Ohio Answer to Complaint for Divorce with Children
B. COMPUTATION OF CURRENT INCOME
Husband
Wife
Base yearl y incom e
$
$
Average yearly overtime,
commissions and/or bonuses
over last 3 y ears (from part A)
$
$
Unemployment compensation
$
$
Dis abil it y be nefits
$
$
Workers’ Compensation
Soci al Secur it y
Other:
Retirement benefits
$
$
Soci al Secur it y
Other:
Spousal support received
$
$
Interest and dividend income
(source)
$
$
Other income (type and source)
$
$
TOTAL YEARLY INCOME
$
$
Supplemental Security Income
(SSI) or public assistance
$
$
Court-ordered child support that
you receive for minor and/or
dependent child(ren) not of the
marriage or relationship
$
$
Supreme Court of O hio
Uniform Dom estic Relat i ons Form – Affid a vit 1
Affidavit o f Inco me and Expenses
Approved under Ohio Civi l Rul e 84
Effective Date: July 1, 2010
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