Child support determination form - Quebec
6
Part 9 – Declaration under oath
I declare that the above information is accurate I declare that the above information is accurate
and complete for my part and I sign: and complete for my part and I sign:
at at
on the day of on the day of
Father’s signature Mother’s signature
Declaration sworn to before me Declaration sworn to before me
at at
on the day of on the day of
Signature of person empowered to administer oath Signature of person empowered to administer oath
Part 8 – Statement of each parent’s assets and liabilities (cont’d)
Division 2 Statement of mother’s assets and liabilities
Assets VALUE
Give cash, amounts deposited in bank accounts or in other financial institutions and the market value of property
in each of the following categories (regardless of any debt related thereto): immovables, furniture, automobiles,
works of art, jewelry, shares, bonds, interests in a business, other investments, pension plans, retirement savings plans,
debts owing, etc.
TOTAL
Liabilities VALUE
Give debts or financial commitments of any nature in the form of loans or credit (mortgage, personal loan, credit line,
credit cards, instalment sales, security, etc.) or that you must pay under a statute (fiscal debts, assessments, dues and
other unpaid duties, etc.) or a decision by a Court (damages, support, employment insurance or income security
overpayments, fines, etc.)
TOTAL
Summary (assets – liabilities)
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