Free Sheet - Michigan

STATE OF MICHIGAN COUNTY OF MACOMB CIRCUIT COURT Family Division

CONFIDENTIAL ASSET DISCLOSURE SHEET
Deliver this form to the opposing party!

Case No.

Do not file with the Court!
Plaintiff Defendant

v

This sheet must be signed by each party and their attorney and be delivered to the other party as required by the discovery/scheduling order or other order of the Court. All values are to be fair market value at the time this sheet is signed. Attach additional sheets, if necessary. ASSET Real Estate: Marital Home: Vacation Home: Other: Cash on Hand: Cash: Savings: Checking: Other: Investments: Stocks: Bonds: Mutual Funds: Certificates of Deposit: Profit Sharing: Other: HOW TITLED ESTIMATED FMV ENCUMBRANCE NET VALUE

Asset Disclosure Sheet (p.2)
Retirement Savings: Pension: IRA: 401(k): Annuities: Insurance:

Case No.

Business Interests: Business 1: Business 2: Other: Beneficial Interests (trusts, estates, and powers of attorney:

Automobiles: Auto 1: Auto 2: Other: Personal Property (in order of highest value: 1: 2: 3: 4:

Asset Disclosure Sheet (p.2)
5: Other (summarize value of any additional personal property):

Case No.

VERIFICATION UNDER MCR 2.114(2)(b): I declare that the statements above are true to the best of my information, knowledge and belief. I understand that any misrepresentation or failure to disclose may result in a sanction under MCR 2.114 as well as consequences such as those imposed in Sands v Sands, 192 Mich App 698 (1992); affd 442 Mich 30 (1993).

____________________________________ ___________________________________ Date (Signature of Party)

(Signature of Attorney)

STATE OF MICHIGAN COUNTY OF MACOMB CIRCUIT COURT Family Division

CONFIDENTIAL LIABILITY DISCLOSURE SHEET
Deliver this form to the opposing party!

Case No.

Do not file with the Court!
Plaintiff Defendant

v

This sheet must be signed by each party and their attorney and be delivered to the other party as required by the discovery/scheduling order or other order of the Court. Attach additional sheets, if necessary. LIABILITY AMOUNT PARTY RESPONSIBLE

____________________________________ ___________________________________ Date (Signature of Party)

(Signature of Attorney)