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    Full Name of Party Filing Document: Affidavit Verifying Income

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    joy dole
    This affidavit verifies the income of two parties, [Your Name] and [Other Parent's Name]. It provides sections to report gross income from various sources like wages, business income, interest, and public assistance. Deductions from gross income are also listed. The adjusted gross income is calculated, along with in-kind benefits and potential income. Guidelines income is determined by combining the adjusted gross, in-kind benefits, and potential income. Monthly income under Idaho Child Support Guidelines is calculated by dividing the Guidelines income by 12. The affidavit is signed under penalty of perjury.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Full Name of Party Filing Document: Affidavit Verifying Income

    Uploaded by

    joy dole
    21 views2 pages
    This affidavit verifies the income of two parties, [Your Name] and [Other Parent's Name]. It provides sections to report gross income from various sources like wages, business income, interest, and public assistance. Deductions from gross income are also listed. The adjusted gross income is calculated, along with in-kind benefits and potential income. Guidelines income is determined by combining the adjusted gross, in-kind benefits, and potential income. Monthly income under Idaho Child Support Guidelines is calculated by dividing the Guidelines income by 12. The affidavit is signed under penalty of perjury.

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    Original Title

    CAO_FL_1-11

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    This affidavit verifies the income of two parties, [Your Name] and [Other Parent's Name]. It provides sections to report gross income from various sources like wages, business income, interest, and public assistance. Deductions from gross income are also listed. The adjusted gross income is calculated, along with in-kind benefits and potential income. Guidelines income is determined by combining the adjusted gross, in-kind benefits, and potential income. Monthly income under Idaho Child Support Guidelines is calculated by dividing the Guidelines income by 12. The affidavit is signed under penalty of perjury.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    21 views2 pages

    Full Name of Party Filing Document: Affidavit Verifying Income

    Uploaded by

    joy dole
    This affidavit verifies the income of two parties, [Your Name] and [Other Parent's Name]. It provides sections to report gross income from various sources like wages, business income, interest, and public assistance. Deductions from gross income are also listed. The adjusted gross income is calculated, along with in-kind benefits and potential income. Guidelines income is determined by combining the adjusted gross, in-kind benefits, and potential income. Monthly income under Idaho Child Support Guidelines is calculated by dividing the Guidelines income by 12. The affidavit is signed under penalty of perjury.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Full Name of Party Filing Document

    Mailing Address (Street or Post Office Box)

    City, State and Zip Code

    Telephone

    Email Address (if any)

    IN THE DISTRICT COURT FOR THE JUDICIAL DISTRICT


    FOR THE STATE OF IDAHO, IN AND FOR THE COUNTY OF

    , Case No.
    Petitioner,
    AFFIDAVIT VERIFYING INCOME
    vs.

    ,
    Respondent.

    I hereby certify that the following information is true: Other Parent’s


    Your Name Name

    A. GROSS INCOME
    1. Wages, salary, commissions, bonuses, etc.
    2. Rent, royalties, trade, or business income, etc.
    (net of ordinary & necessary expenses)
    3. Interest, dividends, pensions, annuities, etc.
    4. Social security, worker's compensation, disability,
    unemployment benefits, veterans' benefits, etc.
    5. Public assistance, welfare for self (not children)

    6. Alimony

    7. Grants, distributions from trusts, etc.

    8. Other

    9. SUBTOTAL

    AFFIDAVIT VERIFYING INCOME PAGE 1


    CAO FL 1-11 07/01/2017
    Other Parent’s
    Your Name Name

    B. DEDUCTIONS FROM GROSS INCOME


    (I.C.S.G. Sections F and G)
    1. Straight line depreciation on assets
    2. One-half of self-employment Social Security taxes

    3. Child support & alimony from another relationship


    4. Support for child of another relationship living in the
    home
    5. DEDUCTIONS SUBTOTAL

    C. GROSS INCOME, AS ADJUSTED


    (line B5 subtracted from line A9)
    D. IN-KIND BENEFITS (I.C.S.G. Section F(2))
    (housing, food, transportation, recreation)
    E. POTENTIAL INCOME (I.C.S.G. Section F(3))
    Potential earned income + Potential unearned income
    F. GUIDELINES INCOME (C + D + E)

    G. MONTHLY I.C.S.G. INCOME (F÷12 months)

    CERTIFICATION UNDER PENALTY OF PERJURY

    I certify under penalty of perjury pursuant to the law of the State of Idaho that the foregoing is
    true and correct.

    Date:

    Typed/Printed Name Signature

    AFFIDAVIT VERIFYING INCOME PAGE 2


    CAO FL 1-11 07/01/2017

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