Post Separation Support Financial Affidavit

I, [Your Name], residing at [Your Company Address], do hereby depose and state as follows:

1. Personal Information:

   • Name: [Your Name]

   • Address: [Your Company Address]

   • Email: [Your Company Email]

   • Phone Number: [Your Company Number]

   • Date of Birth: [Birthdate]

2. Income:

   • Employment Income: $5,000 per month

   • Other Income Sources: None

3. Expenses:

   • Housing: $1,200 (Monthly Rent)

   • Utilities: $200 (Electricity, Water, Gas)

   • Transportation: $300 (Car Payments, Fuel, Maintenance)

   • Insurance: $150 (Health, Auto)

   • Childcare: $500 (Child Support)

   • Other Living Expenses: $1,000 (Food, Clothing, Entertainment)

4. Assets:

   • Real Estate: None

   • Vehicles: 2018 Honda Accord

   • Investments: $10,000 (Savings Account)

   • Personal Property: Antique Furniture

5. Liabilities:

   • Mortgages: None

   • Loans: $5,000 (Personal Loan)

   • Credit Card Balances: $2,000

   • Other Debts: None

6. Additional Financial Information:

   • No additional financial information to disclose.

I declare under penalty of perjury that the preceding is true and correct to the best of my knowledge and belief.

[Your Name]

[Date Signed]

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