AOC-CV-264 — Financial Affidavit for Family Law Matters

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⚠ THIS IS A SWORN DOCUMENT — All information is provided under oath. False statements may subject you to criminal prosecution for perjury under G.S. 14-209.

01 PARTY INFORMATION

Full Legal Name *

Role in Case *

Street Address *

Employer Name

Occupation

Case File Number *

County *

Plaintiff / Petitioner Name *

Defendant / Respondent Name *

02 GROSS MONTHLY INCOME

Salary / Wages (before taxes)

$/Month

Self-Employment Income (gross)

$/Month

Rental Income

$/Month

Dividends / Interest / Investment Income

$/Month

Social Security / Disability Benefits

$/Month

Pension / Retirement Distributions

$/Month

Alimony / Spousal Support Received

$/Month

Other Income (describe)

$/Month

TOTAL GROSS MONTHLY INCOME $0.00

03 MONTHLY DEDUCTIONS FROM INCOME

Federal Income Tax Withheld

$/Month

State Income Tax Withheld (NC)

$/Month

FICA / Social Security / Medicare

$/Month

Health / Dental / Vision Insurance Premium

$/Month

Mandatory Retirement Contributions (401k, pension)

$/Month

Other Mandatory Deductions (describe)

$/Month

TOTAL DEDUCTIONS $0.00

NET MONTHLY INCOME (Gross − Deductions) $0.00

04 MONTHLY LIVING EXPENSES

HOUSING

Rent / Mortgage Payment

$/Month

Property Taxes (if not escrowed)

$/Month

Homeowner / Renter Insurance

$/Month

Utilities (electric, gas, water, internet)

$/Month

Food / Groceries

$/Month

TRANSPORTATION

Car Payment(s)

$/Month

Gas / Fuel

$/Month

Auto Insurance

$/Month

INSURANCE

Health Insurance (out-of-pocket premium)

$/Month

Life Insurance

$/Month

Childcare / Daycare / After-School Care

$/Month

Medical / Dental / Prescription (out-of-pocket)

$/Month

Clothing

$/Month

Entertainment / Recreation

$/Month

Child Support / Alimony Paid (existing orders)

$/Month

Other Expenses (describe)

$/Month

TOTAL MONTHLY EXPENSES $0.00

05 ASSETS

Checking Account(s) — Bank Name(s)

Balance

Savings / Money Market Account(s)

Balance

Retirement Accounts (401k, IRA, pension)

Value

Real Property — Address

FMV

Vehicle(s) — Year / Make / Model

Value

Other Assets (stocks, jewelry, business interest, etc.)

Value

06 LIABILITIES / DEBTS

Mortgage Balance — Lender

Balance Owed

Car Loan(s) — Lender

Balance Owed

Student Loans

Balance Owed

Credit Cards (total balance)

Balance Owed

Other Debts (describe)

Balance Owed

07 NET WORTH SUMMARY

TOTAL GROSS MONTHLY INCOME $0.00

TOTAL DEDUCTIONS $0.00

NET MONTHLY INCOME $0.00

TOTAL MONTHLY EXPENSES $0.00

TOTAL ASSETS $0.00

TOTAL LIABILITIES $0.00

NET WORTH (Assets − Liabilities) $0.00

FAMILY LAW REPRESENTATION

NC family law matters — custody, support, alimony, and equitable distribution — require careful legal strategy. Barker Richardson represents clients statewide.

SCHEDULE CONSULTATION →

WHEN IS CV-264 REQUIRED?

Required in virtually all child custody and support proceedings
Required for alimony and post-separation support claims
Required in equitable distribution (property division) under G.S. 50-20
Courts use this document to calculate NC Child Support Guidelines amounts
Judges rely on it to assess ability to pay and need for alimony

STATUTORY AUTHORITY

G.S. 50-13.4Child support standard

G.S. 50-16.3AAlimony factors

G.S. 50-20Equitable distribution

G.S. 14-209Perjury — false oath

PERJURY WARNING

This affidavit must be signed under oath before a notary or Clerk of Court
Intentionally false statements constitute perjury under G.S. 14-209
Perjury is a Class F felony in North Carolina
Omitting assets or underreporting income can result in contempt and sanctions

RELATED FORMS

CV-267 — Monthly Income & Expense Statement →
Simplified version for support hearings
CV-226 — Affidavit of Indigency →
G-100 — Certified Copies Application →

WHAT GETS GENERATED

Formal multi-page sworn financial affidavit
Income, deductions, expenses, assets, liabilities, net worth
Signature and notary/jurat block included
Court-ready PDF, letter size (8.5" × 11")