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South Dakota Financial Affidavit Form

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South Dakota Financial Affidavit Form Page 4
South Dakota Financial Affidavit Form
Page 4 of 4
Form UJS-304
Rev. 02/2014
TOTAL LIABILITIES …..$_____________
3. ANTICIPATED INCOME (money or property you are expecting)
a. Total monies or income from sale of house or land, gifts, inheritance, allotments,
trust funds, lease money, etc……………………………………………………………$______________
When is the money/income expected ______________________
Dated:
Signature of Person Filling out this Affidavit
(Sign only in front of notary public or clerk of courts.)
Sworn/affirmed before me this
day of , .
If notary, My Commission Expires ________________________
Notary Public \ Clerk of Courts
(SEAL)
If you have children, you must complete the child support calculation. The DSS calculator is found at
http://dss.sd.gov/childsupport/services/obligationcalculator.asp
Attach your calculation of child support
South Dakota Financial Affidavit Form
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