Form F37 Child Support Affidavit (Sole) Sample
Form F37 Child Support Affidavit (Sole) Sample
Form F37 Child Support Affidavit (Sole) Sample
Claimant:
Respondent:
I, ELYSE EDITH KEATON, architect, of 123 Queen Street in the City of Vancouver, in the
Province of British Columbia, SWEAR (OR AFFIRM) THAT:
1. I am the Claimant.
(a) Parties:
(b) Children
Alex Albert Keaton 1 January 2000 13 Both parties Adopted child Adopted child
Mallory Marie Keaton 1 January 2002 11 Both parties Natural child Natural child
Jennifer Jean Keaton 1 January 2004 9 Both parties Natural child Natural child
Andrew Adam Keaton 1 January 2006 7 Both parties Natural child Natural child
3. The Notice of Family Claim includes a claim for a child support order.
4c. The Claimant and the Respondent have entered into an agreement as to income pursuant to
section 15(2) of the Guidelines, a copy of which agreement is attached.
5. I have completed and attach to this Affidavit Supplementary Child Support Fact Sheet B.
6. The proposed order sets out that $500 is the amount of child support payable by the
Respondent, in accordance with the agreement referred to in section 4(c) of this Affidavit.
7. I have completed and attached to this affidavit Supplementary Child Support Fact Sheet A
(special expenses), and the amount set out in the proposed order for the expenses under
section 7 of the Guidelines is $355.
8b. Medical coverage is available for the children under the Respondent’s medical insurance
plan.
9. There is no order of any court in force dealing with support of the children.
10. Attached as Exhibit A is the written agreement that deals with the support of the children.
11. The amount of arrears of child support, as at 1 March 2013, under any existing order or
written agreement is nil.
Anne Attorney
Hope & Despair LLP
123 Main Street
Vancouver, BC V1A 2B3
Section 7 expenses (net of tax credits and contribution from child, etc.):
Annual Monthly
Parties’ respective proportionate shares of the total net monthly section 7 expenses referred to at
Line G above:
Percentage Amount
Total monthly child support payable by the Respondent, including the monthly Guidelines table
amount under Schedule 1 of the Guidelines and the section 7 expenses, is $355.
Claimant Respondent
Number of children: 4
Approximate percentage of time children spend with each parent 50% 50%
Difference between the Guidelines table amount of the Claimant and $1,470
the Guidelines table amount of the Respondent
Any other relevant information regarding the conditions, means, needs and other circumstances
of each spouse or of any child for whom support is sought:
It is proposed that child support in the amount of $500 per month be paid by the Respondent.