CIRCUIT COURT FOR THE 16TH JUDICIAL CIRCUIT State of Illinois SS. County of DeKalb GENERAL No. ________________ _____________________________________________________________________________________________ In Re: The Marriage of And Petitioner Respondent _____________________________________________________________________________________________ AFFIDAVIT IN SUPPORT OF TEMPORARY MAINTENANCE, SUPPORT AND INJUNCTION ___________________________________, the Petitioner Respondent in this cause having been duly sworn upon oath, states as follows: Length of Marriage: _____________________________________________________ Number of Children of the Marriage: ______, aged _____________________________ Petitioner Respondent Both parties. and in the custody of: My monthly income: (Multiply weekly income by 4.3) Voluntary Deductions: Net: $ _____________________ $ _____________________ $ _____________________ AFFIANT SPOUSE Place of employment: Position title: Address: The parties are living: separately together Affiant’s budget is as follows: (on a monthly basis) Rent $_______________ Mortgage $_______________ Real Estate Tax $_______________ Electricity $_______________ Water $_______________ Home Fuel $_______________ Telephone $_______________ Food $_______________ House Insurance Health Insurance Baby-sitter Clothes Car Insurance Car Fuel Other Total $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ My monthly installment payments are: Creditor Total Balance Minimum Payment The foregoing facts are true and correct. ___________________________________________ (Petitioner) (Respondent) Subscribed and sworn to before me this _____ day of ___________________________, 20____. _____________________________________ NOTARY PUBLIC Support affidavit 8/7/08 American LegalNet, Inc. www.FormsWorkflow.com