JSUPREME COURT OF THE STATE OF NEW YORK 12/15/04COUNTY OF ________________________ county in which divorce is pending ---------------------------------------------------------------x : Index No. ______________ insert court index no. Plaintiff, : AFFIDAVIT IN SUPPORT -against- : OF MOTION FOR MONEY JUDGMENT : Defendant. : ----------------------------------------------------------------x STATE OF NEW YORK ) s.s.: COUNTY OF ________________________) where this affidavit is signed I, ____________________________, being duly sworn, depose and say that: your name 1. I am the ________________________ in this action for a divorce. Plaintiff/Defendant 2. I make this affidavit in support of my Motion for a Money Judgment. (complete the following sections that apply to your situation) CHILD SUPPORT ARREARS: 3. I seek a Money Judgment in the amount of $_________________, plus interest, amount owed for child support arrears. 4. By a Judgment of this Court entered on _________________________, date of Judgment or Court Order _______________________ was directed to pay me $______________ per ______________ as name of person who owes money amount week, month or year 1 American LegalNet, Inc. www.USCourtForms.com>>>> 2child support commencing on _______________________. (a copy of the Judgment or Court date payments were supposed to start Order is attached) 5. _______________________ failed to make the child support payments as name of person who owes money required by that Order. 6. I request this Court direct the entry of a Money Judgment against______________ name of person who_____________________ in the sum of __________________, plus interest, representing child owes money amount owed support arrears from _____________ through _______________. dates/period of time during which arrears are owed MAINTENANCE ARREARS: 7. I seek a Money Judgment in the amount of $_________________, plus interest, amount owed for maintenance arrears. 8. By a Judgment of this Court entered on _________________________, date of judgment or court order_______________________ was directed to pay me $______________ per ______________ as name of person who owes money amount week, month or yearmaintenance commencing on _______________________. (a copy of the Judgment or Court date payments were supposed to start Order is attached) 9. _______________________ failed to make the maintenance payments as name of person who owes money required by that Order. 2 American LegalNet, Inc. www.USCourtForms.com>>>> 310. I request this Court direct the entry of a Money Judgment against ______________ name of person who _____________________ in the sum of __________________, plus interest, representing owes money amount owed maintenance arrears from _____________ through _______________. dates/period of time during which arrears are owed EQUITABLE DISTRIBUTION: 11. I seek a Money Judgment in the amount of $_________________, plus interest, amount owed as a distributive award after equitable distribution. 12. By a Judgment of this Court entered on _________________________, date of Judgment or Court order____________________________ was directed to pay me $___________________ name of person who owes money amount as my share of marital property pursuant to a distributive award. (a copy of the Judgment is attached) 13. _________________________ failed to pay me the amount ordered, as name of person who owes money required by that Order. 14. I request this Court direct the entry of a Money Judgment against______________ name of person who _____________________ in the sum of __________________, plus interest, representing owes money amount owed the amount due me pursuant to the Judgment granting me a distributive award. 3 American LegalNet, Inc. www.USCourtForms.com>>>> 4 ADDITIONAL ARREARS ACCRUED SINCE DATE OF THIS APPLICATION: 15. I request an additional amount in the Money Judgment to include any additional arrears at the rate of $ _______________ per ______________wh ich have accrued amount week, month or year since the date of this application to the date of the hearing or submission of this Motion. ADDITIONAL FACTS THAT YOU WOULD LIKE THE COURT TO CONSIDER: 16. __________________________________________________________________ ________________________________________________________________________ ______ ________________________________________________________________________ ______ ________________________________________________________________________ ______ ________________________________________________________________________ ______ ________________________________________________________________________ ______ 17. No prior application has been made for the relief requested herein. WHEREFORE , I respectfully request that my Motion be fully granted. ___________________________ sign your nameSworn to before me this______day Print name, address and telephone no. of _________,200__ ______________________________ (THIS AFFIDAVIT MUST BE NOTARIZED) ______________________________ ______________________________ 4 American LegalNet, Inc. www.USCourtForms.com