AFFIDAVIT OF DIRECT PAYMENTS
STATE OF ____________________ ∋
COUNTY OF ___________________ ∋
BEFORE ME, the undersigned authority, personally appeared, _________________
_________________________ (your name), who, by me duly sworn, deposed as follows:
"My name is ___________________________________. I am of sound mind and
capable of making this affidavit. I am personally acquainted with the facts
herein stated, which are true."
"I was named Managing Conservator of our child(ren):________________________
___________________________________________(names), and am entitled to receive
child support on behalf of said child(ren) according to the terms of the court
order entered on _________________________________ (date).
"I have received $__________________ in child support payments directly from
__________________________________________(name of payor). The last payment I
received directly from _______________________________________(name of payor) was
on _______________________________(date). I acknowledge that the facts contained
in this exhibit are true and correct."
SIGNED on ______________________________, 200_____.
SUBSCRIBED AND SWORN TO BEFORE ME, the undersigned Notary Public, on this
________________ day of ___________________________, 200____.
NOTARY PUBLIC, STATE OF _____________