Superior Court of Washington

County of

Sealed Financial Source Documents

(List documents below and write "Sealed" at least one inch from the top of the first page of each document.)

[ ]      Income Tax records

[ ]      Pay Stubs

[ ]      Credit Card Statements

[ ]      Bank statements

[ ]      Checks or the equivalent

[ ]      Check registers

[ ]      Loan application documents

[ ]      Retirement plan orders

[ ]      Other

                                                                  Submitted by:

Notice:  The other party will have access to these financial source documents.  If you are concerned for your safety or the safety of the children, you may redact (block out or delete) information that identifies your location.