The Uniform Support Declaration (USD) form plays a crucial role where child or spousal support payments might become a matter for legal discussion. It serves as a comprehensive document that gathers essential information concerning the involved parties' financial status and their capacity to contribute financially. Its core purpose is to ensure a fair evaluation of support matters by providing a clear overview of income, expenses, and other pertinent financial details. For those navigating through the complexities of support issues, completing the USD is a significant step towards achieving a resolution. Ready to fill out your form? Click the button below to get started.
The Uniform Support Declaration is a critical form used in family law cases, particularly when child or spousal support payments are a matter of concern. Its main function is to gather comprehensive information regarding the parties' finances, including income, expenses, and the ability to pay support. This declaration requires individuals to meticulously document a wide range of financial details, from gross monthly income and childcare expenses to health care coverage and medical expenses for the children involved. The form emphasizes the importance of protecting sensitive information; it instructs the filer to redact confidential details such as social security numbers and banking information to ensure privacy is maintained in public records. Additionally, the necessity of providing accurate and complete documentation is underscored, with the form specifying that originals of financial documents should not be brought to the court expecting duplication services. Instead, the responsibility falls on the individual to attach copies of pertinent documents, like pay stubs and tax returns, to their Uniform Support Declaration, making it a comprehensive, standalone document for the court's review. The declaration not only aids in establishing a fair and equitable support arrangement by presenting a clear picture of the financial standings of both parties but also highlights the legal obligations of individuals in safeguarding their personal information during the court process.
UNIFORM SUPPORT DECLARATION
The Uniform Support Declaration must be completed when the payment of child or spousal support is or could be an issue in the case.
The USD provides basic information about expenses and ability to pay.
CAUTION:
Please read the instructions for and use UTCR 2.130 forms to separate social security numbers, dates of birth and other private information from public records.
It is your responsibility to black out (redact) any confidential information on the attachments or copies. Examples of confidential information that should be redacted are social security numbers, dates of birth, checking account information, etc.
Do not bring the originals of your attachments, such as paystubs and tax returns, and expect the court to make photocopies to attach to your Uniform Support Declaration. You are responsible for making copies and ensuring they are on 8½” x 11” paper.
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR WASHINGTON COUNTY
In the Matter of:
Case No.
Judge Assigned:
Petitioner
Co-Petitioner
Check one box:
PETITIONER RESPONDENT
and
CO-PETITIONER
OTHER:
Respondent
OR CSP Case No.
SUMMARY INFORMATION—COMPLETE THIS PAGE LAST
After completing Sections 1 through 5, on Pages 2 through 5 below, insert the information and/or total MONTHLY amounts in this Summary Information section.
Date of Completion
_______________
mm/dd/year
1.
Number of Joint Children From This Relationship:
2.
Number of Joint Children Over 18 But Under 21 Attending School:
3.
Number of Nonjoint Additional Children:
4.
Gross Monthly Income From All Sources:
$_______________
5.
Receiving Temporary Assistance for Needy Families?
Yes
No
6.
Child(ren) on Oregon Health Plan/Healthy Kids or Other Public Health Plan?
7.
Social Security or Veteran’s Benefits Received for Child(ren):
Person with Disability is: Child Me
Other Parent
8.
Spousal Support RECEIVED by You:
9.
Spousal Support PAID by You:
10.
Mandatory Union Dues Paid:
11.
Health Care Premiums for Yourself Only if You Provide Insurance for Child(ren): $_______________
12.
Health Care Premiums Paid for Joint Child(ren):
13.
Out-of-Pocket Medical Expenses Paid for Joint Child(ren):
14.
Number of ANNUAL Overnights Child(ren) Spends With You:
15.
Childcare Expenses Paid for Joint Child(ren):
16.
City Where Childcare is Provided:
____________________________________________
Page 1—UNIFORM SUPPORT DECLARATION (December 2019)
This form is a DECLARATION under penalty of perjury required for support determinations. It must be completed in its entirety, signed, filed with the court or appropriate administrative agency, and served upon the other party (or their attorney).
INSTRUCTIONS: Answer all questions. Items marked with an * should be transferred to Page 1. If you are seeking spousal support, you need to complete Schedule 1. Attach additional page if needed.
IMPORTANT: This information will be disclosed to the other party and may be subject to public access. Protections are available using the court’s “Confidential Information Form” process.
1.CHILDREN
A. *List all JOINT CHILDREN (children under the age of 21 born or adopted during this relationship):
Children Living With:
Over 18 & Under
21
Attending School
Name of Child
Age
Me
Other Parent
Other
Yes
No
B.*List all NONJOINT ADDITIONAL CHILDREN (children under the age of 21 born to or adopted by you but not of this relationship).
Name
2.YOUR GROSS INCOME
A. From Your Employment:
Description
Monthly Amount
1
Gross hourly wage.
2
Average number of hours worked per pay period.
x
3
Convert to annual. If paid monthly, enter “12”. If paid twice
monthly, enter “24”. Every two weeks, enter “26”. Every
week, enter “52”.
4
Convert to monthly.
÷
12
5
Gross monthly income: 1. x 2. x 3. ÷ 4.
6
Gross monthly tips/commissions/bonuses (identify):
Subtotal of Monthly Income From Employment (5) + (6)
SUBTOTAL: 2.A.
Page 2—UNIFORM SUPPORT DECLARATION
B.Other Sources of Your Monthly Income:
(Attach verification of your gross monthly income as listed below):
Self-Employment
Dividends
Interest Income
Trust Income
Annuity Income
Social Security Income
Workers’ Compensation Benefits per week multiplied by 52; divided by 12
Unemployment Benefits per week multiplied by 52; divided by 12
Disability Income
Expense Reimbursements and/or Per Diem Allowance not listed in item A. above
Other (specify source/type)
Other (specify source/type):
SUBTOTAL: 2.B.
*Total of 2A + 2B Enter here and on Page 1, #4
TOTAL:
C. *Do you receive Temporary Assistance for Needy Families?
Yes, $________ monthly No
D.*Do you receive Social Security or Veteran’s benefits for any joint child(ren) due to parent’s disability?
Name of Beneficiary Child(ren) _______________________ Yes, $________ monthly No
Name of Disabled Parent ____________________________ Source
E.*Do you receive Social Security or Veteran’s benefits for any joint child(ren) due to child’s disability?
Name of Child(ren) _________________________________ Source
F. *Is there an order for you to RECEIVE spousal support from your spouse involved in this proceeding?
G. *Is there an order for you to RECEIVE spousal support from a former/subsequent spouse?
Yes, $________ monthly
H. *Are you ordered to PAY spousal support?
If Yes, to whom? __________________________________
I. *Do you pay mandatory union dues?
J.ATTACH A COPY OF YOUR FOUR MOST RECENT PAY STUB(S), BENEFIT STATEMENTS, AND COPIES OF YOUR MOST RECENTLY FILED STATE AND FEDERAL TAX RETURNS.
ATTACH COPIES OF SPOUSAL SUPPORT ORDERS AND ANY CHILD SUPPORT ORDERS FOR NONJOINT ADDITIONAL CHILD(REN) NOT LIVING WITH YOU.
Page 3—UNIFORM SUPPORT DECLARATION
3.HEALTH CARE COVERAGE AND MEDICAL EXPENSES
A.
*Is there a cost to insure just yourself if you provide insurance for the child(ren)?
B.
Do you provide health care coverage for your joint child(ren)?
C. Does someone else provide health care coverage for your joint child(ren)?
Name of person, or entity, providing, if other than you:
D.Are you or any member of your household:
i. Enrolled in the Oregon Health Plan, Healthy Kids, or any other public health care coverage?
ii. Receiving a state subsidy for public or private health care coverage?
E. Are any of the joint children enrolled in public health care coverage (Healthy Kids/Oregon Health Plan)? Name of child(ren) enrolled? _________________________________________ Yes No
If you answered “YES” to A, B, C, D, or E above:
i.Name all persons covered: Relationship to you:
ii.What is the source of the insurance? (such as through your employer, spouse, other):
iii. Insurance Co.:
Phone Number:
iv.Monthly amount of any state subsidy received by your household for public or private health-care coverage $____________.
v. Policy Number:
Group Number:
vi.Address for submission of claims:
vii.Your total monthly premium cost: (A)$____________; Cost to cover only you: (B)*$____________;
Total number of people enrolled (not counting yourself): (C)____________; Number of joint
children enrolled: (D)______
*The cost for the joint child(ren) only is (A – B) ÷ C = $____________ x D = *$____________
viii.ATTACH PROOF OF INSURANCE PREMIUMS.
F. *Do you pay any out-of-pocket medical expenses (not covered by insurance) for any joint child(ren) on
a monthly basis?
Yes No
If yes, list the name of the child, the reason for the cost(s), and the amount per month:
i.
; $
ii.
iii.
iv.
G.Does anyone pay a share of the monthly out-of-pocket medical costs for the child(ren)?
Yes No
If yes, who?
; amount they pay? $
H.ATTACH PROOF OF MONTHLY MEDICAL EXPENSES.
Page 4—UNIFORM SUPPORT DECLARATION
4.YOUR CHILDCARE EXPENSES
A. *Do you pay for childcare for the joint child(ren) so you can work, train, or look for work? Yes No
If yes,:
Paid to:
Average Monthly Payment
B. *Does anyone else share the cost of childcare for the joint child(ren)?
If yes, name:
Average Monthly Amount $
C.*City where childcare is provided:
D.ATTACH COPIES OF PROOF OF CHILDCARE EXPENSES.
5.*YOUR PARENTING TIME
PROPOSED
OCCURRING
EXISTING PLAN OR WRITTEN AGREEMENT
A.How many ANNUAL overnights does each joint child spend with YOU?
i.Name of Child: ___________________________________ # of overnights: _______________
ii.Name of Child: ___________________________________ # of overnights: _______________
iii.Name of Child: ___________________________________ # of overnights: _______________
iv.Name of Child: ___________________________________ # of overnights: _______________
B.ATTACH COPY OF MOST RECENT PARENTING PLAN OR WRITTEN AGREEMENT.
6.YOUR REBUTTAL FACTORS
A.The amount of child support to be paid may be rebutted under OAR 137-050-0760. http://oregonchildsupport.gov/laws/rules/docs/050_0760.pdf
Are you seeking a rebuttal (an adjustment to the support amount)?
Explain briefly:
B. ATTACH SUPPORTING EVIDENCE/ADDITIONAL INFORMATION.
I HEREBY DECLARE THAT THE ABOVE STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF, AND THAT I UNDERSTAND THEY ARE MADE FOR USE AS EVIDENCE IN COURT AND ARE SUBJECT TO PENALTY FOR PERJURY.
Signature
Printed Name
Date
I am: PETITIONER RESPONDENT CO-PETITIONER OTHER:
Page 5—UNIFORM SUPPORT DECLARATION
ATTACHMENT CHECKLIST: Check the box and include the appropriate attachment(s).
Four most recent pay stubs or benefit statements
Most recent state and federal tax returns (including all applicable schedules)
Proof of insurance premiums
Proof of medical costs
Most recent parenting plan or written agreement
Proof of childcare costs
Copies of Spousal and Child Support Orders
Additional Page: Number items to correspond, include your name and case number
Other: _________________________________
CERTIFICATE OF MAILING
I hereby certify that I served a true and complete copy of this Uniform Support Declaration and all attachments
by mailing it first class mail, with postage prepaid, on(date) to the following people:
(Other Party/Attorney name)
Address:
(name)
Page 6—UNIFORM SUPPORT DECLARATION
SCHEDULE 1
Spousal/Partner and Child Support Factors
You must complete this schedule and prepare and submit the attachments requested in this schedule if either party seeks spousal support or deviation from the uniform child support guidelines. These are the total household expenses you must pay each month for yourself only and not for others in your household. Utility bills should be averaged over the year. Any other annual, quarterly, or other periodic payments should be converted to a monthly average. DO NOT LIST ANY EXPENSE IF IT IS DEDUCTED FROM YOUR WAGES.
1.FIXED COSTS:
RESIDENCE:
Mortgage or Rent
Second Mortgage/Home Equity Loan
Property Taxes (if not included in Mortgage)
Insurance (if not included in Mortgage)
UTILITIES:
Electricity
Gas
Water
Garbage
Telephone
Cable/Internet
C.
TRANSPORTATION:
Car Payments
Fuel
Maintenance and Repairs
Other (specify):
D.
INSURANCE:
Life
Automobile
Medical/Dental
E. Food and Household Items
F.
Medicine &Pharmaceutical – unreimbursed medical/dental costs
G. Court/DHR-Ordered Support Payments for other than child(ren)/spouse/RDP in
this case
TOTAL FIXED COSTS (A-G):
Page 7—UNIFORM SUPPORT DECLARATION
CONSUMER OBLIGATIONS:
Balance
Name of Creditor
Due
E.
TOTAL PAYMENTS ON CONSUMER OBLIGATIONS (A-F):
SUMMARY OF EXPENSES:
Fixed Costs (item 1 above)
Consumer Obligations (item 2 above)
TOTAL EXPENSES:
4.OTHER FACTORS:
Other factors that affect my income and expense or that should be considered (attach supporting documentation whenever possible).
My (printed) Name is: ____________________________________________
Page 8—UNIFORM SUPPORT DECLARATION
The Uniform Support Declaration form is a crucial document required when seeking support for children or spousal maintenance. It asks for comprehensive information about your financial situation, including income, expenses, and the particulars of any child or spousal support currently received or paid. This form is integral in establishing a fair support arrangement and must be filled out with accuracy and honesty. Before filling out the form, gather all necessary documentation, such as pay stubs, tax returns, and insurance premium statements, to ensure the information provided is precise. Follow the steps below carefully to complete the Uniform Support Declaration form.
Upon completion, review the form and attached documents to ensure all information is accurate and well-documented. It's critical to follow instructions for submitting the form to the respective court or administrative agency, along with serving the other party involved as per legal requirements. Accurate and thorough documentation supports a smoother process in determining support matters.
The Uniform Support Declaration is a form used in legal proceedings where child or spousal support payments are or could be a concern. It collects detailed information about an individual's finances, including income, expenses, and the ability to pay support. This form is crucial for determining fair support amounts in family law cases.
Redacting sensitive information such as social security numbers, dates of birth, and checking account details is crucial to protect your privacy. This action prevents unauthorized access to your confidential information, which could be used for identity theft or other fraudulent activities. Courts require that these details be obscured to ensure your personal data remains secure.
All income and expenses must be reported as monthly amounts on the USD. For income, this includes salary, self-employment revenue, dividends, and any benefits received, like social security or veteran’s benefits. Expenses related to childcare, healthcare premiums, and out-of-pocket medical costs for joint children should also be detailed.
If your financial situation changes significantly after submitting the USD, you should file an updated form with the court or appropriate administrative agency. This update is essential to ensure that child and spousal support amounts reflect current financial realities and are fair to both parties involved.
A completed USD must be filed with the court or appropriate administrative agency handling the support case. Additionally, a copy must be served upon the other party involved in the case or their attorney. Serving this document ensures that both parties are fully informed of the financial details influencing support determinations.
Completing the Uniform Support Declaration form accurately is crucial for cases involving child or spousal support. However, individuals often make errors that can significantly impact the process. Recognizing these common mistakes can help ensure that submissions are both accurate and effective.
Not redacting confidential information such as social security numbers, dates of birth, and checking account details, contrary to the strong cautions for privacy protection outlined in the instructions.
Failing to attach copies of pay stubs, tax returns, and other essential documents, or bringing originals to court with the expectation that copies will be made there.
Incorrectly calculating and reporting gross monthly income from all sources, leading to inaccuracies that can affect support decisions.
Omitting or incorrectly listing the number of joint and nonjoint children, a critical factor in determining support obligations.
Forgetting to include information on whether they or the child(ren) receive public health insurance or benefits like the Healthy Kids/Oregon Health Plan, which can affect the support calculations.
Overlooking to report spousal support received or paid, mandatory union dues, or health care premiums, which are essential components of the financial overview.
Not detailing out-of-pocket medical expenses for joint children, thereby missing a key aspect of the children's financial needs.
Misunderstanding the section on health care coverage and medical expenses, leading to incomplete or incorrect information about insurance premiums and out-of-pocket costs.
Incorrectly completing the summary information page last or not at all, which can cause inconsistencies with detailed entries made in previous sections.
These mistakes, ranging from privacy oversights to incomplete financial disclosures, underscore the importance of attentiveness and accuracy when completing the Uniform Support Declaration form. Addressing these areas effectively can help ensure that the information provided supports a fair and accurate determination of support obligations.
The process of determining child or spousal support involves more than just the Uniform Support Declaration form. This essential document gathers data on income and expenses to accurately assess the financial responsibilities one might owe or receive. However, to ensure a comprehensive evaluation, several other forms and documents are also commonly required. These are designed to provide a full picture of an individual's financial standing, which is crucial for making fair support determinations.
Together with the Uniform Support Declaration form, these documents enable the court or an administrative body to make informed, equitable decisions regarding support payments. The goal is to ensure that the financial needs of children and, when applicable, a spouse, are met in a way that reflects each parent's or spouse's ability to pay. It is a thorough process, demanding accuracy and transparency from all parties, for the benefit of those directly affected by the outcome.
Financial Affidavit for Child Support: Similar to the Uniform Support Declaration, this document collects detailed financial information from both parents to calculate child support obligations. It encompasses income, expenses, debts, and assets, mirroring the comprehensive nature of the Uniform Support Declaration in its pursuit of ensuring a fair and adequate support arrangement.
Spousal Support Affidavit: This parallels the Uniform Support Declaration by requiring detailed financial information from both parties in a separation or divorce. It specifically focuses on establishing the need for, and ability to pay, spousal support, akin to the spousal support sections in the Uniform Support Declaration.
Child Custody and Visitation Application Attachment: Although primarily used for determining custody arrangements, this form shares similarities with the Uniform Support Declaration in its inclusion of information about the children’s needs and the parents' living situations, which can indirectly influence financial support decisions.
Income and Expense Declaration: Similar to the Uniform Support Declaration, this form is designed to provide a court with a detailed overview of an individual's financial situation, including income, expenses, assets, and debts, crucial for decisions on support and maintenance in family law matters.
Asset and Debt Statement: This document requires a detailed listing of all assets and debts, similar to parts of the Uniform Support Declaration. While it focuses more on the division of property, it plays a significant role in determining parties' financial capabilities for support purposes.
Health Insurance Coverage Declaration: Like the health care coverage sections in the Uniform Support Declaration, this document outlines the health insurance available for dependents, detailing coverage options and costs, essential for determining how health care costs will be divided or attributed in support calculations.
Declaration of Disclosure: In divorce and separation proceedings, this comprehensive financial document requires disclosure of income, expenses, assets, debts, and all material facts and information regarding financial obligations and opportunities. Its comprehensive nature and requirement for full transparency align closely with the Uniform Support Declaration’s objective of fair support arrangements.
Childcare Costs Declaration: This form gathers detailed information about childcare expenses, similar to the childcare expenses section of the Uniform Support Declaration. It ensures that both parents accurately disclose childcare costs, which are crucial for calculating support obligations.
Temporary Assistance for Needy Families (TANF) Application: Although a government assistance program application, it parallels the Uniform Support Declaration in collecting detailed financial information to assess eligibility for benefits, which can also be relevant for determining need and ability to pay in support cases.
Statement of Net Worth: Commonly used in divorce proceedings, this document requires a detailed disclosure of financial status, including income, expenses, assets, and liabilities. Its holistic approach to financial disclosure resonates with the thorough financial examination seen in the Uniform Support Declaration.
When completing the Uniform Support Declaration form, certain guidelines should be followed to ensure accuracy and protect sensitive information. Below are key dos and don'ts to consider:
There are several misconceptions about the Uniform Support Declaration (USD) form that need to be cleared up. Understanding these misconceptions can help ensure that individuals are better prepared to complete the form accurately and efficiently. Here's a list of six common misunderstandings:
In reality, the USD form must be completed whenever payment of child or spousal support is or could be an issue in a case. It provides essential information about expenses and the ability to pay, making it a crucial component of the support determination process.
Actually, individuals are responsible for making copies of relevant financial documents. The court requires these copies to be on 8½” x 11” paper. Originals should not be brought to court expecting the court staff to make photocopies.
Contrary to this belief, it is crucial to redact any confidential information such as social security numbers, dates of birth, and checking account information on the attachments or copies to protect one's privacy.
While financial information is critical, the form also requires detailed information about children from the relationship, including those over 18 but under 21 attending school, and any nonjoint additional children. This comprehensive information is necessary for a complete support evaluation.
While the form is detailed, it is designed to be completed by individuals without requiring legal assistance. Clear instructions are provided, and it’s organized to collect all necessary information systematically.
The information will indeed be disclosed to the other party involved in the proceeding and may be subject to public access. However, protections are available using the court’s “Confidential Information Form” process for those concerned about privacy.
By understanding these misconceptions, individuals can approach the Uniform Support Declaration form with greater confidence and precision, ensuring all relevant information is accurately provided and processed.
The Uniform Support Declaration (USD) form is essential in proceedings where child or spousal support payments are or might become a matter. Presented are several vital takeaways to ensure its correct completion and use:
Finalizing the Uniform Support Declaration necessitates a meticulous approach to ensure both accuracy and confidentiality, reflecting the complexities inherent in the management of personal financial information within legal frameworks.
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