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Filling Out a Financial Disclosure Affidavit

The purpose of this guide is to help you fill out a financial disclosure affidavit. Each section of the affidavit is reproduced in this guide and is followed by explanations and definitions. You may want to have this guide next to you while filling out the financial disclosure affidavit.

What is a financial disclosure affidavit?

Financial means related to money.

Disclosure means to make public.

Affidavit means a sworn statement.

financial disclosure affidavit is an official document describing a person’s income (how much you make) and expenses (how you spend it).
The person filling out the financial disclosure affidavit must swear that everything written in the document is true and must sign it in front of a specific public official, like a notary public or a judge. (Notary publics are described later in this guide.)

Why do I have to fill it out?

Courts use the financial information of both parents to decide the amount of child support one parent will receive from the other parent. The financial disclosure affidavit provides this information. For more information on how the court makes child support decisions, see Family Legal Care’s guide “Child Support Basics.”

Do both parents have to fill it out?


What happens if someone doesn’t fill it out?

It depends. If you are the petitioner, the parent asking for child support, and you do not submit your financial disclosure affidavit, the support magistrate may reschedule the hearing to give you more time to complete the affidavit.
If you are the respondent, the parent being asked to pay child support, and you do not submit the financial disclosure affidavit, the support magistrate may decide to reschedule the hearing to give you another chance to submit the financial disclosure affidavit to court. However, the court also may order you to pay whatever child support the other parent requested, or the amount that the court determines your child needs, without taking your income and expenses into account.

Do I have to give the other parent a copy of my completed financial disclosure affidavit?

Both parents are entitled to a copy of the other parent’s financial disclosure affidavit. If you want a copy of the other parent’s financial disclosure affidavit, you can go to the record room, ask for the case file, and make a photocopy.


Why does it say “Commissioner of Social Services, Assignor, on behalf of, Assignee”?

When a parent applies for and receives public assistance (also called cash assistance or welfare) from the City, the parent gives the City his or her right to collect child support from the child’s other parent. (To assign means to give a right to someone else.)

What do “assignor” and “assignee” mean?

An assignor is a person or group that gives legal rights or legal interests to another person or group. That person or group is called an assignee. In this case, the assignor is the parent who is giving his or her legal right to collect child support to the Department of Social Services, the assignee.

What is a “docket number”?

docket number is a number given to each case. In Family Court, docket numbers begin with a different letter depending on the type of case. The letter is followed by a series of numbers that ends with the two-digit year in which the case was started. Child support cases begin with the letter “F”.


What does it mean by “income from all sources”?

The financial disclosure affidavit uses the term income from all sources to make sure that you know to list all of the support you receive from any source. This means that, in addition to the income you receive from a job, you must also list money you might receive from any other source, including:
  • Investments
  • Workers’ compensation
  • Disability benefits
  • Unemployment insurance
  • Social security
  • Veterans’ benefits
  • Pensions
  • Retirement benefits
  • Fellowships and stipends
  • Annuity payment
Income does not only mean money. Any free meals or housing that you receive as a benefit from your job are also part of your income. For example, if you are the superintendent of a building and receive free or reduced rent in that building, the reduced or free rent counts as income.

What are “Addendum A” and “Addenda B and C”?

These addenda are sections that contain additional information about child support and can be found at the very end of the financial disclosure affidavit. An addendum is one section. Addendum A states the child support percentages. (These are discussed later in this guide.) Addendum B explains that when the combined parental income is over $141,000 a year, the court may not always follow the child support percentages. Addendum C states that in some cases, the noncustodial parent should have to pay only $25 per month. This usually happens when paying child support would cause the noncustodial parent’s income to fall below the poverty level. If you have questions about any of these addenda, please ask a Family Legal Care representative in court or call our Helpline at (212) 343-1122.

I get paid bi-weekly, but it is asking for my “weekly gross salary/wages”. Should I put down what I make bi-weekly since that is what my pay check says?

No. It is important to answer the question as it is written. The question asks you how many hours you work each week. It also asks how much you earn each week. If you get paid bi-weekly (every two weeks), you will need to divide the total by two to figure out your weekly salary. If you put down your bi-weekly salary, it may result in the judge making the wrong calculations about how much has to be paid in child support.

Why does it ask about the income of the “other members of my household”?

The court tries to figure what the standard of living for the child would be if his or her parents were living together. Standard of living means what kinds of items and services someone has available to them. It includes everything from how often someone eats at expensive restaurants to whether someone sends a child to private school.
Sometimes the court may impute income that other household members bring in to the non-custodial parent. Impute means to assign or to attribute. When someone’s income is imputed to you, it increases your total income in the eyes of the court. It may increase the amount of child support you are ordered to pay.

Why does it ask about the “number of dependents” and “number of members in household”?

When making a decision about child support, the support magistrate may take into account the needs of the dependent children living with the non-custodial parent. Dependent is explained in the next question.

What is a dependent?

dependent is a person who counts on someone else for their food, clothing, and shelter. A dependent child is a child being financially supported by a parent. A dependent child usually lives in the same home as the person who is supporting them.

What does “interest/dividend income” mean?

Interest and dividend income refers to income from investments. For example, if you or the child’s other parent own stock (an interest in a company corporation) and receive regular payments (called dividends) from the company or corporation you own stock in, you must report those payments as income. Similarly, if you have a savings account from which you receive interest payments, you must include these payments as income on the affidavit.

If someone gives me cash or a check for a birthday present or holiday gift every year, does that count as “income from other sources?”

Yes. The form asks you to write down “money, goods, or services provided by relatives and friends” in this section. That includes a present you may receive every year in cash or as a check from someone.


What is an “asset?”

An asset is any item that is worth something. Here, asset means something worth money. Common examples include cash, stocks and bonds, cars, and other property.

Why does it matter what licenses I have?

There are three reasons:
  • Child support can be based on how much money the court thinks you can earn. This means that it may not be based on how much you are earning right now. If you have a license related to certain jobs, such as a barber’s license or a license to drive a taxi, this can affect how much the court thinks you can earn and how much child support you can pay.
  • If you are ordered to pay child support and you do not follow the order, the Support Collection Unit (SCU) can have your licenses suspended.
  • The court can place a value on a license. This means that the court might think that a license is worth a certain amount of money.

Why does it matter what kind of automobile I own? Why does it ask if I own a residence or real estate?

Cars and real estate are considered assets (see assets defined above) because they are items that are worth money. If you own a car, you must include it when listing your assets on the document. Listing assets, like cars, helps give the court an idea of the type of lifestyle your child is used to and how much child support you and the child’s other parent can afford to pay.

What if my husband or wife bought our car or our home?

You only need to list assets that are in your name. However, sometimes assets belonging to a member of your household may be imputed to you. For information on imputing see Section I, “Income from all Sources,” above.
deduction lowers the amount of income from which child support will be calculated.


What is a “deduction”?

deduction lowers the amount of income from which child support will be calculated.

What does “child support actually paid on behalf of non-subject child(ren)” mean?

This means child support that you are already paying for another child. This can be through a court order or a written agreement with the other parent of that child.

If I am paying “child support actually paid on behalf of non-subject children,” how could it affect my child support order?

If you are already paying child support for another child, the court might base your new order on the income that you have left after you pay for the order that came first.

When it asks about “child support actually paid on behalf of non-subject children” does that include any children that I support? Even if the child lives with me and there is no child support order for him or her?

No. The only amount you can include in this category is for child support that you pay because of a court order or a written agreement you have with the other parent of another child. The court takes children who live with you and don’t have a child support order into account in another way. Before the court makes a final decision regarding this child support order, it can consider the needs of these other children.

What is “maintenance actually paid to spouse”?

Maintenance is another word for alimony. It is money paid after a divorce to support an ex-husband or an ex-wife.


What does the term “pro-rated” mean?

Pro-rated means to divide proportionally. In this case, it means both parents will have to pay part of their child’s health costs. How much each one pays will be figured out by comparing the income of both parents. For example, if one parent makes twice as much as the other, that parent may be responsible for twice the amount of the child’s health care costs.

Why does it ask me for information about my health insurance?

The court may order you to include your child on your health insurance. If the support magistrate orders one parent to include the child on his or her health insurance, the court can ask the other parent to pay some of the cost of coverage.

How can I find out what portion of the cost of my insurance is paid by my employer?

Either your employer or your human resources director should be able to tell you how much money your employer contributes to your insurance coverage. You might also find the answer in your employee handbook.

What is a “beneficiary”?

beneficiary is someone who receives a benefit. For example, if a child is listed as a beneficiary under their parent’s life insurance policy, he or she will receive the payments listed in that policy.

If my child is already a beneficiary, will that mean I can pay less in child support?

No. Your child’s status as your life insurance beneficiary is not one of the factors that courts consider in determining your income and/or whether your contribution should vary from the percentages listed above.


What does “variance from the percentages” mean?

The percentages the court usually uses for child support orders are from the Child Support Standards Act (CSSA). The CSSA is a law that sets the guidelines used by support magistrates to make child support orders. Parents are usually ordered to pay a percentage of their adjusted gross income based on how many children are included in the support order. Gross income is the amount of money you earn before taxes are taken out. Adjusted gross income is your gross income minus some special expenses, like previous child support orders. Once the court determines the total income of the two parents together, it uses the formula below to decide the amount needed to support the child. Variance from the percentages means different from these percentages. For more information, please see Family Legal Care’s guide “Child Support Basics” or call our Helpline at (212) 343-1122. The percentages from the Child Support Standards Act are:
  • 1 child – 17% of your adjusted gross income
  • 2 children – 25% of your adjusted gross income
  • 3 children – 29% of your adjusted gross income
  • 4 children – 31% of your adjusted gross income
  • 5 children – 35% of your adjusted gross income
The court can ignore this formula in special situations. For example, if a child has special needs and high expenses because of those needs, the child support order may be higher than the usual percentage. On the other hand, if the respondent has educational needs that are costly and keep him or her from working, the court order might be lower than the usual percentage. For these reasons, or one of many others, the court may make a child support order that is different from the percentages that they usually use.

Is this the section where I should put down information about the child care and educational needs of a child that isn’t included in this order?

Yes. There is space for you to include reasons that you believe the court should vary from the percentage of child support that you can be ordered to pay. In this section, you may include information about another child’s needs if you think it affects the amount you are able to pay.

What factors will the court look at when deciding how to vary from the percentages?

When deciding how to vary from the percentage listed above, the court can consider each of the following factors:
  • The financial resources of each parent and those of the child;
  • The physical and emotional health of the child and his/her special needs and capabilities;
  • The standard of living the child would have enjoyed if the parents lived together;
  • The tax consequences to the parties;
  • The non-monetary contributions that the parents will make toward the care and well-being of the child;
  • The educational needs of either parent;
  • Whether one parent makes a lot more than the other parent;
  • The needs of the children of the respondent that are not part of a child support order;
  • Extraordinary expenses that the respondent must spend in visiting the child; and
  • Any other factors that the court decides are important.


Can I list some expenses “weekly” and some expenses “monthly”? What about “yearly”?

You may not list some expenses as weekly and others as monthly. You must choose to list all of your expenses as either monthly or weekly expenses. You may not list any expenses as yearly expenses. If you choose to list expenses on a monthly basis but you have expenses that you pay weekly you must multiply your weekly expenses by four and list them as monthly expenses.

If my expenses are more than what I am paying now—meaning I can’t afford to pay as much as I would like—should I put down what I actually pay, or what I would like to pay?

You can put down both – what you are paying and what you would like to pay. If you put down both, you must write in an explanation of why you have put down two numbers on the financial disclosure affidavit.

What gets included in entertainment?

Entertainment expenses include money you use for fun, like going to a movie. These are expenses that are not related to your daily living expenses.

What does “amortization” mean?

Amortization describes the payment of a loan and its interest over a period of time.

Where can I find out my “mortgage interest and amortization”?

Your loan officer is the best source to find out about your mortgage interest and amortization. That information might also be contained in your mortgage statements or the original mortgage documents.

Why am I being asked to list these expenses?

While the court is not required to look at expenses when determining child support, if the court decides to vary the amount of child support each parent is responsible for providing (see section 5, “Variance from the Percentages,” above), the court can consider each parent’s expenses. These expenses can also help the court understand your standard of living.

Can I include my own schooling?

Yes. When deciding the amount of child support you must pay, the court may consider the educational needs of both parents. Additionally, if the custodial parent has additional child care expenses because of his or her schooling, the other parent can be ordered to help pay for some of those extra expenses.


What is a “liability”?

liability is money you owe. It is something that you are responsible for paying back, like a loan.

What is a “creditor”?

creditor is a person or company to whom you owe money.


Why does this have to be notarized?

The document you’re filling out is an affidavit. That means it is a formal sworn statement. Under the law, the truth of all the information in an affidavit must be sworn to before an officer authorized to administer oaths, such as a notary public.

What is a notary public and where can I find one?

notary public, or notary, is someone who watches people sign their names on official papers and verifies that the people signing are who they say they are. You can find a notary by looking in a phone book or at online directories. Some notaries have offices near courthouses. Additionally, many banks and law offices employ notary publics.

: A notary public may charge a fee of $2.00 for each signature or oath.
This document should not take the place of a consultation with a lawyer. Family Legal Care encourages all individuals involved with the Criminal and Family Court systems to consult with a lawyer.

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