Certificate Of Compliance With Mandatory Financial Disclosures printable pdf download



District Court

Denver Juvenile Court

__________________ County, Colorado

Court Address:

In re:



The Marriage of:



Parental Responsibilities concerning:

______________________________________________________

Petitioner:__________________________

and

COURT USE ONLY

Co-Petitioner/Respondent:____________________________

Attorney or Party Without Attorney

Case Number:

(Name and Address)

Phone Number:__________ E-mail:___________________________

Division _______ Courtroom ______

FAX Number:___________ Atty. Reg. #: ____________________

CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES

*****EACH PARTY MUST COMPLETE AND FILE THIS FORM WITH THE COURT*****



I, the

Petitioner

Co-Petitioner/Respondent (check one) hereby certify that I have sent the other party the following

Mandatory Disclosures as required by Rule 16.2(e)(7) of the Colorado Rules of Civil Procedure.

See JDF 1125: Mandatory Disclosure – Form 35.1 for explanation on what is required by the disclosures being listed.

Check those that you have furnished to the other party. (Note

: Only the Sworn Financial Statement and Child

Support Worksheet should be filed with the Court.)



Sworn Financial Statement

Retirement Plans



Income Tax Returns (most recent 3 years)

Bank/Financial Institution Accounts



Personal Financial Statements (last 3 years)

Income Documentation (Pay Stubs, etc.)



Business Financial Statements (last 3 years)

Employment and Education – Related child



Real Estate Documents (Appraisal, Title, etc.)

Care Documentation



Personal Debt (Loans, Title, Credit Card Statements, etc.)

Insurance Documentation



Investments

Extraordinary Children’s Expense



Documentation

Employment Benefits

If I have not provided information, it is because:

I hereby certify that, to the best of my knowledge, information, and belief, the disclosures I have made are

complete and correct as of this date.

________________________________________________

Petitioner/Co-Petitioner/Respondent Signature

Date

________________________________________________

Attorney Signature, if any

Date

You must complete the Certificate of Service below:

CERTIFICATE OF SERVICE

I certify that on _______________________ (date) a true and accurate copy of the CERTIFICATE OF COMPLIANCE WITH

MANDATORY FINANCIAL DISCLOSURES was served on the other party by:



Hand Delivery,

E-filed,

Faxed to this number ____________________, or



by placing it in the United States mail, postage pre-paid, and addressed to the following:

To: ___________________________________

___________________________________

(Your signature)

JDF 1104

R8/10

CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES

Certificate Of Compliance With Mandatory Financial Disclosures

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