SUPERIOR COURT Docket No. , ss. STATE OF MAINE DISTRICT COURT Location Docket No. , Plaintiff v. , Defendant CERTIFICATE IN LIEU OF FINANCIAL STATEMENT M. R. Civ. P. 108(c) I make the following statement in lieu of filing the Financial Statement, form FM-043. To the best of my knowledge the following statement is true. I certify that in the divorce action in which I am a party, (check all that apply) o There is no dispute regarding spousal support (alimony) o There is no dispute regarding attorney fees o There is no dispute regarding real estate o There is no dispute regarding personal property *** If any of the above are not true, you must file the Financial Statement, form FM-043 *** I understand that if the opposing party disagrees with any of the above statements, I will be required to file the Financial Statement. Date: Signature of Party FM-042, Rev. 04/14 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com