Rule 68 - Dissolution of Marriage
Rule 68 - Form 6804E - Suggestions and Affidavit in Support of Application for Pendente Lite Orders
IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI
FAMILY COURT DIVISION
At Kansas City At Independence
IN RE THE MARRIAGE OF:
______________________________ Petitioner, Case No. ______________
and
_______________________________
Respondent.
SUGGESTIONS AND AFFIDAVIT IN SUPPORT OF
APPLICATION FOR PENDENTE LITE ORDERS *
COMES NOW __________________ and states:
1. Petitioner has $_________ per month gross income.
2. Respondent has $_________ per month gross income.
3. ___________ pays court-ordered support for child/ren not involved in this action in the amount of: None $____ per month.
4. ___________ pays court-ordered support for child/ren not involved in this action in the amount of: None $__________ per month.
5. ___________ pays maintenance to a former spouse not involved in this action of: None $_____________ per month.
6. Petitioner has the following number of minor children not
*Strike all inapplicable portions
from this marriage who reside with Petitioner and for whom Petitioner receives no support: None Number of children:____. 7. Respondent has the following number of minor children not from this marriage who reside with Respondent and for whom Respondent receives no support: None Number of children:____.
8. ___________ has $__________ monthly gross day care expenses for the child/ren which are $_________ per month after application of the child care tax credit.
9. The child/ren are covered by health benefit plan/s available to ____________ through employment/union at a cost of $________ per month for the child/ren's coverage.
10. Uninsured extraordinary medical expenses for the child/ren as defined by the Missouri Child Support Guidelines are $____________ per month.
11. The child/ren have extraordinary expenses as defined by the Missouri Child Support Guidelines of $___________ per month for _______________(child's name), $______ per month for _____________ (child's name) for a total per month expense of $___________.
12. ____________ has ___ per cent of the combined gross incomes of Petitioner and Respondent and so Petitioner should pay ____ per cent and Respondent should pay ____ per cent of the medical, dental, eye, vision, prescription and orthodontic expenses of the child/ren not paid by insurance.
13. _____________ has total expenses of $__________ per month, of which $_________ per month are for the child/ren's support and $___________ per month are for __________________'s support.
14. ____________ estimates that he/she will require $_______ in temporary attorney fees and $_________ in costs based on the following: (i.e., hourly rate of attorney, appraisal cost, expert estimated costs, businesses to be valued, etc.)
Respectfully Submitted,
_____________________________________
(Attorney name, address and bar #)
ATTORNEY FOR _____________________
STATE OF MISSOURI )
) ss.
COUNTY OF JACKSON )
___________________, of lawful age and having been duly sworn, acknowledges being _________________ in the above case and having knowledge of all the facts stated in the above and foregoing Suggestions and Affidavit In Support of Application for Pendente Lite Orders and states that all the facts therein are true.
________________________________
Subscribed and sworn to before me this ____ day of _______, 199___.
___________________________ Notary Public
My Commission Expires:
I hereby certify that a copy of the foregoing pleading was faxed/mailed, postage prepaid, this ____ day of ______, 199__, to: ___________________________________________________, Attorney for __________________.
_____________________________________
(Attorney name)
Adopted by Court en banc 3/22/96
Effective 4/22/96
Form 6804E