IN · rules
Ind. DeKalb Cnty. Local Rules App., Appendix 3, Income
Income
RE: Marriage of: ________ Cause No. ________
| | Employer's Address | Job Classification | Length of Employment | Rate of Pay | Gross Earnings per Pay Period | Net Earnings per Pay Period |
|---|---|---|---|---|---|---|
| Husband | | | | | | |
| Wife | | | | | | |
OTHER INCOME (SOURCE – AMOUNT)
| Husband | |
|---|---|
| Wife | |
I affirm under penalties for perjury that the foregoing representations, and all attachments hereto, are true and correct.
Dated: ________ ________ Petitioner
Dated: ________ ________ Respondent
You are under a continuing duty prior to trial to amend this statement if you learn the information contained herein is no longer accurate. Both parties should endeavor to stipulate as to the value of all assets, or be prepared to establish the values by appraisal.
CERTIFICATE OF SERVICE
I hereby certify that I did, on the _____ day of ______________, 20___, mail or hand deliver to the other party or their Attorney, a completed copy of this disclosure.
________ Attorney for Petitioner/Respondent Or Petitioner / Respondent
Provenance
- Source
- www.in.gov
- Retrieved
- 2026-10-02
- Edition
- supplied-in-28-18-dekalb-local-rules-appendices-2026-10-02
- Content hash
3b6408c4aa3b0cc587ad4d80ef891d4353cf8476751460885d6cd26ce13806b7
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