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I hereby certify that, to the best of my knowledge, the disclosures I have made are complete and correct as of this
date._________________________________________________
Petitioner/Co-Petitioner/Respondent Signature Date
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Attorney Signature, if anyDate
You must complete the Certificate of Service below:
CERTIFICATE OF SERVICE
District Court Denver Juvenile Court
__________________ County, Colorado
Court Address:
In re:
The Marriage of: The Civil Union of:
Parental Responsibilities concerning:
Petitioner: |
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COURT USE ONLY |
and |
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Co-Petitioner/Respondent: |
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Attorney or Party Without Attorney (Name and Address): |
Case Number: |
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 |
Employment Benefits |
Documentation |
If I have not provided information, it is because: |
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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 R6/2016 CERTIFICATE OF COMPLIANCE WITH MANDATORY FINANCIAL DISCLOSURES © 2016Colorado Judicial Department for use in the Courts of Colorado