• you are a party in a new divorce, legal separation, civil union dissolution, annulment or parentage case and you have minor children with the other party
• you or the other party are trying to change your support order
• you are ordered to pay support and the other party has filed to enforce the support order
• the other party has asked you to fill it out as part of your divorce/dissolution case
• the other party has asked, in writing, once a year, for you to fill it out and there is an ongoing child support order
• you have been ordered by the court to fill out this affidavit 

This form takes a long time to fill out. Gather your income, expense and asset information first.

Information Checklist

Before you start, you will need to gather: 

• information about your income, including copies of your income tax returns from the past 2 years and your last 4 pay stubs (if any)
• documentation of any other income you receive
• information about the cost of your health insurance plan (contact your insurance provider or employer for information about what it would cost for you alone and what insurance would cost for you and your children)
• information about your regular monthly household expenses for housing, food, clothing, etc.
• the amount you actually pay for each expense every month if another member of your household shares the monthly household expenses
• documentation (bills or credit card statements, for example) of debts that require regular monthly payments
• information about your business income and expenses, if you own your own business
• information about rent you receive and expenses, if you own rental property
• all other information about your income, expenses and debts

PDF Version of the Form to Print or Fill Out

This is the PDF version of Form 813A - Financial Affidavit: Income and Expenses.

Learn about the divorce process and watch short videos, and get all the forms you need on our Divorce Roadmap.

Find more family court forms on the Vermont Judiciary website.