Local Rule - State of Indiana

APPENDIX BFINANCIAL DECLARATION FORMSTATE OF INDIANA: CIRCUIT AND SUPERIOR COURTSOF PORTER COUNTYIN RE: THE MARRIAGE OF:Cause No:andPetitionerRespondentIn accordance with Local Rule 2200.1 of the Porter Superior Court and Indiana TrialRules 26, 33, 34, 35 and 37, the undersigned, Petitioner or Respondent, hereby submits thefollowing VERIFIED FINANCIAL DISCLOSURE STATEMENT:I. PRELIMINARY INFORMATIONFINANCIAL DECLARATION OFHusband*Address:Soc. Sec. No.Badge/Payroll No:Occupation:EmployerWife*Address:Soc. Sec. No.Badge/Payroll No:Occupation:Employer:Birth Date:Children:Birth Date:Date of Marriage:Date of Physical Separation:Date of Filing:6