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• Failure to complete and serve this form may result in sanctions consistent with MCR 2.313.

• Each party must complete a copy of this form and sign page 7 before a notary public. All the applicable sections must
be completed.

• You must serve a completed copy of your form on the other party within 28 days after the date of service of defendant’s

initial responsive pleading to the complaint that started the case.

• Completing this form is not necessary if you and the other party agreed in writing not to exchange the form, or if a
settlement agreement, consent judgment, or other final order that resolves the case has been signed by you and the
other party at the time the case is filed.

• A proof of service must be filed with the court after you have served this form on the other party.

• Do not file this document with the court.

Note: If you are a victim of domestic violence, sexual assault, or stalking by another party in this case, you may leave out
any information which might lead to the location of where you live or work, or where a minor child (if any) may be found.
If you are self-represented and do not provide your address because of domestic violence, you will need to give this
form to the other party at the first scheduled matter, or as otherwise directed by the court or agreed to by the parties. If
you leave out information, you must explain the reasons why in a sworn affidavit and file it with the court by the date this
disclosure form is due to the other party.

PERSONAL INFORMATION

First, middle, and last name

Name:

Address:

Date of birth:

Driver’s license number and state:

EMPLOYMENT INFORMATION

Employer name:

Employer address:

Occupation:

Street City State Zip

Phone:

Social Security Number:

Provide information for each source of employment income. Use additional sheets if necessary.

Self-employed

Street

City

State

Zip

Professional license, type and no.:

Gross income (before taxes and other deductions): $

weekly

biweekly

bimonthly

monthly

Hourly pay rate (including shift premium and cost of living adjustment): $

Total regular hours worked per pay period:

Average overtime hours for past 12 months:

Total amount of owner’s draws during the past twelve months (if self-employed) :

Approved, SCAO
Form CC 320, Rev. 6/22
MCR 3.206
Page 1 of ___

STATE OF MICHIGANJUDICIAL CIRCUITDOMESTIC RELATIONS VERIFIED FINANCIAL INFORMATION FORMCASE NO. and JUDGE Plaintiff’s namevDefendant’s nameDomestic Relations Verified Financial Information Form
Page 2 of ___

(6/22)

Case No.

health insurance

vision insurance

dental insurance

life insurance

Employment benefits:

retirement

car allowance

Amount

expense reimbursements

other

If unemployed and not receiving unemployment or worker’s compensation benefits, or working part-time only, provide the

following information regarding your last full-time employer:

Never employed full-time.

Name of last full-time employer:

Name

Address of last full-time employer:

Position:

Last day employed full-time:

Date

Length of time employed:

Street City State Zip

Reason for leaving last full-time employment:

Gross earnings per pay period (earnings before taxes): $

OTHER INCOME

Provide monthly income from all other sources.

Unemp. Benefits

Strike Pay

Nat’l Guard/Res. Drill

Armed Services

SUB Pay

Allowance for Rent

Sick Benefits

Rental Income

Workers’ Comp.

Spousal Support

Soc. Sec. Benefits

State Disability Asst.

Pensions/Longevity

VA Benefits

Deferred Comp/IRA

Disability Ins.

Trust Funds

GI Benefits

F I P

SSI

Other

Does anyone pay any living or housing expenses on your behalf?

yes

If yes, provide details of the payments including amount per month paid on your behalf:

Commissions

Bonuses

Profit Sharing

Interest

Dividends

Annuities

NOTE: Attach your four most recent paycheck stubs, or a statement from your employer(s) of wages and deductions, and
year-to-date earnings, and a copy of your last federal and state income tax returns, including all schedules to this form. If
self-employed, also attach a copy of your three most recent business tax returns and/or corporate returns.

Domestic Relations Verified Financial Information Form
Page 3 of ___

(6/22)

Case No.

Provide asset information for divorce, separate maintenance, and annulment cases only (DO and DM case types).

Provide the following information for any real estate in which you own an interest. Use additional sheets if necessary.

Street

City

State

Zip

Date of purchase:

Date

Estimated value: $

SEV: $

The monthly payment includes:

taxes.

insurance.

ASSET INFORMATION

Real Property

Address of property:

Balance on mortgage/land contract: $

Monthly payment: $

Name of lender:

Property is titled as follows:

Primary residence

Other:

Balance of equity loan or line of credit: $

Name of lender for equity loan or line of credit:

Financial Accounts

Name(s) and specific ownership interest in property

Monthly payment: $

List all financial accounts including, but not limited to, bank, credit union, CDs, stocks, annuities, IRAs, 401(k), 403(b), trust,
Michigan Education Savings Program (MESP), and health savings accounts in which you have an interest. Use additional
sheets if necessary.

Type of account

Account no.

Name of institution

Name on account

Type of account

Account no.

Name of institution

Name on account

Type of account

Account no.

Name of institution

Name on account

Type of account

Account no.

Name of institution

Name on account

Current balance
(before taxes)

Balance 90 days before
current balance

Current balance
(before taxes)

Balance 90 days before
current balance

Current balance
(before taxes)

Balance 90 days before
current balance

Current balance
(before taxes)

Balance 90 days before
current balance

as of:

Pension

Company or employer name:

Lump sum value: $

Life Insurance

Insurance Company:

Policy owner:

Death benefit: $

Domestic Relations Verified Financial Information Form
Page 4 of ___

(6/22)

Case No.

List all defined benefit plans that will pay you a monthly benefit at retirement age. Use additional sheets if necessary.

Earliest date you are eligible to receive your pension benefit:

Date

Estimated monthly payment: $

Provide the following information for all life insurance policies in which you have an interest. Use additional sheets if necessary.

Policy no.:

Beneficiary:

Premium: $

per

week/month/year

Cash/surrender value: $

as of

Date

Taxable

Employer provided:

yes

Motorized Vehicles

List all motorized vehicles in which you own an interest. Include automobiles, boats, snowmobiles, motorcycles, recreational
vehicles, etc. Include information on any loans that you co-signed for the benefit of another person. Use additional sheets if
necessary.

Year, make and model

Title holder

Lender

Estimated value

Year, make and model

Title holder

Lender

Estimated value

Year, make and model

Title holder

Lender

Estimated value

Year, make and model

Title holder

Lender

Estimated value

Amount owed

as of

Domestic Relations Verified Financial Information Form
Page 5 of ___

(6/22)

Case No.

Personal Property

List all other items of personal property such as furniture, jewelry, gold, silver, collectibles, artwork, guns, furs, tools, etc.
Do not include items of minimal value such as clothing. Use additional sheets if necessary.

Description of property

Estimated value

Date purchased or
acquired

Total: $

1. Do you own or have access to any safe deposit boxes?

yes

If yes, provide information on where it is

2. Are any accounts, money, or assets being held for your benefit?

yes

If yes, provide amount, where it

Miscellaneous Use additional sheets if necessary.

located and a list of the contents:

is held, and the reason it is being held:

3. Are you holding or acting as the custodian of any money, accounts, or asset for the benefit of someone else?

yes

If yes, describe what it is, where it is located, and why you are holding it or acting as custodian:

4. Do you have any ownership interests in any type of business?

yes

If yes, describe the business and

what your ownership interests are:

5. Are there any other assets or income to which you are entitled, or to which you believe you will become entitled?

yes

If yes, describe the assets, their value, and why you believe you are or will be entitled to them:

Balance owed

as of

Domestic Relations Verified Financial Information Form
Page 6 of ___

(6/22)

Case No.

6. Are there any debts that are owed to you?

yes

If yes, describe who owes the money, how much is

owed, the amount and frequency of payments, the purpose of the loan, and the loan end date:

7. Are there any other items you own that have financial value such as electronic assets, season tickets, or electronic
If yes, describe asset, where it is held and its current value as of a
currency such as bitcoin?

yes

8. Are there any outstanding court cases other than this one involving you, your spouse, or family members that may

If yes, describe the case, where it is filed and the possible

result in an award for or against you?

yes

Provide debt information for divorce, separate maintenance, and annulment cases only (DO and DM case types).

Credit cards, personal loans, student financial aid loans, other unsecured loans

Include all loans that are for your benefit or that you are a co-signer on for another person. Use additional sheets if necessary.

award or liability:

DEBTS

specific date:

Type of debt

Name of lender

Account no.

Name(s) on account

Type of debt

Name of lender

Account no.

Name(s) on account

Type of debt

Name of lender

Account no.

Name(s) on account

Type of debt

Name of lender

Account no.

Name(s) on account

Attach the last three statements for all accounts.

Domestic Relations Verified Financial Information Form
Page 7 of ___

(6/22)

Case No.

Court ordered financial obligations

Provide the following information for all your court-ordered financial obligations including, but not limited to, child or spousal
support in a different case, garnishment, civil judgment against you, and court-ordered fines, fees or restitution. Use additional
sheets if necessary.

Child support, spousal support, garnishment, judgment, etc.

per

Type of obligation:

Payment amount: $

Balance (if applicable): $

Court:

Estimated end date (if applicable):

Date

Case no.:

MISCELLANEOUS

Provide miscellaneous information for divorce, separate maintenance, and annulment cases only (DO and DM case
types).

1. Have you ever filed for bankruptcy?

yes

If yes, provide the date, case number, and current status

of the bankruptcy:

2. Do you claim that any of the assets or debts that you listed are your separate property?

yes

If yes,

provide detailed information on which asset(s) or debt(s) and why you think they are your separate property:

3. If there is any additional information regarding assets, debts, business interests, stocks, bonds, anticipated income, or
any financially related information of any kind that has not been disclosed on this form, provide that information below.

declare that the statements above are true to the best of my information, knowledge, and belief.

Signature

Subscribed and sworn to before me on

Date

My commission expires on

Deputy clerk/Notary public signature

Name (type or print)

Notary public, State of Michigan, County of

Acting in the County of

This notarial act was performed using an electronic notarization system or a remote electronic notarization platform.

Date

CC320, Domestic Relations Verified Financial Information Form

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

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.courts.michigan.gov/Domestic-Relations (2023-03)
Page(s): 7
Fields(s): 266
Average fields per page: 38
Reading Level: Grade 10
LIST Grouping(s): WO-02-00-00-00, BE-04-00-00-00, WO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

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.

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signature_date was Date (1.00 conf)
subscribed_sworn was Subscribed and sworn to before me on (0.40 conf)
commission_expires was My commission expires on (0.40 conf)
undefined__4 was undefined_7 (0.39 conf)
public_state_michigan_county was Notary public State of Michigan County of (0.51 conf)
acting_county was Acting in the County of (0.37 conf)
undefined__5 was undefined_8 (0.39 conf)
notarial_act_performed_using_electronic_notarization_system_remote_platform was This notarial act was performed using an electronic notarization system or a remote electronic notarization platform (0.44 conf)
text__14 was Text17 (0.35 conf)
text__15 was Text18 (0.35 conf)
yes__11 was yes11 (0.35 conf)
no11 was no11 (0.35 conf)
no12 was no12 (0.35 conf)
yes__12 was yes12 (0.35 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

plaintiffs_name
defendants_name
users1_name
users1_phone_number
users1_address_line_one
users1_birthdate
social_security_number
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employer_name
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text__1
never_employed_fulltime
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sev
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undefined__3
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date_purchased_acquired__8
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description_property_row__10
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total
access_safe_deposit_boxes
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yes_describe_owes_money_much
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names_account__4
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yes__8
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no9
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text__10
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text__12
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type_obligation
payment_amount
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balance_applicable
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court
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provide_assets_debts
kind_disclosed_form__1
kind_disclosed_form__2
signature_date
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commission_expires
undefined__4
public_state_michigan_county
acting_county
undefined__5
notarial_act_performed_using_electronic_notarization_system_remote_platform
text__14
text__15
yes__11
no11
no12
yes__12

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

CC320, Domestic Relations Verified Financial Information Form

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02