affidavit in support affidavit in response to

CANDICE ADAMS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707

3226 (Rev. 12/20)AFFIDAVIT FOR MAINTENANCE, CUSTODY ETC - DOMESTIC RELATIONS

AFFIDAVIT IN SUPPORT AFFIDAVIT IN RESPONSE TO

PETITION FOR MAINTENANCE, CUSTODY, CHILD SUPPORT, ATTORNEY'S FEES AND COURT COSTS (STRIKE OUT INAPPROPRIATE PORTIONS)

B. This child(ren) in the custody of at (location)

File Stamp Here

vsCASE NUMBER

being first duly sworn, states as follows:

UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT

PETITIONER

RESPONDENT

IN RE THE MARRIAGE OF

of 2

1. That is the in the above entitled matter.2. The parties have been married years; the wife's age is ; and the husband's age is .3. The parties have been separated months, during which the has paid $ to the

4. Facts concerning the child(ren) of the parties as follows:A. The child(ren) of the parties, aged respectively

C. For the best interest of the child(ren) custody should be awarded to

D. The has minor child(ren) by a previous marriage. 5. The property of the parties, its market value and encumbrances are:

ITEM

MARKET VALUE

he

wifehusband wife.

husband

she petitioner respondent

respondentpetitioner

HUSBAND WIFE JOINT TENANCY ENCUMBRANCES

HomesteadOther realtyHousehold goodsAutomobilesStock, bonds, notesCash and bank creditsClaims, accounts receivable

$

$

$

$

$

$

$

$

$

$

$

$

$

$ $

$

$

$

$

$

$

$

$

$

$

$

$

$

TOTALS

6. A. Unsecured debts of husband not included in above B. Unsecured debts of wife not included in above C. Unsecured joint debts not included in above

$$$$

$

$

$

CANDICE ADAMS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707

3226 (Rev. 12/20)AFFIDAVIT FOR MAINTENANCE, CUSTODY ETC - DOMESTIC RELATIONS

11. A. Husband's total income after deductions is monthly

Signed and sworn to before me

Date

Circuit Clerk or Notary Public

of 2

7. The necessary weekly - monthly expenses are:

G. UtilitiesF. FoodE. FuelD. Personal contact paymentsC. Realty contract paymentsB. Realty TaxesA. Rent

H. InsuranceI. ClothingJ. TransportationK. Mecidal and dental

CHILD (IF SEPARATE)

$

$

$

$

$

$

$

$

WIFE

$

$

$

$

$

$

$

$

HUSBAND

$

$

$

$

$

$

$

$

$$$

$$$

$$$

TOTAL $ $ $

8. Husband's EmployerNameAddress Phone

Gross Income $ Itemized deductions $

10. The family home contains bedrooms; is by the parties and is now occupied by

12. A. Reasonable amount for support for child(ren) is $ per .

15. is reasonable for wife's temporary attorney fees plus for disbursements.16. State additional material facts. If any, respondent should set forth facts in answer thereto.

NameAddressGross Income $

PhoneItemized deductions $

rentedowned

weekly

B. Wife's total income after deductions is weekly monthly

$

C. Child(ren)'s total income after deductions is monthlyweekly$

$

month week

B. Reasonable amount for temporary alimony is $ per . monthweek C. The dates for payment should be

D. Husband's necessary living expenses will be .13. has been paid on husband's attorney fees and disbursements.14. has been paid on wife's attorney fees and disbursements.

$

$

$ $

monthlyweekly $

Name: DuPage Attorney Number: Attorney for: Address: City/State/Zip: Telephone Number:

Pro Se

Email:

9. Wife's Employer

affidavit in support affidavit in response to

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