Here is the text we could read:
DECLARACIÓN JURADA DEL(LA)
DEMANDADO(A) EN RELACIÓN CON
LA SOLICITUD DE UNA ORDEN DE
MANUTENCIÓN DE MENORES
NÚM. DE EXPEDIENTE (SOLO PARA USO
DEL TRIBUNAL)
TRIBUNAL DE PRIMERA INSTANCIA
DE MASSACHUSETTS
NOMBRE DEL(LA) DEMANDANTE
NOMBRE DEL(LA) DEMANDADO(A)
DIVISIÓN DEL TRIBUNAL
Yo,
, declaro o afirmo que lo siguiente es cierto, según mi leal saber y entender:
1. Soy la madre/el padre (indique uno) del(la) niño(a) o de los(as) niño(as) siguiente(s):
2. El(la) demandante es el(la) tutor(a) legal del(la)/(los)(las) niño(a)/niños(as) mencionado(a)/(os)(as) arriba
3.
Trabajo como
Trabajo para
cuya dirección es
.
,
.
4. Mis ingresos brutos y mis gastos son los siguientes:
Ingresos brutos (ingresos antes de impuestos)
Gano $
por semana/mes (indique uno)
Seguro de salud
Pago $
por semana/mes (indique uno).
Seguro dental y/o de visión
Pago $
por semana/mes (indique uno).
Mis gastos por cuidados de niño(a)/niños(as) en par. 1 Pago $
por semana/mes (indique uno).
Otras obligaciones de manutención
Pago $
por semana/mes (indique uno).
Afirmo que lo anterior es cierto, bajo pena de perjurio.
NOMBRE EN LETRA IMPRENTA DEL(LA) DEMANDADO(A)
FECHA (mm/dd/aaaa)
FIRMA DEL(LA) DEMANDADO(A)
FA-12 (1/12) Defendant's Affidavit in Connection with Request for a Child Support Order - Spanish (06/14)
This form is for your reference only.Do not submit tothecourt. Este formularioes solopara consulta. Favor de no entregar altribunal.
FA-2 & 2A.qxd
This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Massachusetts state courts.
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Downloads: You can download both the original form (last checked 2023-03)
and the machine-processed form with normalized data fields.
About This Form:
- Sourced from www.mass.gov (2023-03)
- Page(s): 1
- Fields(s): 6
- Average fields per page: 6
- Reading Level: Grade 7
- LIST Grouping(s):
Unknown
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Identified Data Fields:
We have done our best to automaticly identify and name form fields according to our naming conventions.
When possible, we've used names tied to our question library. See e.g., user1_name.
If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.
Here are the fields we could identify.
yo
was yo (0.58 conf)el_es_del_los_las
was 2__el_la__demandante_es_el_la__tutor_a__legal_del_la_los__las__niño_a__niños_as__mencionado_a_os__as__arriba (0.53 conf)trabajo_como
was trabajo_como (0.43 conf)trabajo_para
was trabajo_para (0.37 conf)de_primera_instancia
was tribunal_de_primera_instancia (0.55 conf)que_lo_es_cierto_de
was afirmo_que_lo_anterior_es_cierto__bajo_pena_de_perjurio (0.49 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
Suggested Screen 1:
Suggested Screen 2:
trabajo_como
trabajo_para
de_primera_instancia
Suggested Screen 3:
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