FORM 8:FINANCIAL APPLICATION FORM WITH EVIDENCE
The Republic of Trinidad & Tobago
In the High Court of Justice Petition/ Application No.
Family
Between
A.B.
Applicant
And
C.B.
Respondent
APPLICATION FOR FINANCIAL RELIEF
The applicant applies to the Court for an order for the following
financial provision for [her(him)self] [her(him)self and the children named below], [the children named below]
-
(Details of order sought)
(full names and dates of birth of any children
on whose behalf order sought)
Signed: (Applicant in person)
(Attorney for the Applicant)
whose address for service is as follows:
Postal Address:
FAX number:
Telephone number:
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NOTICE OF DIRECTIONS HEARING
Directions will be given relating to this application at the directions hearing on
(date) at (time)
at .
[Directions have already been given at the directions hearing on ]
The Court Office is at [ ],
telephone number xxx.xxxx, FAX number xxx.xxxx. The office is open between [8.00 am
and 4.00 p.m. every days except Public Holidays and on such days as the Court Office is
closed.
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EVIDENCE OF APPLICANT
I, of
make oath and say as follows:
hat the information set out below is correct to the best of my knowledge, information and belief:
(1) Date of Birth
(2) Date of marriage
(if not married length of cohabitation)
(3). Details of other proceedings relating to
the relationship: court order made date
(a) Divorce or Judicial Separation
(b) Maintenance
(c) Children issues
(d) Domestic Violence
(d) Other
(4) Full details of the children are set out in Form 2
(a) filed at the Court under case number xx.xxx OR
(b) filed with this application.
Details of my income
(5). Details of employment
(a) type of main employment
(b) name of employer
(c) address of employer
(d) if self employed give details of business
and of any people with whom you are in
partnership.
(d) gross pay/income $
per [week][month][year]
(e) normal take home pay/income $
per [week][month][year]
(f) what deductions are made for pension?
(6). Other income:
(a) State benefits $
per [week][month][year]
(b) voluntary maintenance $
per [week][month][year]
(c) maintenance under court order $
per [week][month][year]
Copy order exhibited marked 'A'
(d) income from investments $
per [week][month][year]
(e) rents received
per [week][month][year] $
(f) income from other work than main employment
per [week][month][year] $
Employment
(7) If not working:
(a) Are you looking for work?
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(b) Do you expect to look for work
within the next two years?
(c) What sort of work could you do?
(d) What qualifications have you?
(e) When did you last work?
(8) If working-
(a) how are any children cared for?
(b) what is the cost of child care?
(c) are you thinking about changing
your job within the next year? YES/NO
(d) are you likely to get promotion within YES/NO
next year?
[If answer to (c) or (d) 'yes' - give details]
Health
(9) Do you suffer from any health problems?
If so give details and state if they affect
your employment or ability to get work.
Cohabitation
(10) Are you living with any person other
than the respondent and any children?
(11) If so give details of any financial support
you receive from that person.
Expenditure
(12) What do you spend on - per [week][month][year]
House -
Mortgage Repayments
Life Insurance Premiums
Building Insurance Premiums
Contents Insurance Premiums
Rent
Land & building taxes
Water and sewerage charges
Electricity
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Cooking Gas
Telephone
Repairs and Decoration
Furniture/furnishing replacements
Personal Expenses
Food
Laundry/Cleaning
Medical/Dental/Optical
Clothing/Shoes
Hairdressing
General Housekeeping expenses
Help in house
Gardener/yard help
Entertainment
Holidays and Outings
Presents
Newspapers/Magazines
Other
Repayment of debts/loans etc.
Cost of working
Travel to work
Pension contributions
Union/Professional Body Subscriptions
Expenditure on Children
Food
General Clothing
School Uniform etc.
School fees
Lunch money
School books
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General school supplies
Extra tuition
Travel to School
Medical /Dental costs
Toys/Games/Sports
Outings
Holidays
Hairdressing
Presents
Pocket money
Child Care
Car
Insurance
Hire Purchase etc
Repairs/Servicing
Gas/Oil
Capital and other assets
(13) Is the house you live in -
(a) owned by you? YES/NO
(b) owned jointly with...................(name) of
...................................................(address)? YES/NO
(c) owned under a statutory lease? YES/NO
(d) rented? YES/NO
If owned:
(a) what do you think the house
is worth? $
(b) Is the house mortgaged? YES/NO
(c) Who is the lender?
(d) How much is owing on the mortgage? $
(e) Is there any other security (e.g. life insurance policy)? YES/NO
If so, give details
(i) name of insurance company
(ii) number of policy
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(iii) with or without profits
(iv) when due to mature
(iv) estimated value at maturity. $
(14). Do you own any other property? YES/NO
If so -
(a) in your sole name
(b) jointly with [give full name
and address]
(c) what do you think the house
is worth? $
(d) Is the house mortgaged YES/NO
(e) Who is the lender?
(f) How much is owing on the mortgage? $
(g) Is there any other security (e.g. life insurance policy)? YES/NO
If so, give details
(i) name of insurance company
(ii) number of policy
(iii) with or without profits
(iv) when due to mature
(iv) estimated value at maturity. $
(15) Do you own any stocks or shares? YES/NO
If so give details below or on a separate piece of paper:
details of stock/share
date bought
price paid
present estimated value.
(16) Do you have any money invested in-
Bank
Building Society
Life Insurance Policy
Business
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Unit Trusts
Credit Unions
Other
(if so, give details)
Bank Account
(17) Do you have a Bank Account? YES/NO
(1) (2) (3) (4)
If so -
name of bank
account number
type of account
present balance
Other assets
(18) Do you own a car YES/NO
if so give details -
Registration Number
Make and Model
Value
Outstanding loan.
(19) Do you have any other assets worth more than $2,500?
If so, give details
(a) Jewellery
(b) Antiques
(c) Paintings
(d) Works of Art.
(e) Boat
(f) Computer
(g) Other
Debts
(20) (a) Are you behind with -
Mortgage repayments? YES/NO
Rent? YES/NO
How much?
(b) have any steps been taken to repossess your house?
Do you owe
(c) debts to financial institution/bank/credit company/credit cards?
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if so, give details of -
(1) (2) (3) (4)
amount of debt
when borrowed
for what
amount outstanding
repayments $
per[week][month][year]
are any repayments in arrear?
(d) personal debts
give details.
Respondent
So far as you know -
(21) Is the respondent to this application working? YES/NO
If so
For whom?
What is his/her take home income $
per [week][month][year]?
Does he/she own/ have share in a business? YES/NO
If so, give details
If not working, could the Respondent work? YES/NO
What do you say the Respondent could
(a) do?
(b) earn?
Does the Respondent own a house? YES/NO
If so -
(a) address
(b) solely? or
(c) jointly with ___________
(d) what is value
(e) is it mortgaged
(f) for how much
Does the Respondent have
(a) other property
(b) investments
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(c) life insurance policies
(d) bank account
(e) money in building society
(f) money invested elsewhere
(g) car
(h) other valuable assets
If so, give brief details
(22) Other matters including other liabilities not otherwise mentioned:
(set out BRIEFLY any other matters which you think may be relevant to your application for financial provision)
What orders do you seek?
(23) Set out as clearly as possible what orders you seek
A. for maintenance of yourself
B for maintenance of the children
C about the matrimonial home
D about capital.
SWORN etc
The Court Office is at [ ],
telephone number xxx.xxxx, FAX number xxx.xxxx. The office is open between [8.00 am
and 4.00 p.m. every days except Public Holidays and such other days as the Court Office is
closed.
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