Form 6. Default Information for Spousal Maintenance
Arizona Revised Statutes AnnotatedRules of Family Law Procedure
17B A.R.S. Rules Fam.Law Proc., Form 6
Form 6. Default Information for Spousal Maintenance
(To be included with an Application for Default if spousal maintenance is requested with
your petition and you choose to proceed by motion without a hearing.)
To qualify for spousal maintenance under A.R.S. § 25-319, you must provide the following information. Check all boxes that apply.
I lack sufficient property, including property I will be receiving in the dissolution, to provide for my reasonable needs.
I am unable to be self-sufficient through appropriate employment.
I am unable to earn enough money to support myself.
I am the custodian of a child whose age or condition is such that I should not be required to seek employment outside the home.
I contributed to the educational opportunities of my spouse.
My marriage has lasted __________ years.
I am __________ years old.
There have been excessive or abnormal expenditures, destruction, concealment or fraudulent disposition of community, joint tenancy and other property held in common.
There are actual damages and judgments from conduct resulting in criminal conviction of either you or your spouse in which the other spouse or child was the victim.
If the court finds you qualify for spousal maintenance, it will need the following information in determining the appropriate amount and duration. To assist the court, please answer the following:
Complete this financial statement.
NECESSARY MONTHLY EXPENSES (For yourself and minor children who reside with you)
House (mortgage/rent) | $__________ |
Repair/Upkeep | $__________ | MONTHLY PAYMENTS/DEBTS |
Utilities | Creditor | Balance | Payment |
Electricity | $__________ | $ | $ | |
Gas | $__________ | $ | $ | |
Water & Sewer | $__________ | $ | $ | |
Phone | $__________ |
Garbage | $__________ | Total Monthly Payments | $ |
Food & Household | Total Expenses, Payments | ||
Supplies | $__________ | $ | |
Work/School Lunch | $__________ | ||
Medical, dental, drugs, supplies | $__________ | INCOME | |
Insurance not deducted from pay | $__________ | GROSS PAYCHECK | |
weekly twice mo.* | $ | ||
Clothing | $__________ | monthly every 2 weeks | $ |
Laundry/Dry Cleaning | $__________ | *For example, the 1st and 15th | $ |
Childcare/Sitter | $__________ | Less: Federal Taxes | $ |
Support paid for spouse and/or minor children of prior relationship | $__________ | Less: State Taxes | $ |
SS & Medicare | $ | ||
Insurance | $ | ||
Car Repair/Maintenance | $__________ | Savings, etc. | $ |
Car Insurance | $__________ | Other __________ | $ |
Gas/Oil | $__________ | Other __________ | $ |
Vehicle License | $__________ | $ | |
Public Transportation | $__________ | Total Deductions | $ |
Other _______________ | $__________ | ||
$__________ | Net Paycheck | $ | |
Total Monthly Expenses | $__________ | ||
TOTAL GROSS MONTHLY INCOME$_________________________ |
Credits
Added Aug. 30, 2018, effective Jan. 1, 2019.
17B A. R. S. Rules Fam. Law Proc., Form 6, AZ ST RFLP Form 6
State Court Rules are current with amendments received through April 1, 2024. The Code of Judicial Administration is current with amendments received through April 1, 2024.
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