10

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Form Information

Fact Name Description
Governing Law The Indiana Financial Declaration Form is governed by Local Rule 18 of the Porter Superior Court and Indiana Trial Rules 26, 33, 34, 35, and 37.
Purpose This form is used to provide a verified financial disclosure statement in divorce proceedings.
Parties Involved The form requires information from both the Petitioner and the Respondent regarding their financial status.
Health Insurance Details It collects information about health insurance coverage, including costs and providers for all family members.
Income Information Users must disclose their gross and net income, including employment history and various income sources.
Weekly Deductions The form requires itemization of weekly deductions from gross income, such as taxes and insurance premiums.
Disposable Income Calculation It calculates weekly disposable income by subtracting total weekly deductions from total gross income.
Monthly Living Expenses The form includes a section for detailing monthly living expenses, covering housing, groceries, and healthcare.

Detailed Guide for Filling Out Indiana Financial

Completing the Indiana Financial Declaration Form is a crucial step in your legal process. It requires gathering detailed information about your financial situation, including income, expenses, and health insurance. Taking your time to fill it out accurately will help ensure that your financial disclosures are clear and complete.

  1. Gather Personal Information: Collect your and your spouse's names, addresses, Social Security numbers, and other identifying details.
  2. Fill in Preliminary Information: Enter the names and details of both spouses, including occupation and employer information, as well as the dates relevant to your marriage and separation.
  3. Document Children’s Information: List the names, ages, dates of birth, and Social Security numbers of your children.
  4. Health Insurance Information: Provide details about your health insurance, including the name of the insurance company, costs, and any extraordinary health care concerns.
  5. Employment History: Record your current employer's information and your job description. Also, document your employment history for the last five years, including dates and compensation.
  6. Income Summary: Calculate your gross weekly income from various sources, including salary, pensions, and any other income. Be sure to include all relevant income streams.
  7. Itemized Weekly Deductions: List all deductions from your gross income, including taxes, insurance, and other expenses.
  8. Calculate Weekly Disposable Income: Subtract total weekly deductions from total gross weekly income to determine your disposable income.
  9. Monthly Living Expenses: Document all monthly living expenses, including housing, groceries, healthcare, and other necessary costs.
  10. Attach Required Documentation: If child support is involved, prepare and attach the Indiana Child Support Guideline Worksheet along with any necessary income verification.

Once you have completed the form, review it for accuracy. Ensure all information is correct and that you have included all required attachments. This thorough preparation will support your case effectively.

Obtain Answers on Indiana Financial

  1. What is the purpose of the Indiana Financial Declaration Form?

    The Indiana Financial Declaration Form is designed to provide a comprehensive overview of a person's financial situation during divorce or custody proceedings. This form helps the court assess income, expenses, and overall financial health, which is crucial for determining child support, alimony, and property division.

  2. Who needs to fill out this form?

    Both parties involved in the divorce or custody case—referred to as the Petitioner and Respondent—are required to complete the Indiana Financial Declaration Form. Each party must disclose their financial information to ensure transparency and fairness in the proceedings.

  3. What kind of information is required on the form?

    The form requires detailed information including:

    • Personal details such as names, addresses, and Social Security numbers.
    • Employment history, including current and past employers, job descriptions, and income.
    • Health insurance details, including coverage costs and names of providers.
    • Monthly living expenses, including housing costs, utilities, groceries, and healthcare expenses.
  4. How is income calculated on the form?

    Income is calculated by summing all sources of income, including salary, bonuses, pensions, Social Security benefits, and any other income streams. The form provides a specific section to itemize gross weekly income and deductions, allowing for a clear calculation of net income.

  5. What are itemized weekly deductions?

    Itemized weekly deductions refer to the specific amounts subtracted from gross income. These can include state and federal taxes, Social Security and Medicare contributions, health insurance premiums, retirement contributions, and any other regular deductions such as child support or garnishments.

  6. What is disposable income?

    Disposable income is the amount left after all deductions have been taken from gross income. It is calculated by subtracting total weekly deductions from total weekly gross income. This figure is important for understanding what funds are available for living expenses and other obligations.

  7. Are there any additional documents required with the form?

    Yes, if the case involves child support, it is mandatory to prepare and attach an Indiana Child Support Guideline Worksheet. This worksheet must include documentation verifying income and should be submitted within ten days of exchanging the Financial Declaration Form.

  8. What happens if the form is not completed accurately?

    Inaccurate or incomplete information on the Indiana Financial Declaration Form can lead to legal consequences. The court may view it as a lack of transparency, which could negatively impact decisions regarding child support, alimony, and property division. It's essential to ensure that all information is truthful and complete.

  9. Where can I find the Indiana Financial Declaration Form?

    The Indiana Financial Declaration Form can typically be obtained from the Porter County Circuit and Superior Courts' websites or directly from the court clerk's office. It's advisable to ensure you have the most current version of the form, as requirements may change.

Common mistakes

Filling out the Indiana Financial Declaration Form requires careful attention to detail. One common mistake is failing to provide accurate personal information. This includes names, addresses, and Social Security numbers. Inaccuracies can lead to delays in processing and may raise questions about the validity of the submission.

Another frequent error involves the income summary section. Individuals often miscalculate their gross weekly income. It is crucial to include all sources of income, such as salary, bonuses, and other compensations. Neglecting to report certain income can result in an incomplete financial picture, which may affect child support calculations.

Many people also overlook the importance of itemizing weekly deductions. This section requires a comprehensive list of all deductions from gross income, including taxes and insurance. Missing deductions can skew the calculation of disposable income, leading to potential issues in financial assessments.

Additionally, individuals sometimes fail to provide necessary documentation. The form requires an Indiana Child Support Guideline Worksheet to be attached. Not including this worksheet or submitting it late can complicate the process and delay any decisions regarding child support.

Lastly, some individuals do not accurately report their monthly living expenses. This section is critical for understanding overall financial obligations. Incomplete or incorrect entries can misrepresent financial stability and impact court decisions. It is essential to take the time to fill out this section thoroughly and accurately.

Documents used along the form

When navigating financial disclosures in Indiana, several forms and documents complement the Indiana Financial Declaration Form. Each serves a specific purpose in providing a comprehensive overview of financial circumstances, especially in legal matters such as divorce or child support. Below is a brief description of some essential documents you may encounter.

  • Indiana Child Support Guideline Worksheet: This worksheet helps calculate the appropriate amount of child support based on the income and expenses of both parents. It is crucial for ensuring that financial support aligns with state guidelines and the needs of the children involved.
  • Affidavit of Financial Status: This document provides a sworn statement regarding an individual's financial situation. It includes details about income, expenses, assets, and liabilities, offering a clearer picture of one's financial standing.
  • Income Verification Documents: These may include pay stubs, tax returns, or bank statements. They are used to confirm the income reported in the financial declaration and ensure transparency in financial disclosures.
  • Property Settlement Agreement: This agreement outlines how assets and debts will be divided between parties during a divorce. It is essential for clarifying financial responsibilities and ensuring both parties understand their rights and obligations.

Understanding these documents can streamline the process and help ensure that all financial matters are addressed fairly and accurately. Being prepared with the right forms will facilitate a smoother experience in legal proceedings.

Similar forms

  • Financial Affidavit: Similar to the Indiana Financial form, a financial affidavit requires individuals to disclose their financial situation, including income, expenses, and assets. This document is often used in divorce proceedings and child support cases to assess financial obligations.
  • Income and Expense Declaration: This document outlines a person's income and expenses, similar to the Indiana Financial form. It is often used in family law cases to provide a clear picture of financial stability and obligations.
  • Child Support Worksheet: This worksheet helps calculate child support obligations based on income and expenses. Like the Indiana Financial form, it requires detailed financial information to ensure fair support arrangements.
  • Asset Disclosure Statement: This document focuses on a person's assets, providing a comprehensive view of their financial status. It complements the Indiana Financial form by detailing what the individual owns, which is crucial in divorce and asset division cases.
  • Spousal Support Worksheet: Similar to the Indiana Financial form, this worksheet assesses the financial needs of a spouse seeking support. It requires income and expense details to determine appropriate support levels.
  • Debt Disclosure Form: This form outlines an individual's debts and liabilities. Like the Indiana Financial form, it provides a complete financial picture, essential for equitable settlements in divorce proceedings.
  • Tax Return Documentation: Tax returns provide a detailed account of income and deductions, similar to the income information required in the Indiana Financial form. They are often used to verify financial claims made in family law cases.
  • Budget Worksheet: This document helps individuals track their monthly income and expenses, akin to the living expenses section of the Indiana Financial form. It assists in budgeting for future financial needs, especially during divorce or separation.

Dos and Don'ts

When filling out the Indiana Financial form, it is essential to follow certain guidelines to ensure accuracy and compliance. Here is a list of things you should and shouldn't do:

  • Do provide accurate and complete information for all sections.
  • Do double-check your calculations, especially for income and deductions.
  • Do include all sources of income, including side jobs and freelance work.
  • Do attach necessary documentation, such as pay stubs and tax returns.
  • Do keep a copy of the completed form for your records.
  • Don't leave any sections blank; if not applicable, write "N/A."
  • Don't underestimate or overestimate your expenses; be realistic.
  • Don't forget to include health insurance costs and other deductions.
  • Don't submit the form without reviewing it for errors or omissions.

Misconceptions

  • Misconception 1: The Indiana Financial form is only necessary for divorce cases.

    This form is often misunderstood as being exclusively for divorce proceedings. However, it is also required in various family law matters, including child custody disputes and modifications of support orders. Understanding its broader application is crucial for anyone involved in family law cases.

  • Misconception 2: Completing the form is optional.

    Some individuals believe that submitting the Indiana Financial form is optional. In reality, it is a mandatory requirement set forth by the court. Failing to submit this form can lead to delays in your case or even unfavorable rulings. Timely and accurate submission is essential.

  • Misconception 3: The form only requires basic income information.

    Many assume that the Indiana Financial form only asks for basic income details. In truth, it requires a comprehensive overview of your financial situation. This includes not just income but also expenses, debts, and assets. Providing complete and accurate information is vital for a fair assessment.

  • Misconception 4: Once submitted, the information cannot be changed.

    Some people worry that once they submit the Indiana Financial form, they cannot make any changes. This is not entirely accurate. If your financial situation changes, you may be able to amend your form. However, it is important to notify the court and provide updated information as soon as possible to avoid complications.

Key takeaways

  • Ensure that all sections of the Indiana Financial form are completed accurately. Missing information can lead to delays in processing.

  • Provide detailed information about your income, including all sources. This includes salaries, bonuses, and any additional income streams.

  • Itemize your deductions carefully. List all relevant expenses, including taxes, insurance, and any garnishments.

  • Attach the Indiana Child Support Guideline Worksheet as required. This must be submitted within ten days of exchanging the Financial form.

  • Review the form for accuracy before submission. Errors can complicate the process and may require resubmission.