Form AOC-238 (AOC-239) "Preliminary Verified Disclosure Statement/Final Verified Disclosure Statement" - Kentucky

What Is Form AOC-238 (AOC-239)?

This is a legal form that was released by the Kentucky Court of Justice - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2015;
  • The latest edition provided by the Kentucky Court of Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AOC-238 (AOC-239) by clicking the link below or browse more documents and templates provided by the Kentucky Court of Justice.

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Download Form AOC-238 (AOC-239) "Preliminary Verified Disclosure Statement/Final Verified Disclosure Statement" - Kentucky

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q AOC-238 Doc. Code DSPV
Case No. ____________________
q AOC-239 Doc. Code DSFV
Rev. 1-15
l e x
Court
____________________
e t
j u s t i t i a
Page 1 of 10
County
____________________
Commonwealth of Kentucky
q Preliminary Verified Disclosure Statement*
Court of Justice
www.courts.ky.gov
Division
____________________
q Final Verified Disclosure Statement*
FCRPP 2 and FCRPP 3
IN RE THE MARRIAGE OF:
________________________________________
PETITIONER
and
________________________________________
RESPONDENT
q Petitioner q Respondent
submits under oath the following Verified Disclosure Statement pursuant to FCRPP 2 OR
FCRPP 3, which requires full and prompt disclosure of the following information:
NOTE: A response of “see attached” is not appropriate for any portion of this statement. Attach documents
requested herein only.
I. IDENTIFYING INFORMATION OF BOTH PARTIES
Petitioner
Respondent
Name: _______________________________________
Name: ______________________________________
Street Address: ________________________________
Street Address: _______________________________
City, State, Zip: ________________________________
City, State, Zip: _______________________________
Age: ____
Phone #: _________________________
Age: ____ Phone #: ___________________________
II. INCOME AND EMPLOYMENT INFORMATION OF BOTH PARTIES (If self-employed name of company and
adjusted gross monthly income)
Petitioner
Respondent
Employer Name: _______________________________
Employer Name: ______________________________
Gross monthly income: $ ________________________
Gross monthly income: $ ________________________
Other income: $ _______________________________
Other income: $ _______________________________
III. MARRIAGE INFORMATION
Date of Marriage: ______________________________
Date of separation: _____________________________
Place of Marriage (city, county & state): _______________________________________________________________
q AOC-238 Doc. Code DSPV
Case No. ____________________
q AOC-239 Doc. Code DSFV
Rev. 1-15
l e x
Court
____________________
e t
j u s t i t i a
Page 1 of 10
County
____________________
Commonwealth of Kentucky
q Preliminary Verified Disclosure Statement*
Court of Justice
www.courts.ky.gov
Division
____________________
q Final Verified Disclosure Statement*
FCRPP 2 and FCRPP 3
IN RE THE MARRIAGE OF:
________________________________________
PETITIONER
and
________________________________________
RESPONDENT
q Petitioner q Respondent
submits under oath the following Verified Disclosure Statement pursuant to FCRPP 2 OR
FCRPP 3, which requires full and prompt disclosure of the following information:
NOTE: A response of “see attached” is not appropriate for any portion of this statement. Attach documents
requested herein only.
I. IDENTIFYING INFORMATION OF BOTH PARTIES
Petitioner
Respondent
Name: _______________________________________
Name: ______________________________________
Street Address: ________________________________
Street Address: _______________________________
City, State, Zip: ________________________________
City, State, Zip: _______________________________
Age: ____
Phone #: _________________________
Age: ____ Phone #: ___________________________
II. INCOME AND EMPLOYMENT INFORMATION OF BOTH PARTIES (If self-employed name of company and
adjusted gross monthly income)
Petitioner
Respondent
Employer Name: _______________________________
Employer Name: ______________________________
Gross monthly income: $ ________________________
Gross monthly income: $ ________________________
Other income: $ _______________________________
Other income: $ _______________________________
III. MARRIAGE INFORMATION
Date of Marriage: ______________________________
Date of separation: _____________________________
Place of Marriage (city, county & state): _______________________________________________________________
q AOC-238 Doc. Code DSPV
q AOC-239 Doc. Code DSFV
Disclosure of
Rev. 1-15
_____________________________________
Page 2 of 10
Case No. _________________________________________
IV. CHILDREN’S INFORMATION (If more than 3 children, continue on a separate sheet)
A. Minor children born to parties (number ________)
q More CHILDREN attached?
Name
Current Age
B. Monthly child care/day care expenses: Cost $ ________________
Paid by ________________
C. Monthly medical, dental and vision insurance for children: Cost $ ________________ Paid by ________________
D. Either party court-ordered to pay child support for a child born before the children born of this marriage?
q Yes q No
Paying party _____________________________________________
Amount: $ ____________________________
Children: (List names and ages) _____________________________________________________________________
_______________________________________________________________________________________________
V. SUMMARY OF ASSETS & DEBTS
A. REAL ESTATE (If more than 2 properties, continue on a separate sheet)
Are you making a non-marital claim?
q Yes q No
If yes, you must comply with Section IX below.
Property 1:
Address: _______________________________________________________________________________________
1st Mortgage Company: ___________________________________________________________________________
1st Mortgage Payoff Amount: ________________________
2nd Mortgage Company or Home Equity Loan: _________________________________________________________
2nd Mortgage or Home Equity Loan Payoff Amount: ______________________________
Fair Market Value: _________________
Valuation Date: __________________
Equity: ____________________
Property 2:
Address: _______________________________________________________________________________________
1st Mortgage Company: ___________________________________________________________________________
1st Mortgage Payoff Amount: ________________________
2nd Mortgage Company or Home Equity Loan: _________________________________________________________
2nd Mortgage or Home Equity Loan Payoff Amount: ______________________________
Fair Market Value: _________________
Valuation Date: __________________
Equity: ____________________
More REAL ESTATE attached?
q Yes q No
Total Real Estate Equity: ___________________________
q AOC-238 Doc. Code DSPV
q AOC-239 Doc. Code DSFV
Disclosure of
Rev. 1-15
_____________________________________
Page 3 of 10
Case No. _________________________________________
B. VEHICLES - Automobiles, Motorcycles, Boats, Trucks, Motor Homes, etc. (If more than 3 vehicles, continue on a separate sheet)
Are you making a non-marital claim?
q Yes q No
If yes, you must comply with Section IX below.
Vehicle 1:
Primary Driver: __________________________ Year, Make & Model: ______________________________________
NADA Value: _______________
Valuation Date: _______________
Debt Owed: ________________
Lien Holder: _____________________________________________________________
Equity: ________________
Is this a leased vehicle?
q Yes q No
If yes, please complete the following: Monthly Payment:
________________
Lease Term Ends: ________________
Vehicle 2:
Primary Driver: __________________________ Year, Make & Model: ______________________________________
NADA Value: _______________
Valuation Date: _______________
Debt Owed: ________________
Lien Holder: _____________________________________________________________
Equity: ________________
Is this a leased vehicle?
q Yes q No
If yes, please complete the following: Monthly Payment:
________________
Lease Term Ends: ________________
Vehicle 3:
Primary Driver: __________________________ Year, Make & Model: ______________________________________
NADA Value: _______________
Valuation Date: _______________
Debt Owed: ________________
Lien Holder: _____________________________________________________________
Equity: ________________
Is this a leased vehicle?
q Yes q No
If yes, please complete the following: Monthly Payment:
________________
Lease Term Ends: ________________
More VEHICLES attached?
q Yes q No
Total Vehicle Equity: ___________________________
C. BANK ACCOUNTS – Checking, Savings, CDs, Money Market accounts, etc. (If more than 3 accounts, continue on
a separate sheet) (Do not list account numbers)
Are you making a non-marital claim?
q Yes q No
If yes, you must comply with Section IX below.
Owner(s)
Institution Name
Type of Account
Valuation Date
Balance
[ NO ACCOUNT NUMBERS]
More BANK ACCOUNTS attached?
q Yes q No
Total Current Balances:
D. STOCKS, BONDS, PORTFOLIOS, MUTUAL FUNDS, ETC. (If more than 3, continue on a separate sheet)
Are you making a non-marital claim?
q Yes q No
If yes, you must comply with Section IX below.
Institution Name
Stock/Portfolio Name
Valuation Date
Current Value
More INVESTMENTS attached?
q Yes
q No
Total Current Values:
q AOC-238 Doc. Code DSPV
q AOC-239 Doc. Code DSFV
Disclosure of
Rev. 1-15
_____________________________________
Page 4 of 10
Case No. _________________________________________
E. RETIREMENT BENEFITS – IRA, Keogh, 401(K), 403(b), Pension, etc. (If more than 3, continue on a separate sheet)
Are you making a non-marital claim?
q Yes q No
If yes, you must comply with Section IX below.
Participant
Plan Name
Contrib/Non Vested/Non
Pay Status?
Valuation Date
Balance
More RETIREMENT BENEFITS attached?
q Yes q No
Total Retirement Benefits Values:
Have any loans been taken out against any of these Retirement Benefits?
q Yes q No
If so, describe: ___________________________________________________________________________________
F. LIFE INSURANCE (If more than 3 policies, continue on a separate sheet)
Are you making a non-marital
claim? q Yes q No
If yes, you must comply with Section IX below.
Policy 1:
Company: ____________________________________________
Party Insured: ____________________________
Beneficiary: ___________________________________________________________ Term/Whole: ______________
Policy #: ________________________ Valuation Date: ____________ Cash Surrender Value: ___________________
Policy 2:
Company: ____________________________________________
Party Insured: ____________________________
Beneficiary: ___________________________________________________________ Term/Whole: ______________
Policy #: ________________________ Valuation Date: ____________ Cash Surrender Value: ___________________
Policy 3:
Company: ____________________________________________
Party Insured: ____________________________
Beneficiary: ___________________________________________________________ Term/Whole: ______________
Policy #: ________________________ Valuation Date: ____________ Cash Surrender Value: ___________________
More LIFE INSURANCE attached?
q Yes q No
Total Cash Value: ___________________________
G. BUSINESS INTERESTS (If more than 3 businesses, continue on a separate sheet)
Are you making a non-marital claim? q Yes q No If yes, you must comply with Section
IX
below.
Name of Business & Owner: ________________________________________________________________________
Percentage of Ownership: ___________
Type of Business: __________________________________________
Corporation, Sole Proprietorship, Partnership, Etc.: ______________________________________________________
Valuation Date: _______________ Business Loan(s) Balance: _______________ Value of Interest: ______________
Name of Business & Owner: ________________________________________________________________________
Percentage of Ownership: ___________
Type of Business: __________________________________________
Corporation, Sole Proprietorship, Partnership, Etc.: ______________________________________________________
Valuation Date: _______________ Business Loan(s) Balance: _______________ Value of Interest: ______________
q AOC-238 Doc. Code DSPV
q AOC-239 Doc. Code DSFV
Disclosure of
Rev. 1-15
_____________________________________
Page 5 of 10
Case No.
_________________________________________
Name of Business & Owner: ________________________________________________________________________
Percentage of Ownership: ___________
Type of Business: __________________________________________
Corporation, Sole Proprietorship, Partnership, Etc.: ______________________________________________________
Valuation Date: _______________ Business Loan(s) Balance: _______________ Value of Interest: ______________
More BUSINESS INTERESTS attached?
q Yes q No
Total Values:
__________________________
H. HOUSEHOLD GOODS:
Are you making a non-marital
claim? q Yes q No
If yes, you must comply with Section IX below.
Agreed Division?
Yes
No, but not expected to be in dispute.
q
q
No, but dispute anticipated (Suggested appraiser: _____________________________________)
q
Attached is a list of the disputed household items
I. OTHER ASSETS – Cash, Travelers Checks, Debts Others Owe You, Copyrights, Trademarks, Pets or Animals,
Jewelry, Collectibles, Tools, Inventions, Other “Liquid Assets,” etc. (If more than 5 items, continue on a separate sheet)
Are you making a non-marital claim? q Yes q No If yes, you must comply with Section IX below.
Item 1:
Item Description: _________________________________________________________________________________
Who Holds Possession: ____________________________
Valuation Date: ________________________________
Fair Market Value: ______________ Amount Owed: ____________________ Net Value or Equity: ______________
Item 2:
Item Description: _________________________________________________________________________________
Who Holds Possession: ____________________________
Valuation Date: ________________________________
Fair Market Value: ______________ Amount Owed: ____________________ Net Value or Equity: ______________
Item 3:
Item Description: _________________________________________________________________________________
Who Holds Possession: ____________________________
Valuation Date: ________________________________
Fair Market Value: ______________ Amount Owed: ____________________ Net Value or Equity: ______________
Item 4:
Item Description: _________________________________________________________________________________
Who Holds Possession: ____________________________
Valuation Date: ________________________________
Fair Market Value: ______________ Amount Owed: ____________________ Net Value or Equity: ______________
Item 5:
Item Description: _________________________________________________________________________________
Who Holds Possession: ____________________________
Valuation Date: ________________________________
Fair Market Value: ______________ Amount Owed: ____________________ Net Value or Equity: ______________
More OTHER ASSETS attached?
q Yes q No
Total Values: ____________________