FORM # 13B NORTH CAROLINA 20A JUDICIAL DISTRICT COUNTY OF _______________ __________________________________ Plaintiff, -vs__________________________________ Defendant. IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION CASE NUMBER____________ ) ) ) ) ) ) ) ) EQUITABLE DISTRIBUTION INVENTORY AFFIDAVIT OF DEFENDANT OR RESPONDING PARTY AND CERTIFICATE OF SERVICE NOW COMES the defendant, or responding party, and itemizes what he/she alleges to be the marital, divisible, and separate property of the parties, as well as the marital debts of the parties, all as set out in the schedules, which are attached. Defendant certifies that he/she has made a full and complete disclosure of all marital and separate property known to him/her. This is to further certify that the undersigned has this day filed the original of this affidavit and all attachments with the Clerk, and has served a copy of this affidavit and all attachments to opposing counsel, or opposing party if unrepresented, by depositing a copy in a postpaid wrapper in a post office or official depository under the exclusive care and custody of the United States Post Office Department, properly addressed as follows: (type or print full name and address) __________________________________ __________________________________ __________________________________ __________________________________ This the ___ day of ________________, _________. ___________________________ Signature of Attorney/Party Typed or printed name, address, and phone _____________________________ _____________________________ _____________________________ Family Court Domestic Rules 20A Judicial District (20FCDR) Page 1 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B Equitable Distribution Inventory Affidavit PURPOSE The Plaintiff and the Defendant were married, and they accumulated some property. Now someone has asked the Judge to fairly, or equitably, divide this property. The purpose of this affidavit is to give the Judge the information he or she will need to equitably divide the property. The Judge will need to know this information because at trial the Judge must determine the fair market value (value) of each item of property and whether each item of property is Marital or Separate (classification), and the Judge must then decide who gets each item of property (distribution). So, you must carefully list each item of property which either of you owned or had any interest in as of the day of separation, no matter in whose name the property was titled, and no matter who had possession of the property. List everything, and if you believe that the property is not Marital, show that the item as “Separate”. MEANINGS As used in these schedules, the following abbreviations have the following meanings: DOM means the “date of marriage of the parties”, which plaintiff contends to be __________ and which defendant contends to be ___________, and which the Court finds to be ___________. DOS means the “date separation of the parties”, which plaintiff contends to be __________ and which defendant contends to be ___________, and which the Court finds to be ___________. FMV means “fair market value”. LIEN means “a lien on property”, whether created by a mortgage, deed of trust, security agreement, or otherwise. PROPERTY means anything you can own (not just land and house, but also other things like bank accounts and retirement accounts: anything you can own). SEPARATE PROPERTY means Property that either of you received either before the marriage or after the DOS, or that either of you received during the marriage by gift or inheritance. MARITAL PROPERTY means Property that is not Separate Property, no matter whose name it is in, that either of you received between the date of your marriage and the DOS. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 2 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE I REAL PROPERTY AND MOBILE HOME This includes land, houses, anything permanently attached to land, and mobile homes. Include a description of the property sufficient that the Court can identify it. Value PROPERTY Husband contends: DOS FMV Wife contends: DOS FMV Classification Agreed or Court finding: FMV Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 1. 2. 3. 4. 5. SCHEDULE II MOTOR VEHICLES Include a description of the property sufficient that the Court can identify it. Value PROPERTY Husband contends: DOS FMV Wife contends: DOS FMV Classification Agreed or Court finding: FMV Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 6. 7. 8. 9. 10. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 1 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE III HOUSEHOLD FURNISHINGS, COLLECTIBLES Include a description of the property sufficient that the Court can identify it. Value PROPERTY Husband contends: DOS FMV Wife contends: DOS FMV Classification Agreed or Court finding: FMV Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 2 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE IV MISCELLANEOUS PERSONAL PROPERTY (Tools, Guns, Lawn Equipment, Jewelry, Animals) Include a description of the property sufficient that the Court can identify it. Value PROPERTY Husband contends: DOS FMV Wife contends: DOS FMV Classification Agreed or Court finding: FMV Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 3 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE V ACCOUNTS (Checking, Savings, CD's) Include a description of the account sufficient that the Court can identify it. Value PROPERTY Husband contends: DOS FMV Wife contends: DOS FMV Classification Agreed or Court finding: FMV Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 47. 48. 49. 50. 51. 52. SCHEDULE VI BUSINESSES AND STOCKS Include a description of the account sufficient that the Court can identify it. Value PROPERTY Husband contends: DOS FMV Wife contends: DOS FMV Classification Agreed or Court finding: FMV Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 53. 54. 55. 56. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 4 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE VII RETIREMENT (Pension, 401 (k), Profit-Sharing, IRA) Value NAME- INSTITUTION Husband contends: DOS FMV Wife contends: DOS FMV Classification Husband contends: Marital or Sep (M/S) Agreed or Court finding: FMV Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 57. 58. 59. SCHEDULE VIII LIFE INSURANCE POLICIES (Use the Cash Value of your policies) Value PROPERTY Husband contends: DOS Cash Value Wife contends: DOS Cash Value Classification Agreed or Court finding: Cash Value Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 60. 61. 62. 63. 64. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 5 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE IX PROPERTY ACQUIRED AFTER DOS Include a description of the account sufficient that the Court can identify it. Value PROPERTY Husband contends: DOS FMV Wife contends: DOS FMV Classification Agreed or Court finding: FMV Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Agreed or Court finding: Marital or Sep Possession Husband contends Who has it? (H/W) Wife contends: Who has it? (H/W) Distribution Agreed or Court finding: Who has it? Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 6 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE X DEBTS WHICH ARE SECURED List here debts, which ARE secured by a lien on property. Include the name, address, telephone number, and account number of the creditor, and for each creditor identify (the same way you did in the “property schedules”) the property securing the debt. Also, attach a copy of the documents, which show the amount of debt. Value CREDITOR Husband contends: DOS BALANCE Wife contends: DOS BALANCE Classification Agreed or Court finding: BALANCE Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Distribution Agreed or Court finding: Marital or Sep Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 78. 79. 80. 81. SCHEDULE XI DEBTS WHICH ARE NOT SECURED List here debts, which are NOT secured by a lien on property. Include the name, address, telephone number, and account number of the creditor. Also, attach a copy of the documents, which show the amount of debt. Value CREDITOR Husband contends: DOS BALANCE Wife contends: DOS BALANCE Classification Agreed or Court finding: BALANCE Husband contends: Marital or Sep (M/S) Wife contends: Marital or Sep (M/S) Distribution Agreed or Court finding: Marital or Sep Husband contends Who gets it? (H/W) Wife contends: Who gets it? (H/W) Agreed or Court finding: Who gets it? 82. 83. 84. 85. 86. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 7 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE XII DIVISIBLE PROPERTY Itemize on separate sheet as needed FACTORS 87. Appreciation and diminution in value of marital property and divisible property of the parties occurring after the date of separation and prior to the date of distribution. Do not include here appreciation or diminution in value, which is the result of post-separation actions or activities of a spouse. HUSBAND’S CONTENTIONS WIFE’S CONTENTIONS AGREED OR COURT FINDINGS 88. Property, property rights, or any portion thereof received after the date of separation but before the date of distribution that was acquired as a result of the efforts of either spouse during the marriage and before the date of separation, including, but not limited to, commissions, bonuses, and contractual rights. 89. Passive income from marital property received after the date of separation, including, but not limited to, interest and dividends. 90. Increases in marital debt and financing charges and interest related to marital debt. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 8 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B SCHEDULE XIII FACTORS JUSTIFYING AN UNEQUAL DISTRIBUTION Itemize on separate sheet as needed FACTORS HUSBAND’S CONTENTIONS AGREED OR COURT FINDING WIFE’S CONTENTIONS (1) The income, property, and liabilities of each party at the time the division of property is to become effective; (2) Any obligation for support arising out of a prior marriage; (3) The duration of the marriage and the age and physical and mental health of both parties; (4) The need of a parent with custody of a child or children of the marriage to occupy or own the marital residence and to use or own its household effects; (5) The expectation of pension, retirement, or other deferred compensation rights, that are not marital property; (6) Any equitable claim to, interest in, or direct or indirect contribution made to the acquisition of such marital property by the party not having title, including joint efforts or expenditures and contributions and services, or lack thereof, as a spouse (7) Any direct or indirect contribution made by one spouse to help educate or develop the career potential of the other spouse; (8) Any direct contribution to an increase in value of separate property which occurs during the course of the marriage; (9) The liquid or non-liquid character of all marital property and divisible property; (10) The difficulty of evaluating any component asset or any interest in a business, corporation or profession, and the economic desirability of retaining such asset or interest, intact and free from any claim or interference by the other party; (11) The tax consequences to each party; (11a) Acts of either party to maintain, preserve, develop, or expand; or to waste, neglect, devalue or convert the marital or divisible property, or both, during the period after separation of the parties and before the time of distribution; and (8, 11a, 12) Payments on marital debts since separation. (8, 11a, 12) Repairs or improvements to marital assets since separation. (12) Any other factor which the court finds to be just and proper. (12) Separate property was used for the purchase price of a marital asset. (12) Party's family paid the purchase price of a marital asset. Family Court Domestic Rules 20A Judicial District (20FCDR) Page 9 of 12 American LegalNet, Inc. www.FormsWorkflow.com FORM # 13B VERIFICATION STATE OF NORTH CAROLINA COUNTY OF ________________________________ _______________________________________, first being duly sworn, says that he/she is the Plaintiff/Defendant in the above entitled action, and that the foregoing Equitable Distribution Inventory Affidavit and Attachments is true of his/her own knowledge, except as to matters and things therein state upon information and belief, and as to those matters and things Plaintiff/Defendant verily believes said contents to be true. ______ ____________________________________ Subscribed and sworn to before me, this the ____ day of _________________, ______. ______________________________ NOTARY PUBLIC My commission expires: _____________________ Family Court Domestic Rules 20A Judicial District (20FCDR) Page 10 of 12 American LegalNet, Inc. www.FormsWorkflow.com