FINANCIAL STATEMENTS

Supreme Court Family Rule 5-1 – Financial Disclosure, sets out what documents must be produced, which parties are required to file a financial statement and when the various parts of the document are applicable.

There is no fee to file a Financial Statement, however, this document must be sworn by a commissioner for taking affidavits. If you wish to have your document sworn at the court registry, the fee is $40.00.

The following information is included in this package:1) Supreme Court Rule 5-1 – Financial Disclosure2) Form F8 – Financial Statement.

Rule 5-1 — Financial Disclosure

Interpretation

Interpretation

(1)  In this rule:

"applicable income documents" means, in respect of a person,

(a) a copy of every personal income tax return filed by the person for each of the 3 most recent taxation years,

(b) a copy of every notice of income tax assessment or reassessment issued to the person for each of the 3 most recent taxation years,

(c) if the person is receiving employment insurance benefits, a copy of the 3 most recent employment insurance benefit statements,

(d) if the person is receiving workers' compensation benefits, a copy of the 3 most recent workers' compensation benefit statements,

(e) if the person is receiving social assistance, current documentary evidence of the social assistance that is being received by that person,

(f) if the person is an employee,(i)  the most recent statement of earnings indicating the total earnings paid to the person in the year to date, including overtime, or (ii)  if that statement is not provided by the employer, a letter from the person's employer setting out the information referred to in subparagraph (i) and including the person's rate of annual salary or remuneration,

(g) if the person is self employed, the following information for the 3 most recent taxation years:

(i)  the financial statements of the person's business or professional practice, other than a partnership; (ii)  a statement showing a breakdown of all salaries, wages, management fees or other payments or benefits paid to, or on behalf of, persons or corporations with whom the person does not deal at arm's length,

(h) if the person is a partner in a partnership, confirmation of the person's income and draw from, and capital in, the partnership for each of its 3 most recent taxation years,

(i) if the person controls a corporation, the following information for the corporation's 3 most recent taxation years:

(i)  the financial statements of the corporation and its subsidiaries; (ii)  a statement showing a breakdown of all salaries, wages, management fees or other payments or benefits paid to, or on behalf of, persons or corporations with whom the corporation and every related corporation does not deal at arm's length,

(j) if the person is a beneficiary under a trust, a copy of the trust settlement agreement and copies of the trust's 3 most recent financial statements, and

(k) if the person owns or has an interest in real property, a copy of the most recent assessment notice issued from an assessment authority for each property;

"child support guidelines" means,

(a) in reference to a claim under the Family Law Act, the child support guidelines established under the Family Law Act, or

(b) in reference to a claim under the Divorce Act, the child support guidelines established under the Divorce Act;

"party" means a person named as a party to a family law case who is claiming, or against whom is claimed,

(a) an order for child support or an order changing, suspending or terminating an order for child support,

(b) an order for spousal support or an order changing, suspending or terminating an order for spousal support,

"social assistance" includes

(a) income assistance within the meaning of the Employment and Assistance Act, and

(b) disability assistance within the meaning of the Employment and Assistance for Persons with Disabilities Act;

"stepparent" means, in relation to a child,

(a) a stepparent of the child within the meaning of section 146 of the Family Law Act, or

(b) a person who stands in the place of a parent for the child within the meaning of the Divorce Act.

Application of this rule

(2)  This rule applies to a family law case as follows:

(a) if, in the family law case, a person is seeking to obtain or to change, suspend or terminate an order for child support, subrules (1), (3) to (8) and (11) to (32) apply;

(b) if, in the family law case, a person is seeking to obtain, review or change, suspend or terminate an order for spousal support, subrules (1), (3), (9) and (11) to (32) apply;

(c) if, in the family law case, a person is seeking to obtain or to change, suspend or terminate an order for relief under Part 5 of the Family Relations Act, subrules (1), (3) and (10) to (32) apply.

(d) if, in the family law case, a person is seeking to set aside or replace the whole or any part of that portion of an agreement that deals with child support, subrules (1), (3) to (8) and (11) to (32) apply;

(e) if, in the family law case, a person is seeking to review, set aside or replace the whole or any part of that portion of an agreement that deals with spousal support, subrules (1), (3), (9) and (11) to (32) apply.,

Numbering applicable income documents

(3)  Each page of the applicable income documents that are to be used in court must be numbered sequentially.

Claims for Child Support

Who must provide Part 1 of a Form F8 financial statement

(4)  Each party who is required under the child support guidelines to provide income information must file the following documents and must serve them under subrule(11):

(a) Part 1 of a Form F8 financial statement;

(b) the party's applicable income documents;

(c) any other documents that the party is required to file and serve under subrules (5) to (7).

Who must provide Parts 2 and 3 of a Form F8 financial statement

(5)  In addition to any other documents a party is obliged to file and serve under this rule, the party must file Parts 2 and 3 of a Form F8 financial statement and must serve those documents under subrule (11), if one of the following is true:

(a) the child support guidelines require the court to consider any or all of the following:

(i)  the financial ability of the parties; (ii)  the means of the parties; (iii)  the condition, means, needs and other circumstances of the parties or the child;

(b) the party who is to pay the child support is a stepparent of the child.

If special or extraordinary expenses are claimed

(6)  A party who makes a claim for special or extraordinary expenses must

(a) file Part 4 of a Form F8 financial statement, in addition to any other documents the party is obliged to file under this rule, and

(b) serve that Part 4 under subrule (11).

["Special or extraordinary expenses" is defined in section 7 of the child support guidelines.]

If undue hardship is claimed

(7)  In addition to any other documents that a party is obliged to file and serve under this rule, if a claim for undue hardship is made,

(a) the party making the claim for undue hardship must file and serve, under subrule (11), Parts 1, 2, 3, 5 and 6 of a Form F8 financial statement along with that party's applicable income documents, and

(b) unless the court otherwise orders, a party other than the party making the claim for undue hardship must file and serve, under subrule (11), Parts 1, 2, 3 and 6 of a Form F8 financial statement along with that party's applicable income documents.

["Undue hardship" is defined in section 10 of the child support guidelines.]

Agreement avoids need for documents

(8)  Parties are deemed to have complied with the requirements of the child support guidelines respecting the provision of documents, and with the requirements of this rule, as it applies to child support, respecting the filing and service of documents, if

(a) the parties have agreed on the annual income of the party who is to pay the child support,

(b) the parties have signed an agreement in Form F9, and

(c) the agreement in Form F9 has been filed together with the documents referred to in that agreement.

Applications for Spousal Support

Who must provide income documents

(9)  In addition to any other documents a party is obliged to file and serve under this rule, a party must file Parts 1, 2 and 3 of a Form F8 financial statement along with the party's applicable income documents, and must serve those Parts and applicable income documents under subrule (11), if one of the following is true:

(a) the party is seeking to obtain a spousal support order;

(b) the party is seeking to change, suspend or terminate a spousal support order;

(c) a spousal support order is being sought against the party;

(d) a spousal support order has been obtained against the party and another party is seeking to change, suspend or terminate that order.

Applications for Division of Assets

Who must provide Part 3 of a Form F8 financial statement

(10)  Each party who is making a claim under Part 5 of the Family Relations Act or against whom such a claim is being made must

(a) file Part 3 of a Form F8 financial statement, in addition to any other documents that the party is obliged to file under this rule, and

(b) serve that Part 3 under subrule (11).

Service

When party must file and serve documents

(11)  A party who is obliged to file documents under subrule (4), (5), (6), (7), (9) or (10) (in this subrule called the "disclosing party") must file all of those documents that have not already been filed, and serve on each of the other parties all of those documents that have not already been served on that party, as follows:

(a) if the disclosing party's obligation arises because of a claim he or she made, he or she must file and serve those documents within 30 days, or such other period as the court may order, after service of the document in which the claim is made;

(b) if the disclosing party's obligation arises because of a claim made by another party and the disclosing party resides in Canada or the United States of America, the disclosing party must file and serve those documents within 30 days, or such other period as the court may order, after service of the document in which the claim is made;

(c) if the disclosing party's obligation arises because of a claim made by another party and the disclosing party resides in a country other than Canada or the United States of America, the disclosing party must file and serve those documents within 60 days, or such other period as the court may order, after service of the document in which the claim is made.

Assessment Notice

Assessment notice to be included

(12)  If Part 3 of a Form F8 financial statement is to be served on a party under this rule, the party serving the Part 3 must, if that party owns or has an interest in real property, serve, with the Part 3, the most recent

assessment notice prepared for that real property by an assessment authority unless that assessment notice has already been served.

Particulars of Form F8 Financial Statements

Particulars may be demanded

(13)  If a Form F8 financial statement lacks sufficient information, the other party may demand particulars.

Court may order particulars

(14)  If the party from whom particulars are demanded under subrule (13) fails to provide those particulars within 7 days after receipt of the demand, the court may, on terms it considers appropriate, make any order it considers will further the object of these Supreme Court Family Rules, including

(a) an order that particulars be served within a specified time, or

(b) an order that a new Form F8 financial statement be served within a specified time.

Changes in Financial Circumstances

Information must be kept current

(15)  If information contained in a document filed and served under this rule is rendered inaccurate or incomplete by a material change in circumstances, the party who filed and served that document must, promptly after that material change, serve on all parties

(a) a written statement setting out the accurate and complete information, or

(b) a revised Form F8 financial statement containing the accurate and complete information.

Additional documents

(16)  If the material change in circumstances referred to in subrule (15) is such that the party becomes obliged to file and serve documents under

this rule that are additional to the documents previously filed and served under this rule by that party, the party must

(a) serve copies of those additional documents within 28 days after the material change, and

(b) comply with subrule (15) in relation to the previously served documents.

If written statement or particulars provided

(17)  If a party provides particulars under subrule (13) or (14) (a) or serves a written statement under subrule (15) (a),

(a) the particulars or statement may be treated at a trial or hearing as forming part of the original Form F8 financial statement of the party, and

(b) the other party may, with leave of the court, require that the particulars or statement be

(i)  verified by an affidavit of the party providing the particulars or serving the statement, or (ii)  the subject of further cross-examination.

Updated statements

(18)  A party who has served a Form F8 financial statement more than 91 days before the start of the trial or hearing of an application to which a Form F8 is relevant must serve on all parties an updated Form F8 financial statement at least 28 days before but not more than 63 days before the start of the trial or hearing.

Disclosure of Business Interests

Production of documents

(19)  If a party discloses business or corporate interests in a Form F8 financial statement served under this rule, the party receiving the Form F8 financial statement may, in writing, request the disclosing party to produce for inspection and copying specified documents or classes of

documents in the disclosing party's possession or control that might reasonably be required to verify the valuation of the disclosing party's interest or to determine the disclosing party's income.

Responding to demand

(20)  A party who receives a request under subrule (19) must, within 21 days after receipt, serve on the requesting party a notice stating

(a) a time and place, during normal business hours, at which the documents may be inspected, and

(b) the cost of copying the documents.

Request to corporation, partnership or proprietorship

(21)  If a party who makes a request under subrule (19) is not satisfied with the reply to the request, the requesting party may serve on the corporation, partnership or proprietorship in which the disclosing party has disclosed an interest a written request to produce for inspection all documents that are relevant to the valuation of the interest or the determination of the disclosing party's income.

Production required

(22)  A corporation, partnership or proprietorship that receives a request under subrule (21) must, within 21 days after receipt, provide a written statement to the requesting party

(a) detailing the documents in its possession or control that it is obliged to produce in response to the request,

(b) identifying those documents, if any, in respect of which the corporation, partnership or proprietorship intends to seek an exemption under subrule (24),

(c) specifying a time and place at which the documents for which an exemption is not being sought may be inspected, and

(d) specifying the cost of copying the documents for which an exemption is not being sought.

Application to court for directions

(23)  A corporation, partnership or proprietorship or either of the parties may apply to the court at any time for directions respecting any request for production of documents under subrule (19) or (21), including directions respecting payment of the costs of copying the documents, and the court may give those directions accordingly.

Application to court for exemption

(24)  A corporation, partnership or proprietorship may, within 21 days after the date a request is served on it under subrule (21), apply to the court for an order exempting it from the requirement to produce any document.

Application by person authorized

(25)  An application under subrule (23) or (24) may be made on behalf of a corporation or partnership by a person who has been authorized by the corporation or partnership for that purpose.

Court may order exemption

(26)  On an exemption application under subrule (24), the court may make an order exempting the applicant from the requirement to produce all or any of the requested documents if the court considers that

(a) the documents and information already received by the party who made the request under subrule (21) are sufficient for the purposes of the main application,

(b) the production of the documents is not necessary for the purposes of the main application,

(c) in the case of a corporation, the prejudice that is likely to be suffered by the corporation, or to its directors or shareholders, if the exemption is not granted outweighs the prejudice that is likely to be suffered by the person requesting the documents if the exemption is granted, or

(d) in the case of a partnership, the prejudice that is likely to be suffered by the partnership, or to its partners or associates, if the exemption is not granted outweighs the prejudice that is likely to be suffered by the person requesting the documents if the exemption is granted.

Costs

(27)  The court may order that the costs of producing documents under subrule (20) or (22) and the costs of an application under subrule (23) or (24) be paid in favour of or against

(a) either of the parties to the family law case, or

(b) the corporation, the partnership or the owner of the proprietorship, as the case may be.

Enforcement of this Rule

Relief

(28)  Without limiting Rule 21-5 and any other powers the court may have under the Family Law Act, if a party fails to comply with a requirement under this rule to file or serve a Form F8 financial statement or any applicable income document or fails to comply with an order under this rule to provide particulars, the court may do any or all of the following:

(a) order that the Form F8 financial statement, applicable income document or particulars, as the case may be, be filed or served or both on terms the court considers appropriate;

(b) dismiss all or part of that party's claim or application;

(c) strike out all or part of that party's response to family claim or response to counterclaim;

(d) proceed under Rule 21-7 to punish the party for contempt of court;

(e) impose a fine under section 213(2)(d)(iii) of the Family Law Act;

(f) draw an adverse inference against the party;

(g) attribute income to that party in an amount the court considers appropriate;

(h) make an order as to costs.

[Rule 21-5 sets out what the court may do if parties fail to comply with these rules.]

Confidentiality of Information

Confidentiality

(29)  Any person who has access to documents obtained under this rule must keep the documents and any information contained in them in confidence and must not disclose the documents or information to anyone other than

(a) for the purposes of a valuation of an asset,

(b) for a determination of the disclosing party's income, or

(c) in the course of permitting the documents to be introduced into evidence during the family law case.

Sealing of financial information

(30)  If the court considers that public disclosure of any information filed under this rule would be a hardship on the person in respect of whom the information is filed,

(a) the court may order that the whole or any part of the document in which the information is contained, and the whole or any part of the transcript of the cross-examination on the document, must promptly be sealed in an envelope, and

(b) if an order is made under paragraph (a), no person may search the sealed documents without an order of the court.

Conflict with Guidelines

Child support guidelines prevail

(31)  If and to the extent that there is a conflict between any provision of this rule and a provision of the child support guidelines, the provision of the child support guidelines prevails.

No conflict

(32)  For the purposes of subrule (31), it is not a conflict between the child support guidelines and this rule merely because this rule

(a) requires a person to provide information that is different from or additional to the information, if any, that that person would be obliged to provide under the child support guidelines,

(b) requires that certain information required by this rule but not by the child support guidelines be presented in a manner or form that is different from the manner or form in which information required under the child support guidelines is to be presented, or

(c) requires the provision, in one manner or form, of information some or all of which is required under the child support guidelines to be provided in a different manner or form.

Form F8This is the .......... affidavit

of .................................. in this caseand was made on ..................................

Court File No.: .................................Court Registry: .................................

In the Supreme Court of British Columbia

Claimant:

Respondent:

FINANCIAL STATEMENT

Instructions For Completion

You do not need to complete this form if ALL of the following apply:

a) you are applying for child support but are making no claim for any other kind of support;

b) the child support is for children who are not stepchildren;

c) none of the children for whom child support is claimed is 19 years of age or older;

d) the income of the party being asked to pay child support is under $150 000 per year;

e) you are not applying for special expenses under section 7 of the child support guidelines;

f) you are not applying for an order under section 8 of the child support guidelines;

g) you are not applying for an order under section 9 of the child support guidelines;;

h) you are not making a claim based on undue hardship under section 10 of the child support guidelines.

Unless ALL of the conditions above apply, you must swear the following affidavit and complete the Parts of this Form that the following chart indicates apply to you.

This Form has 6 Parts. You may not have to complete all Parts. Which Parts you have to complete depends on which categories of application apply to you as set out in the following chart.

Please check off each of the Items, 1 through 8, that apply to you and then complete the Parts that are noted for those Items. Each required Part need be completed only once regardless of the number of applicable Items for which it is required.

Item Category Part 1 Part 2 Part 3 Part 4 Part 5 Part 61 I am applying for spousal support

2 I am being asked to pay spousal support.

3 I am being asked to pay child support and all of the following conditions apply:

a) There is no claim for special expenses under section 7 of the child support guidelines;

b) The child support is only for children who are not step children;

c) None of the children for whom child support is claimed is 19 years of age or older;

d) There is no application for an order under section 9 of the child support guidelines;

e) My income is under $150, 000 per year;

f) There is no claim based on undue hardship under section 10 of the child support guidelines.

4 I am applying for or being asked to pay child support and one or more of the following conditions apply:

a) One or more of the children is a stepchild;

b) One or more of the children for whom child support is claimed is 19 years of age or older;

c) There is an application for an order under section 9 of

the child support guidelines;d) The income of the party

being asked to pay child support is more than $150,000 per year

5

I am being asked to pay child support and I intend to make a hardship claim under the child support guidelines.

6

I am applying for child support and the opposite party intends to make a hardship claim under the child support guidelines.

7

Either I claim child support or I am being asked to pay child support and there is a claim for special expenses under section 7 of the child support guidelines

8 I am making or responding to a property claim under Part 5 of the Family Law Act.

I, ............................................................................................................................................., of [name]

......................................................................................................................................................, [address for service]

SWEAR (OR AFFIRM) THAT:

1. The information set out in this financial statement is true and complete to the best of my knowledge.

[Check whichever of the following boxes is correct and complete any required information.]

2. I do not anticipate any significant changes in the information set out in this financial statement.

I anticipate the following significant changes in the information set out in this financial statement:

...................................................................................................................

SWORN (OR AFFIRMED) BEFORE )ME at ............................, British Columbia )on ..................................................... . ) .............................................................

)))

............................................................. )

A commissioner for taking )affidavits for British Columbia )

.[print name or affix stamp of commissioner].

PART 1 – INCOME

A. Employer information:

I am employed by .......................................................................................... [name and address of employer]

I am self employed as ................................................................................... [trade or occupation]

I operate an unincorporated business, the name and address of which is

........................................................................................................................ [name and address of business]

B. Documentation supplied:

I have attached to this statement or serve with it a copy of each of the following applicable income documents

[Check the first 2 boxes and check each other box that applies to you and provide the documents referred to beside each checked box]:

every personal income tax return, including all attachments, that I have filed for each of the 3 most recent taxation years;

every income tax notice of assessment or reassessment I have received for each of the 3 most recent taxation years;

[if you are an employee] my most recent statement of earnings indicating the total earnings paid in the year to date, including overtime, or, if such a

statement is not provided by me employer, a letter from my employer setting out that information, including my rate or annual salary or remuneration;

[if you are receiving Employment Insurance benefits] my 3 most recent EI benefit statements;

[if you are receiving Workers’ Compensation benefits] my 3 most recent WCB benefit statements;

[if you are receiving social assistance] a statement confirming the amount of social assistance that I receive;

[if you are self-employed] for the 3 most recent taxation years

(i) the financial statements of my business or professional practice, other than a partnership, and

(ii) a statement showing a breakdown of all salaries, wages, management fees or other payments or benefits paid to, or

on behalf of, persons or corporations with whom I do not deal at arm’s length;

[if you are in a partnership] confirmation of my income and draw from, and capital in, the partnership for its 3 most recent taxation years;

[if you control a corporation] for the corporation’s 3 most recent taxation years

(i) the financial statements or the corporation and its subsidiaries, and

(ii) a statement showing a breakdown of all salaries, wages, management fees or other payments or benefits paid to, or

on behalf of, persons or corporations with whom the corporation and every related corporation does not deal at arm’s length;

[if you are a beneficiary under a trust] the trust settlement agreement and the trust’s 3 most recent financial statements;

[if you own or have an interest in real property] the most recent assessment notice issued from an assessment authority for the property.

NOTE: If the applicable income documents are not attached to or served with this financial statement, they must nonetheless be provided to the other party if and as required by Rule 5-1 of the Supreme Court Family Rules.

C. Annual Income

If line 150 (total income) of your most recent federal income tax return sets out what you expect your income will be for this year and you are not obliged under Note 1 below to complete Schedule A of this Form, ignore lines 1 to 7 below and record the number from line 150 of your most recent federal income tax return at line 8 below. Otherwise, record what you expect your income for this year to be from each of the following sources of income that applies to you. Record gross annual amounts.

LINE GUIDELINE INCOME FOR BASIC CHILD SUPPORT CLAIMSources and amounts of annual income

1 Employment income ($..................................) paid: monthly / twice each month / every 2 weeks) +

2 Employment insurance benefits +3 Workers’ compensation benefits +4 Interest and investment income +5 Pension income +6 Social assistance income relating to self +7 Other income (attach Schedule A) – see Note 1 +8 Child support guidelines income before adjustments

[If you are required to complete lines 1 through 7 above, total the amounts of those lines here. Otherwise, record the number from

line 150 of your most recent federal income tax return]

=

Adjustments to income9 Subtract union and professional dues - ( )

10 Adjustments in accordance with Schedule III of the child support guidelines per line 8 of Schedule B (attached) – see Note 2

+- ( )

11 Child support guidelines income for basic child support(line 8 as adjusted by lines 9 and 10) =

CHILD SUPPORT GUIDELINE INCOME TO DETERMINE SPECIAL EXPENSESChild support guidelines income (from line 11 of this table)

12 Add spousal support received from the other party to the family law case +

13 Subtract spousal support paid to the other party to the family law case - ( )

14 Add Universal Child Care Benefits relating to children for whom special or extraordinary expenses are sought +

15 Child support guidelines income to determine special expenses(line 11 as adjusted by lines 12, 13 and 14) =

INCOME TO BE INCLUDED FOR SPOUSAL SUPPORT CLAIMChild Support guidelines income (from line 11 of this table)

16 Total child support received +17 Social assistance received for other members of household +18 Child Tax Benefit and BC Family Bonus +19 Total income to be used for a spousal support claim

(line 11 plus lines 16, 17 and 18)=

Note:

1. You must complete Schedule A of this Form and include, at line 7 above, the total income recorded at line 11 of Schedule A, if you expect to receive

income this year from any of the following sources:

(a) taxable dividends from Canadian corporations;

(b) net partnership income (limited or non-active partners only);

(c) rental income;

(d) taxable capital gains;

(e) registered retirement savings income;

(f) self-employment income;

(g) any other taxable income that is not included in paragraphs (a) to (f) or in lines 1 to 5 of Schedule A.

2. If there are any adjustments as set out in Schedule III of the child support guidelines that apply to you, you must

(a) complete Schedule B of this Form, and

(b) include at line 10 above, the amount recorded at line 8 of that completed Schedule B.

SCHEDULE A – OTHER INCOME

LINE OTHER SOURCES OF INCOME1 Self employment income: Gross = $............;

Net = $.............

Note: Provide financial statements of the business, including any statement of business activities filed as part of your income tax return

+

2 Other employment income +3 Net partnership income: limited or non-active partners only +4 Rental income: Gross = $............;

Net = $............ +5 Total amount of dividends from Taxable Canadian Corporations +6 Total capital gains ($...............)

minus total capital losses ($............) = +7 Spousal support from another relationship or marriage +8 Registered retirement savings plan income +9 Net federal supplements +

10 Any other income +11 Total of lines 1 through 10 +

SCHEDULE B – ADJUSTMENTS TO INCOME

LINE DEDUCTIONS1 Employment expenses, other than union or professional dues,

claimed under Schedule III of the child support guidelines [list]-

................................................ $...............

................................................ $...............

Total $...............

2 Actual business investment losses during the year -3 Carrying charges and interest expenses paid and deductible under

the Income Tax Act (Canada): [list]

................................................ $...............

................................................ $...............

Total $...............

-

4 Prior period earnings ($.............) minus reserves ($...........) = -5 Portion of partnership and sole proprietorship income required to be

re-invested-

ADDITIONS6 Capital cost allowance for real property +7 Employee stock options in Canadian-controlled private corporations

exercised: value of shares when options exercised ($...........) minus amount paid for shares ($............) minus amount paid to acquire option ($.............)= +

8 Total adjustments

PART 2 – MONTHLY EXPENSES

MonthlyCompulsory deductionsCPP contributionsEI premiumsIncome taxesEmployee pension contributionsOther [specify]

Compulsory Deductions Sub-totalHousingRent or mortgageProperty taxesProperty insuranceWater, sewer, garbageStrata feesHouse repairs and maintenanceOther [specify]

Housing Sub-totalUtilitiesHeat and electricityTelephone

Cellular telephoneCable TVInternet serviceOther [specify]

Utilities Sub-totalHousehold expensesFoodHousehold suppliesMeals outside the homeFurnishings and equipmentOther [specify]

Household expenses Sub-totalTransportationPublic transit, taxisGas and oilCar insurance and licenceParkingRepairs and maintenanceLease paymentsOther [specify]

Transportation Sub-totalOtherCharitable donationsVacationPet careNewspapers, publicationsOther [specify]

Other Sub-totalHealthMSP premiumsExtended health premiumsDental plan premiumsHealth care (net of coverage)Drugs (net of coverage)Dental care (net of coverage)Other [specify]

Health Sub-totalPersonalClothingHair CareToiletries, cosmeticsEducation [specify]Life insuranceDry cleaning/laundryEntertainment/recreationGiftsOther [specify]

Personal Sub-totalChildren

Child careClothingHair careSchool fees and suppliesEntertainment/recreationActivities and lessonsGiftsInsuranceOther [specify]

Children Sub-totalSavingsRRSPRESPOther [specify]

Savings Sub-totalSupport payments to others[specify]

Support payments to others Sub-totalDebt payments[specify minimum monthly payments]

Debt payments Sub-totalTOTAL MONTHLY EXPENSES

TOTAL ANNUAL EXPENSES[multiply TOTAL MONTHLY EXPENSES by 12]

PART 3 – PROPERTY

ASSETS

Assets Details Date Acquired[dd/mmm/yyyy]

Value

1. Real estate Attach a copy of the most recent

assessment notice for any property that you own or in which you have an interest.

Provide details, including address or legal description and nature of interest, or any interest you have in land, including leasehold interests and mortgages, whether or not you are registered as owner.

Record the estimated market value of your interest without deducting encumbrances or costs of disposition.[Record encumbrances under DEBTS below.]

Real estate Sub-total2. Vehicles

List cars, trucks, motorcycles, trailers, motor homes, boats, etc.

Vehicles Sub-total3. Financial assets

List savings and chequing accounts, term deposits, GIC’s, stocks, bonds, Canada Savings Bonds, mutual funds, insurance policies [indicate beneficiaries], accounts receivable, etc.

Record account number and name of institution where accounts are held.

Financial assets Sub-total4. Pensions and RRSP’s

Record name of institution where accounts are held, name and address of pension plan and pension details.

Pension and RRSP’s Sub-total5. Business interests

List any interest you hold, directly or indirectly, in any unincorporated business, including partnerships, trusts and joint ventures.

List any interests you hold in incorporated businesses.

Record the name and address of the company.

Business interest Sub-total6. Other

Include precious metals, collections, works of art and any jewellery or household items of extraordinary value.

Include location of safety deposit boxes

Other Sub-totalTOTAL

DEBTS

Show your debts and other liabilities, whether arising from personal or business dealings, by category, such as mortgages, charges, liens, notes, credit cards, accounts payable and tax arrears. Include contingent liabilities such as guarantees and indicate that they are contingent.

Debt Details Date Incurred[dd/mmm/

yyyy]

Amount

Secured debts Mortgages

Other (specify)Secured debts Sub-total

Unsecured debts Bank loans Personal loans Credit cards [list] Other [specify]

Unsecured debts Sub-totalTOTAL

DISPOSAL OF PROPERTY

List all real and personal property disposed of during the 2 years preceding this statement or, if the parties married within that 2 year period, since the date of marriage.

Description[describe the property disposed of]

Date of Disposal[dd/mmm/yyyy]

Value

PART 4 - SPECIAL OR EXTRAORDINARY EXPENSES

Note:1. Provide a separate statement under this Part 4 for each child for whom a claim is

made.

2. To calculate a net amount, subtract, from the gross amount, subsidies, benefits, income tax deductions or credits relating to the expense.

Name of child: AnnualGross

Annual Net

MonthlyGross

MonthlyNet

Child care expensesMedical/dental insurance premiums attributed to childHealth related expenses that exceed insurance reimbursement by at least $100Extraordinary expenses for primary or secondary schoolPost-secondary education expensesExtraordinary extracurricular expenses [list]

Subtract contributions from child ( ) ( ) ( ) ( )TOTAL

PART 5 – UNDUE HARDSHIP

1. Responsibility for unusually high debts reasonably incurred to support the family prior to separation or in order to earn a living

Owed to: Terms of debt: Monthly Amount [list] [provide details] $.............

Total $.............

2. Unusually high expenses for exercising parenting time or contact with, or access to, a child

Details of expense Amount [list] $.............

Total $.............3. Legal duty under a court order or separation agreement to support another person

Name of person Relationship Nature of duty

4. Legal duty to support a child, other than a child for whom support is claimed, who is (a) under age 19, or (b) 19 or older but unable to support himself or herself because of illness, disability or other cause

Name of person Relationship Nate of duty

5. Legal duty to support a person who is unable to support himself or herself because of illness or disability

Name of person Relationship Nature of duty

6. Other undue hardship circumstances [provide details]

PART 6 – INCOME OF OTHER PERSONS IN HOUSEHOLD

Name of person Annual Income

Total