FINANCIAL STATEMENTS
Supreme Court Family Rule 5-1 – Financial Disclosure, sets out what documents must be
produced, which parties are required to file a financial statement and when the various parts of
the document are applicable.
There is no fee to file a Financial Statement, however, this document must be sworn by a
commissioner for taking affidavits. If you wish to have your document sworn at the court
registry, the fee is $40.00.
The following information is included in this package:
1) Supreme Court Rule 5-1 – Financial Disclosure
2) Form F8 – Financial Statement.
Rule 5-1 — Financial Disclosure
Interpretation
Interpretation
(1) In this rule:
"applicable income documents" means, in respect of a person,
(a) a copy of every personal income tax return filed by the person
for each of the 3 most recent taxation years,
(b) a copy of every notice of income tax assessment or
reassessment issued to the person for each of the 3 most recent
taxation years,
(c) if the person is receiving employment insurance benefits, a
copy of the 3 most recent employment insurance benefit
statements,
(d) if the person is receiving workers' compensation benefits, a
copy of the 3 most recent workers' compensation benefit
statements,
(e) if the person is receiving social assistance, current documentary
evidence of the social assistance that is being received by that
person,
(f) if the person is an employee,
(i) the most recent statement of earnings indicating the
total earnings paid to the person in the year to date,
including overtime, or
(ii) if that statement is not provided by the employer, a
letter from the person's employer setting out the
information referred to in subparagraph (i) and including
the person's rate of annual salary or remuneration,
(g) if the person is self employed, the following information for the
3 most recent taxation years:
(i) the financial statements of the person's business or
professional practice, other than a partnership;
(ii) a statement showing a breakdown of all salaries, wages,
management fees or other payments or benefits paid to, or
on behalf of, persons or corporations with whom the person
does not deal at arm's length,
(h) if the person is a partner in a partnership, confirmation of the
person's income and draw from, and capital in, the partnership for
each of its 3 most recent taxation years,
(i) if the person controls a corporation, the following information
for the corporation's 3 most recent taxation years:
(i) the financial statements of the corporation and its
subsidiaries;
(ii) a statement showing a breakdown of all salaries, wages,
management fees or other payments or benefits paid to, or
on behalf of, persons or corporations with whom the
corporation and every related corporation does not deal at
arm's length,
(j) if the person is a beneficiary under a trust, a copy of the trust
settlement agreement and copies of the trust's 3 most recent
financial statements, and
(k) if the person owns or has an interest in real property, a copy of
the most recent assessment notice issued from an assessment
authority for each property;
"child support guidelines" means,
(a) in reference to a claim under the Family Law Act, the child
support guidelines established under the Family Law Act, or
(b) in reference to a claim under the Divorce Act, the child support
guidelines established under the Divorce Act;
"party" means a person named as a party to a family law case who is
claiming, or against whom is claimed,
(a) an order for child support or an order changing, suspending or
terminating an order for child support,
(b) an order for spousal support or an order changing, suspending
or terminating an order for spousal support,
"social assistance" includes
(a) income assistance within the meaning of the Employment and
Assistance Act, and
(b) disability assistance within the meaning of the Employment and
Assistance for Persons with Disabilities Act;
"stepparent" means, in relation to a child,
(a) a stepparent of the child within the meaning of section 146 of
the Family Law Act, or
(b) a person who stands in the place of a parent for the child
within the meaning of the Divorce Act.
Application of this rule
(2) This rule applies to a family law case as follows:
(a) if, in the family law case, a person is seeking to obtain or to change,
suspend or terminate an order for child support, subrules (1), (3) to (8)
and (11) to (32) apply;
(b) if, in the family law case, a person is seeking to obtain, review or
change, suspend or terminate an order for spousal support, subrules (1),
(3), (9) and (11) to (32) apply;
(c) if, in the family law case, a person is seeking to obtain or to change,
suspend or terminate an order for relief under Part 5 of the Family
Relations Act, subrules (1), (3) and (10) to (32) apply.
(d) if, in the family law case, a person is seeking to set aside or replace
the whole or any part of that portion of an agreement that deals with
child support, subrules (1), (3) to (8) and (11) to (32) apply;
(e) if, in the family law case, a person is seeking to review, set aside or
replace the whole or any part of that portion of an agreement that deals
with spousal support, subrules (1), (3), (9) and (11) to (32) apply.,
Numbering applicable income documents
(3) Each page of the applicable income documents that are to be used in court
must be numbered sequentially.
Claims for Child Support
Who must provide Part 1 of a Form F8 financial statement
(4) Each party who is required under the child support guidelines to provide
income information must file the following documents and must serve them
under subrule(11):
(a) Part 1 of a Form F8 financial statement;
(b) the party's applicable income documents;
(c) any other documents that the party is required to file and serve under
subrules (5) to (7).
Who must provide Parts 2 and 3 of a Form F8 financial statement
(5) In addition to any other documents a party is obliged to file and serve
under this rule, the party must file Parts 2 and 3 of a Form F8 financial
statement and must serve those documents under subrule (11), if one of
the following is true:
(a) the child support guidelines require the court to consider any or all of
the following:
(i) the financial ability of the parties;
(ii) the means of the parties;
(iii) the condition, means, needs and other circumstances of the
parties or the child;
(b) the party who is to pay the child support is a stepparent of the child.
If special or extraordinary expenses are claimed
(6) A party who makes a claim for special or extraordinary expenses must
(a) file Part 4 of a Form F8 financial statement, in addition to any other
documents the party is obliged to file under this rule, and
(b) serve that Part 4 under subrule (11).
["Special or extraordinary expenses" is defined in section 7 of the child support
guidelines.]
If undue hardship is claimed
(7) In addition to any other documents that a party is obliged to file and serve
under this rule, if a claim for undue hardship is made,
(a) the party making the claim for undue hardship must file and serve,
under subrule (11), Parts 1, 2, 3, 5 and 6 of a Form F8 financial statement
along with that party's applicable income documents, and
(b) unless the court otherwise orders, a party other than the party making
the claim for undue hardship must file and serve, under subrule (11),
Parts 1, 2, 3 and 6 of a Form F8 financial statement along with that
party's applicable income documents.
["Undue hardship" is defined in section 10 of the child support guidelines.]
Agreement avoids need for documents
(8) Parties are deemed to have complied with the requirements of the child
support guidelines respecting the provision of documents, and with the
requirements of this rule, as it applies to child support, respecting the filing
and service of documents, if
(a) the parties have agreed on the annual income of the party who is to
pay the child support,
(b) the parties have signed an agreement in Form F9, and
(c) the agreement in Form F9 has been filed together with the documents
referred to in that agreement.
Applications for Spousal Support
Who must provide income documents
(9) In addition to any other documents a party is obliged to file and serve
under this rule, a party must file Parts 1, 2 and 3 of a Form F8 financial
statement along with the party's applicable income documents, and must
serve those Parts and applicable income documents under subrule (11), if
one of the following is true:
(a) the party is seeking to obtain a spousal support order;
(b) the party is seeking to change, suspend or terminate a spousal
support order;
(c) a spousal support order is being sought against the party;
(d) a spousal support order has been obtained against the party and
another party is seeking to change, suspend or terminate that order.
Applications for Division of Assets
Who must provide Part 3 of a Form F8 financial statement
(10) Each party who is making a claim under Part 5 of the Family Relations Act
or against whom such a claim is being made must
(a) file Part 3 of a Form F8 financial statement, in addition to any other
documents that the party is obliged to file under this rule, and
(b) serve that Part 3 under subrule (11).
Service
When party must file and serve documents
(11) A party who is obliged to file documents under subrule (4), (5), (6), (7), (9)
or (10) (in this subrule called the "disclosing party") must file all of those
documents that have not already been filed, and serve on each of the other
parties all of those documents that have not already been served on that
party, as follows:
(a) if the disclosing party's obligation arises because of a claim he or she
made, he or she must file and serve those documents within 30 days, or
such other period as the court may order, after service of the document
in which the claim is made;
(b) if the disclosing party's obligation arises because of a claim made by
another party and the disclosing party resides in Canada or the United
States of America, the disclosing party must file and serve those
documents within 30 days, or such other period as the court may order,
after service of the document in which the claim is made;
(c) if the disclosing party's obligation arises because of a claim made by
another party and the disclosing party resides in a country other than
Canada or the United States of America, the disclosing party must file and
serve those documents within 60 days, or such other period as the court
may order, after service of the document in which the claim is made.
Assessment Notice
Assessment notice to be included
(12) If Part 3 of a Form F8 financial statement is to be served on a party under
this rule, the party serving the Part 3 must, if that party owns or has an
interest in real property, serve, with the Part 3, the most recent assessment
notice prepared for that real property by an assessment authority unless
that assessment notice has already been served.
Particulars of Form F8 Financial Statements
Particulars may be demanded
(13) If a Form F8 financial statement lacks sufficient information, the other party
may demand particulars.
Court may order particulars
(14) If the party from whom particulars are demanded under subrule (13) fails to
provide those particulars within 7 days after receipt of the demand, the
court may, on terms it considers appropriate, make any order it considers
will further the object of these Supreme Court Family Rules, including
(a) an order that particulars be served within a specified time, or
(b) an order that a new Form F8 financial statement be served within a
specified time.
Changes in Financial Circumstances
Information must be kept current
(15) If information contained in a document filed and served under this rule is
rendered inaccurate or incomplete by a material change in circumstances,
the party who filed and served that document must, promptly after that
material change, serve on all parties
(a) a written statement setting out the accurate and complete
information, or
(b) a revised Form F8 financial statement containing the accurate and
complete information.
Additional documents
(16) If the material change in circumstances referred to in subrule (15) is such
that the party becomes obliged to file and serve documents under this rule
that are additional to the documents previously filed and served under this
rule by that party, the party must
(a) serve copies of those additional documents within 28 days after the
material change, and
(b) comply with subrule (15) in relation to the previously served
documents.
If written statement or particulars provided
(17) If a party provides particulars under subrule (13) or (14) (a) or serves a
written statement under subrule (15) (a),
(a) the particulars or statement may be treated at a trial or hearing as
forming part of the original Form F8 financial statement of the party, and
(b) the other party may, with leave of the court, require that the
particulars or statement be
(i) verified by an affidavit of the party providing the particulars or
serving the statement, or
(ii) the subject of further cross-examination.
Updated statements
(18) A party who has served a Form F8 financial statement more than 91 days
before the start of the trial or hearing of an application to which a Form F8
is relevant must serve on all parties an updated Form F8 financial statement
at least 28 days before but not more than 63 days before the start of the
trial or hearing.
Disclosure of Business Interests
Production of documents
(19) If a party discloses business or corporate interests in a Form F8 financial
statement served under this rule, the party receiving the Form F8 financial
statement may, in writing, request the disclosing party to produce for
inspection and copying specified documents or classes of documents in the
disclosing party's possession or control that might reasonably be required
to verify the valuation of the disclosing party's interest or to determine the
disclosing party's income.
Responding to demand
(20) A party who receives a request under subrule (19) must, within 21 days
after receipt, serve on the requesting party a notice stating
(a) a time and place, during normal business hours, at which the
documents may be inspected, and
(b) the cost of copying the documents.
Request to corporation, partnership or proprietorship
(21) If a party who makes a request under subrule (19) is not satisfied with the
reply to the request, the requesting party may serve on the corporation,
partnership or proprietorship in which the disclosing party has disclosed an
interest a written request to produce for inspection all documents that are
relevant to the valuation of the interest or the determination of the
disclosing party's income.
Production required
(22) A corporation, partnership or proprietorship that receives a request under
subrule (21) must, within 21 days after receipt, provide a written statement
to the requesting party
(a) detailing the documents in its possession or control that it is obliged
to produce in response to the request,
(b) identifying those documents, if any, in respect of which the
corporation, partnership or proprietorship intends to seek an exemption
under subrule (24),
(c) specifying a time and place at which the documents for which an
exemption is not being sought may be inspected, and
(d) specifying the cost of copying the documents for which an exemption
is not being sought.
Application to court for directions
(23) A corporation, partnership or proprietorship or either of the parties may
apply to the court at any time for directions respecting any request for
production of documents under subrule (19) or (21), including directions
respecting payment of the costs of copying the documents, and the court
may give those directions accordingly.
Application to court for exemption
(24) A corporation, partnership or proprietorship may, within 21 days after the
date a request is served on it under subrule (21), apply to the court for an
order exempting it from the requirement to produce any document.
Application by person authorized
(25) An application under subrule (23) or (24) may be made on behalf of a
corporation or partnership by a person who has been authorized by the
corporation or partnership for that purpose.
Court may order exemption
(26) On an exemption application under subrule (24), the court may make an
order exempting the applicant from the requirement to produce all or any
of the requested documents if the court considers that
(a) the documents and information already received by the party who
made the request under subrule (21) are sufficient for the purposes of
the main application,
(b) the production of the documents is not necessary for the purposes of
the main application,
(c) in the case of a corporation, the prejudice that is likely to be suffered
by the corporation, or to its directors or shareholders, if the exemption is
not granted outweighs the prejudice that is likely to be suffered by the
person requesting the documents if the exemption is granted, or
(d) in the case of a partnership, the prejudice that is likely to be suffered
by the partnership, or to its partners or associates, if the exemption is
not granted outweighs the prejudice that is likely to be suffered by the
person requesting the documents if the exemption is granted.
Costs
(27) The court may order that the costs of producing documents under subrule
(20) or (22) and the costs of an application under subrule (23) or (24) be
paid in favour of or against
(a) either of the parties to the family law case, or
(b) the corporation, the partnership or the owner of the proprietorship, as
the case may be.
Enforcement of this Rule
Relief
(28) Without limiting Rule 21-5 and any other powers the court may have under
the Family Law Act, if a party fails to comply with a requirement under this
rule to file or serve a Form F8 financial statement or any applicable income
document or fails to comply with an order under this rule to provide
particulars, the court may do any or all of the following:
(a) order that the Form F8 financial statement, applicable income
document or particulars, as the case may be, be filed or served or both
on terms the court considers appropriate;
(b) dismiss all or part of that party's claim or application;
(c) strike out all or part of that party's response to family claim or
response to counterclaim;
(d) proceed under Rule 21-7 to punish the party for contempt of court;
(e) impose a fine under section 213(2)(d)(iii) of the Family Law Act;
(f) draw an adverse inference against the party;
(g) attribute income to that party in an amount the court considers
appropriate;
(h) make an order as to costs.
[Rule 21-5 sets out what the court may do if parties fail to comply with these rules.]
Confidentiality of Information
Confidentiality
(29) Any person who has access to documents obtained under this rule must
keep the documents and any information contained in them in confidence
and must not disclose the documents or information to anyone other than
(a) for the purposes of a valuation of an asset,
(b) for a determination of the disclosing party's income, or
(c) in the course of permitting the documents to be introduced into
evidence during the family law case.
Sealing of financial information
(30) If the court considers that public disclosure of any information filed under
this rule would be a hardship on the person in respect of whom the
information is filed,
(a) the court may order that the whole or any part of the document in
which the information is contained, and the whole or any part of the
transcript of the cross-examination on the document, must promptly be
sealed in an envelope, and
(b) if an order is made under paragraph (a), no person may search the
sealed documents without an order of the court.
Conflict with Guidelines
Child support guidelines prevail
(31) If and to the extent that there is a conflict between any provision of this
rule and a provision of the child support guidelines, the provision of the
child support guidelines prevails.
No conflict
(32) For the purposes of subrule (31), it is not a conflict between the child
support guidelines and this rule merely because this rule
(a) requires a person to provide information that is different from or
additional to the information, if any, that that person would be obliged to
provide under the child support guidelines,
(b) requires that certain information required by this rule but not by the
child support guidelines be presented in a manner or form that is
different from the manner or form in which information required under
the child support guidelines is to be presented, or
(c) requires the provision, in one manner or form, of information some or
all of which is required under the child support guidelines to be provided
in a different manner or form.
Form F8
This is the .......... affidavit
of .................................. in this case
and was made on ..................................
Court File No.: .................................
Court Registry: .................................
In the Supreme Court of British Columbia
Claimant:
Respondent:
FINANCIAL STATEMENT
Instructions For Completion
You do not need to complete this form if ALL of the following apply:
a) you are applying for child support but are making no claim for any other kind of support;
b) the child support is for children who are not stepchildren;
c) none of the children for whom child support is claimed is 19 years of age or older;
d) the income of the party being asked to pay child support is under $150 000 per year;
e) you are not applying for special expenses under section 7 of the child support
guidelines;
f)
you are not applying for an order under section 8 of the child support guidelines;
g) you are not applying for an order under section 9 of the child support guidelines;;
h) you are not making a claim based on undue hardship under section 10 of the child
support guidelines.
Unless ALL of the conditions above apply, you must swear the following affidavit and complete
the Parts of this Form that the following chart indicates apply to you.
This Form has 6 Parts. You may not have to complete all Parts. Which Parts you have to
complete depends on which categories of application apply to you as set out in the following
chart.
Please check off each of the Items, 1 through 8, that apply to you and then complete the Parts
that are noted for those Items. Each required Part need be completed only once regardless of
the number of applicable Items for which it is required.
Item
1

2

3

4

5

6

7

Category
I am applying for spousal support
I am being asked to pay spousal
support.
I am being asked to pay child
support and all of the following
conditions apply:
a) There is no claim for
special expenses under
section 7 of the child
support guidelines;
b) The child support is only for
children who are not step
children;
c) None of the children for
whom child support is
claimed is 19 years of age
or older;
d) There is no application for
an order under section 9 of
the child support guidelines;
e) My income is under $150,
000 per year;
f) There is no claim based on
undue hardship under
section 10 of the child
support guidelines.
I am applying for or being asked to
pay child support and one or more
of the following conditions apply:
a) One or more of the children
is a stepchild;
b) One or more of the children
for whom child support is
claimed is 19 years of age
or older;
c) There is an application for
an order under section 9 of
the child support guidelines;
d) The income of the party
being asked to pay child
support is more than
$150,000 per year
I am being asked to pay child
support and I intend to make a
hardship claim under the child
support guidelines.
I am applying for child support and
the opposite party intends to make
a hardship claim under the child
support guidelines.
Either I claim child support or I am
being asked to pay child support
and there is a claim for special
Part 1
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Part 2
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Part 3
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Part 4
Part 5
Part 6
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8

expenses under section 7 of the
child support guidelines
I am making or responding to a
property claim under Part 5 of the
Family Law Act.

I, ............................................................................................................................................., of
[name]
......................................................................................................................................................,
[address for service]
SWEAR (OR AFFIRM) THAT:
1.
The information set out in this financial statement is true and complete to the best
of my knowledge.
[Check whichever of the following boxes is correct and complete any required information.]
2.

I do not anticipate any significant changes in the information set out in this
financial statement.

I anticipate the following significant changes in the information set out in
this financial statement:
...................................................................................................................
SWORN (OR AFFIRMED) BEFORE
ME at ............................, British Columbia
on ..................................................... .
.............................................................
A commissioner for taking
affidavits for British Columbia
)
)
)
)
)
)
)
)
)
.[print name or affix stamp of commissioner].
.............................................................
PART 1 – INCOME
A.
Employer information:

I am employed by ..........................................................................................
[name and address of employer]

I am self employed as ...................................................................................
[trade or occupation]

I operate an unincorporated business, the name and address of which is
........................................................................................................................
[name and address of business]
B.
Documentation supplied:
I have attached to this statement or serve with it a copy of each of the following applicable
income documents
[Check the first 2 boxes and check each other box that applies to you and provide the
documents referred to beside each checked box]:

every personal income tax return, including all attachments, that I have filed for
each of the 3 most recent taxation years;

every income tax notice of assessment or reassessment I have received for each
of the 3 most recent taxation years;

[if you are an employee] my most recent statement of earnings indicating the
total earnings paid in the year to date, including overtime, or, if such a statement
is not provided by me employer, a letter from my employer setting out that
information, including my rate or annual salary or remuneration;

[if you are receiving Employment Insurance benefits] my 3 most recent EI benefit
statements;

[if you are receiving Workers’ Compensation benefits] my 3 most recent WCB
benefit statements;

[if you are receiving social assistance] a statement confirming the amount of
social assistance that I receive;

[if you are self-employed] for the 3 most recent taxation years
(i)
the financial statements of my business or professional practice,
other than a partnership, and
(ii)
a statement showing a breakdown of all salaries, wages,
management fees or other payments or benefits paid to, or on
behalf of, persons or corporations with whom I do not deal at
arm’s length;

[if you are in a partnership] confirmation of my income and draw from, and capital
in, the partnership for its 3 most recent taxation years;

[if you control a corporation] for the corporation’s 3 most recent taxation years
(i)
the financial statements or the corporation and its subsidiaries,
and
(ii)
a statement showing a breakdown of all salaries, wages,
management fees or other payments or benefits paid to, or on
behalf of, persons or corporations with whom the corporation and
every related corporation does not deal at arm’s length;

[if you are a beneficiary under a trust] the trust settlement agreement and the
trust’s 3 most recent financial statements;

[if you own or have an interest in real property] the most recent assessment
notice issued from an assessment authority for the property.
NOTE: If the applicable income documents are not attached to or served with this financial
statement, they must nonetheless be provided to the other party if and as required by Rule 5-1
of the Supreme Court Family Rules.
C.
Annual Income
If line 150 (total income) of your most recent federal income tax return sets out what you expect
your income will be for this year and you are not obliged under Note 1 below to complete
Schedule A of this Form, ignore lines 1 to 7 below and record the number from line 150 of your
most recent federal income tax return at line 8 below. Otherwise, record what you expect your
income for this year to be from each of the following sources of income that applies to you.
Record gross annual amounts.
LINE
1
2
3
4
5
6
7
8
GUIDELINE INCOME FOR BASIC CHILD SUPPORT CLAIM
Sources and amounts of annual income
Employment income ($..................................) paid:  monthly /
 twice each month /  every 2 weeks)
Employment insurance benefits
Workers’ compensation benefits
Interest and investment income
Pension income
Social assistance income relating to self
Other income (attach Schedule A) – see Note 1
Child support guidelines income before adjustments
+
+
+
+
+
+
+
=
[If you are required to complete lines 1 through 7 above, total the
9
10
11
12
13
14
amounts of those lines here. Otherwise, record the number from
line 150 of your most recent federal income tax return]
Adjustments to income
Subtract union and professional dues
Adjustments in accordance with Schedule III of the child support
guidelines per line 8 of Schedule B (attached) – see Note 2
Child support guidelines income for basic child support
(line 8 as adjusted by lines 9 and 10)
CHILD SUPPORT GUIDELINE INCOME TO DETERMINE
SPECIAL EXPENSES
Child support guidelines income (from line 11 of this table)
Add spousal support received from the other party to the family law
case
Subtract spousal support paid to the other party to the family law
case
Add Universal Child Care Benefits relating to children for whom
special or extraordinary expenses are sought
Child support guidelines income to determine special expenses
(line 11 as adjusted by lines 12, 13 and 14)
15
16
17
18
19
INCOME TO BE INCLUDED FOR SPOUSAL SUPPORT CLAIM
Child Support guidelines income (from line 11 of this table)
Total child support received
Social assistance received for other members of household
Child Tax Benefit and BC Family Bonus
Total income to be used for a spousal support claim
(line 11 plus lines 16, 17 and 18)
+
-
(
)
(
)
(
)
=
+
+
=
+
+
+
=
Note:
1.
2.
You must complete Schedule A of this Form and include, at line 7 above, the
total income recorded at line 11 of Schedule A, if you expect to receive income
this year from any of the following sources:
(a)
taxable dividends from Canadian corporations;
(b)
net partnership income (limited or non-active partners only);
(c)
rental income;
(d)
taxable capital gains;
(e)
registered retirement savings income;
(f)
self-employment income;
(g)
any other taxable income that is not included in paragraphs (a) to
(f) or in lines 1 to 5 of Schedule A.
If there are any adjustments as set out in Schedule III of the child support
guidelines that apply to you, you must
(a)
complete Schedule B of this Form, and
(b)
include at line 10 above, the amount recorded at line 8 of that
completed Schedule B.
SCHEDULE A – OTHER INCOME
LINE
OTHER SOURCES OF INCOME
1
Self employment income: Gross = $............;
Net = $.............
2
3
4
5
6
7
8
9
10
11

+
Note: Provide financial statements of the business, including any
statement of business activities filed as part of your income tax
return
Other employment income
Net partnership income: limited or non-active partners only
Rental income: Gross = $............;
Net = $............

Total amount of dividends from Taxable Canadian Corporations
Total capital gains ($...............)
minus total capital losses ($............) =

Spousal support from another relationship or marriage
Registered retirement savings plan income
Net federal supplements
Any other income
Total of lines 1 through 10
+
+
+
+
+
+
+
+
+
+
SCHEDULE B – ADJUSTMENTS TO INCOME
LINE
1
2
3
DEDUCTIONS
Employment expenses, other than union or professional dues,
claimed under Schedule III of the child support guidelines [list]
 ................................................
$...............
 ................................................
$...............
-
Total $...............

Actual business investment losses during the year
Carrying charges and interest expenses paid and deductible under
the Income Tax Act (Canada): [list]
 ................................................
$...............
 ................................................
$...............
Total $...............

-
4
5
6
7
8
Prior period earnings ($.............) minus reserves ($...........) =

Portion of partnership and sole proprietorship income required to be
re-invested
ADDITIONS
Capital cost allowance for real property
Employee stock options in Canadian-controlled private corporations
exercised: value of shares when options exercised ($...........)
minus amount paid for shares ($............) minus amount paid to
acquire option ($.............)
=

Total adjustments
PART 2 – MONTHLY EXPENSES
Monthly
Compulsory deductions
CPP contributions
EI premiums
Income taxes
Employee pension contributions
Other [specify]
Compulsory Deductions Sub-total
Housing
Rent or mortgage
Property taxes
Property insurance
Water, sewer, garbage
Strata fees
House repairs and maintenance
Other [specify]
Housing Sub-total
Utilities
Heat and electricity
Telephone
Cellular telephone
Cable TV
Internet service
Other [specify]
Utilities Sub-total
Household expenses
Food
Household supplies
Meals outside the home
Furnishings and equipment
Other [specify]
Household expenses Sub-total
Transportation
Public transit, taxis
Gas and oil
-
+
+
Car insurance and licence
Parking
Repairs and maintenance
Lease payments
Other [specify]
Transportation Sub-total
Other
Charitable donations
Vacation
Pet care
Newspapers, publications
Other [specify]
Other Sub-total
Health
MSP premiums
Extended health premiums
Dental plan premiums
Health care (net of coverage)
Drugs (net of coverage)
Dental care (net of coverage)
Other [specify]
Health Sub-total
Personal
Clothing
Hair Care
Toiletries, cosmetics
Education [specify]
Life insurance
Dry cleaning/laundry
Entertainment/recreation
Gifts
Other [specify]
Personal Sub-total
Children
Child care
Clothing
Hair care
School fees and supplies
Entertainment/recreation
Activities and lessons
Gifts
Insurance
Other [specify]
Children Sub-total
Savings
RRSP
RESP
Other [specify]
Savings Sub-total
Support payments to others
[specify]
Support payments to others Sub-total
Debt payments
[specify minimum monthly payments]
Debt payments Sub-total
TOTAL MONTHLY EXPENSES
TOTAL ANNUAL EXPENSES
[multiply TOTAL MONTHLY EXPENSES by 12]
PART 3 – PROPERTY
ASSETS
Assets
Details
Date Acquired
[dd/mmm/yyyy]
Value
1. Real estate
 Attach a copy of the most recent
assessment notice for any property
that you own or in which you have an
interest.
 Provide details, including address or
legal description and nature of
interest, or any interest you have in
land, including leasehold interests
and mortgages, whether or not you
are registered as owner.
 Record the estimated market value of
your interest without deducting
encumbrances or costs of
disposition.
[Record encumbrances under
DEBTS below.]
Real estate Sub-total
2. Vehicles
 List cars, trucks, motorcycles, trailers,
motor homes, boats, etc.
Vehicles Sub-total
3. Financial assets
 List savings and chequing accounts,
term deposits, GIC’s, stocks, bonds,
Canada Savings Bonds, mutual
funds, insurance policies [indicate
beneficiaries], accounts receivable,
etc.
 Record account number and name of
institution where accounts are held.
Financial assets Sub-total
4. Pensions and RRSP’s
 Record name of institution where
accounts are held, name and
address of pension plan and pension
details.
Pension and RRSP’s Sub-total
5. Business interests
 List any interest you hold, directly or
indirectly, in any unincorporated
business, including partnerships,
trusts and joint ventures.
 List any interests you hold in
incorporated businesses.
 Record the name and address of the
company.
Business interest Sub-total
6. Other
 Include precious metals, collections,
works of art and any jewellery or
household items of extraordinary
value.
 Include location of safety deposit
boxes
Other Sub-total
TOTAL
DEBTS
Show your debts and other liabilities, whether arising from personal or business dealings, by
category, such as mortgages, charges, liens, notes, credit cards, accounts payable and tax
arrears. Include contingent liabilities such as guarantees and indicate that they are contingent.
Debt
Details
Date Incurred
[dd/mmm/yyyy]
Amount
Secured debts
 Mortgages
 Other (specify)
Secured debts Sub-total
Unsecured debts
 Bank loans
 Personal loans
 Credit cards [list]
 Other [specify]
Unsecured debts Sub-total
TOTAL
DISPOSAL OF PROPERTY
List all real and personal property disposed of during the 2 years preceding this statement or, if
the parties married within that 2 year period, since the date of marriage.
Description
[describe the property disposed of]
Date of Disposal
[dd/mmm/yyyy]
Value
PART 4 - SPECIAL OR EXTRAORDINARY EXPENSES
Note:
1.
Provide a separate statement under this Part 4 for each child for whom a claim is
made.
2.
To calculate a net amount, subtract, from the gross amount, subsidies, benefits,
income tax deductions or credits relating to the expense.
Name of child:
Annual
Gross
Annual
Net
Monthly
Gross
Monthly
Net
Child care expenses
Medical/dental insurance premiums attributed
to child
Health related expenses that exceed
insurance reimbursement by at least $100
Extraordinary expenses for primary or
secondary school
Post-secondary education expenses
Extraordinary extracurricular expenses [list]
Subtract contributions from child
(
)
(
)
(
)
(
)
TOTAL
PART 5 – UNDUE HARDSHIP
1. Responsibility for unusually high debts reasonably incurred to support the family
prior to separation or in order to earn a living
Owed to:
Terms of debt:
Monthly Amount
$.............
 [list]
 [provide details]
$.............
Total
2. Unusually high expenses for exercising parenting time or contact with, or access to, a
child
Details of expense
Amount
$.............
 [list]
$.............
Total
3. Legal duty under a court order or separation agreement to support another person
Name of person
Relationship
Nature of duty
4. Legal duty to support a child, other than a child for whom support is claimed, who is
(a) under age 19, or (b) 19 or older but unable to support himself or herself because of
illness, disability or other cause
Name of person
Relationship
Nate of duty
5. Legal duty to support a person who is unable to support himself or herself because of
illness or disability
Name of person
Relationship
Nature of duty
6. Other undue hardship circumstances [provide details]
PART 6 – INCOME OF OTHER PERSONS IN HOUSEHOLD
Name of person
Annual Income
Total