COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS CUYAHOGA COUNTY, OHIO ____________________________________ Date: _____________________________________ Plaintiff ____________________________________ Case Number: ______________________________ Date of Birth ____________________________________ Judge: ____________________________________ Address ____________________________________ City, State, Zip Code Vs. ____________________________________ MOTION FOR SUPPORT PENDENTE LITE Defendant ____________________________________ WITH NOTICE Date of Birth ____________________________________ Address ____________________________________ City, State, Zip Code Plaintiff/Defendant moves the Court for an order for support during the pendency of this action and for cause refers to the affidavit attached hereto. CERTIFICATE OF SERVICE The Motion for Support Pendente Lite with Notice has been sent by _________________ mail to _________________________ (NAME OF ATTORNEY OR PARTY) located at _________________________________ __________________________________________ on ________________________ (DATE). __________________________________________ ___________________________________________ Signature of Plaintiff/Defendant, if unrepresented Signature of Attorney for Plaintiff/Defendant __________________________________________ Attorneys Name and Registration Number: __________________________________________ Address: __________________________________________ City, State, and Zip: __________________________________________ Telephone Number: NOTICE OF MOTION Plaintiff/Defendant is hereby notified of the filing of this motion for support pendente lite. Plaintiff/Defendant is hereby directed to complete an answer affidavit (form affidavit available in Legal Department located in Basement Center South or in Journal Department located in Room 306 of Old Courthouse, One Lakeside Avenue, Cleveland, Ohio) and, within fourteen (14) days after receiving this notice, to file the same with the Clerk of Courts of Cuyahoga County, 1200 Ontario Street, Cleveland, Ohio 44113. If he/she fails to do so, the affidavit supporting this motion will be taken as true. STATE OF OHIO AFFIDAVIT OF INCOME, EXPENSES, AND FINANCIAL DISCLOSURE Plaintiff/Defendant herein, ______________________________, having been duly sworn states that he/she has been advis.

1. COURT OF COMMON PLEAS DIVISION OF DOMESTIC
RELATIONS
CUYAHOGA COUNTY, OHIO
____________________________________
Date: _____________________________________
Plaintiff
____________________________________
Case Number: ______________________________
Date of Birth
____________________________________
Judge: ____________________________________
Address
____________________________________
City, State, Zip Code
Vs.
____________________________________
MOTION FOR SUPPORT PENDENTE LITE
Defendant
____________________________________
WITH NOTICE
Date of Birth
____________________________________
Address
____________________________________
City, State, Zip Code

2. Plaintiff/Defendant moves the Court for an order for support
during the pendency of this action and for cause refers to the
affidavit attached hereto.
CERTIFICATE OF SERVICE
The Motion for Support Pendente Lite with Notice has been sent
by _________________ mail to _________________________
(NAME OF ATTORNEY OR PARTY) located at
_________________________________
__________________________________________ on
________________________ (DATE).
__________________________________________
___________________________________________
Signature of Plaintiff/Defendant, if unrepresented
Signature of Attorney for Plaintiff/Defendant
__________________________________________
Attorneys Name and Registration Number:
__________________________________________
Address:
__________________________________________
City, State, and Zip:
__________________________________________
Telephone Number:
NOTICE OF MOTION
Plaintiff/Defendant is hereby notified of the filing of this

3. motion for support pendente lite. Plaintiff/Defendant is hereby
directed to complete an answer affidavit (form affidavit
available in Legal Department located in Basement Center
South or in Journal Department located in Room 306 of Old
Courthouse, One Lakeside Avenue, Cleveland, Ohio) and,
within fourteen (14) days after receiving this notice, to file the
same with the Clerk of Courts of Cuyahoga County, 1200
Ontario Street, Cleveland, Ohio 44113. If he/she fails to do so,
the affidavit supporting this motion will be taken as true.
STATE OF OHIO AFFIDAVIT OF INCOME,
EXPENSES, AND FINANCIAL DISCLOSURE
Plaintiff/Defendant herein,
______________________________, having been duly sworn
states that he/she has been advised that this affidavit may be
used for the following purposes: (1) to disclose completely
affiant’s income and expenses; (2) to assist in determining
orders of child support and spousal support when applicable or
any changes thereto; and (3) to provide for the issuance of an
appropriate support withholding and deduction notice or other
order.
Minor and/or dependent children of this marriage:
___________________________________D.O.B.
____________ is residing with
______________________________
___________________________________D.O.B.
____________ is residing with
______________________________
___________________________________D.O.B.
____________ is residing with
______________________________
If a child is eighteen years of age, is the child still attending
high school? ________Yes ________No

4. SECTION I GROSS YEARLY INCOME
Husband Wife
|_| Unemployed
Unemployed |_|
_______________________________............Name of last
Employer................_______________________________
_______________________________..................Payroll
Address....................._______________________________
_______________________________..................City, State,
Zip......................_______________________________
_______________________________.................Termination
Date....................._______________________________
_______________________________...Income/Salary at the
time of termination...._______________________________
|_| Employed/self-employed |_| |_|
Employed/self-employed |_|
$__________________......Actual or Estimate......Base Yearly
Wages......Actual or Estimate....…$__________________
_______________________________.........................Employer
........................._______________________________
_______________________________..................Payroll
Address...................._______________________________
_______________________________..................City, State,
Zip....................._______________________________
|_| 12 |_| 24 |_| 26 |_| 52...........................Scheduled Paychecks
Per Year........................... |_| 12 |_| 24 |_| 26 |_| 52
$__________________...................Ordinary and Necessary
Business Expenses.................….$__________________
Other income of husband Other income of wife
$__________________....................................Unemployment
Benefits .....................................$___________________
$__________________.....................Social Security or Other
Disability Benefits .......................$_____________________

5. $__________________..................Spousal Support Received
from a prior marriage...................$___________________
$__________________................Interest/Dividend Income
(whether or not taxable) ................$___________________
($_________________)..............Public Assistance or
Supplemental Security
Income.............($____________________)
$__________________.....................................Other Income
Received.....................................$___________________
Specify:
_______________________________________________
_____________________________________________________
__
$__________________.....................................TOTAL
YEARLY
INCOME.....................................$___________________
ANNUAL INCOME, OVERTIME AND BONUSES EARNED
Husband (Past Three Years)
Wife
Base Income
Overtime and/or Bonuses
Base Income
Overtime and/or Bonuses
________
Year 3
$________
$________

6. ________
Year 3
$_______
$_______
________
Year 2
$________
$________
________
Year 2
$_______
$_______
________
Year 1
$________
$________
Most recent year
________
Year 1
$_______
$_______
ADJUSTMENTS
Husband
Wife
$______________per year............Court Ordered Support Paid
for Other Child(ren).............. $____________per year
$____________per year.....Court Ordered Spousal Support Paid
to a Former Spouse .......$______________per year
_______________………......Number of Other Dependent

7. Children Living with the Party.........________________
(Excluding Unadopted Step Children)
$______________per year........Child Support Received for
Other Dependent Children......$______________per year
(Indicated Immediately Above)
$_____________per year...Health Insurance Premium Paid by
Party if Children Included .. $_____________per year
SECTION II AFFIANT'S MONTHLY
EXPENSES
There are ________ adults and ________ children in my
household. Expenses for my present household:
Indicate which party is currently paying each bill. Circle H
(husband) or W (wife).
A. Housing
1. Rent or Mortgage (including taxes and insurance). . |_|H. . .
|_| W ....................................$___________________
2. Utilities
a. Electric and Gas or Oil. . . |_|H. . . |_|W
.............................................................................$_________
__________
b. Water and Sewer. . . |_|H. . . |_|W
.....................................................................................$____
_______________
c. Telephone (excluding long distance). . . |_|H. . . |_|W
........................................................$___________________
3. Other: ______________________________. . . |_|H. . . |_|W
..........................................$___________________
______________________________. . . |_|H. . .
|_|W.........................................................$________________

8. ____
TOTAL HOUSING
...............................................................................................
..................$____________________
B. 1. Auto repairs and license. . . |_|H. . . |_|W
.....................................................................$_____________
_______
2. Gasoline and oil. . . |_|H. . .
|_|W.......................................................................................
$____________________
3. Insurance: ______________________________. . . |_|H. . .
|_|W ...................................$____________________
______________________________. . . |_|H. . .
|_|W......................................$___________________
______________________________. . . |_|H. . .
|_|W......................................$___________________
4. Medical expenses (not covered by insurance). . . |_| H. . . |_|
W .......................................$___________________
5. Clothing. . . |_|H. . . |_|W
...............................................................................................
.....$___________________
6. Groceries (including food, laundry and cleaning
products/toiletries, lunches) |_|.H |_|W.
..$___________________
7. Child care expenses:
a. Education and employment related only. . . |_|H. . .
|_|W....................................$____________________
b. Non-employment related. . . |_|H. . . |_|W
...........................................................$___________________
_
MONTHLY
TOTAL...................................................................................
...............................$____________________

9. C. Monthly Installment Payments
(Do not list expenses previously listed in Section B)
TO WHOM PAID PURPOSE
BALANCE DUE MONTHLY PAYMENT PAID BY:
____________________ _______________________
$_______________ $__________________ |_|H |_|W
____________________ _______________________
$_______________ $__________________ |_|H |_|W
____________________ _______________________
$_______________ $__________________ |_|H |_|W
____________________ _______________________
$_______________ $__________________ |_|H |_|W
MONTHLY
TOTAL...................................................................................
....... $__________________
D. Additional Monthly Expenses
Complete if you are seeking either an award of spousal support
or a significant deviation from the child support schedule.
1. Special and unusual needs of the children
Specify:
________________________________________________.
|_|H.... |_|W.... . $______________________
2. Extraordinary visitation-related travel expenses. . . |_|H. . .
|_|W ..................................$____________________
3. Extraordinary obligations to other children, minor and
handicapped. . |_|H . . |_|W .....$____________________
(Excluding step-children)
4. Mandatory deduction from wages (not taxes, Social Security).
. . |_|H. . . |_|W.............$____________________
5. Additional taxes paid (not from wages). . . |_|H. . . |_|W
................................................$____________________
6. Hair care, dry cleaning. . . |_|H. . . |_|W
.........................................................................$___________

10. ________
7. Newspapers, periodicals, and books. . . |_|H. . . |_|W
...................................................$____________________
8. Children's activity fees. . . |_|H. . . |_|W ...
.....................................................................$_____________
_______
9. Tuition (for minor children or self). . . |_|H. . .
|_|W.........................................................$________________
____
10. Entertainment. . . |_|H. . . |_| W
...................................................................................$_____
_______________
11. Contributions. . . |_|H. . . |_| W
....................................................................................$_____
_______________
12. Memberships (associations, clubs). . . |_|H. . . |_|W
...................................................$____________________
13. Travel, vacations. . . |_|H. . . |_|W
...............................................................................$_______
_____________
14. Housing repairs. . . |_|H. . . |_|W
.................................................................................$______
______________
15. Other Specify:
____________________________________________|_|H. .
|_|W ..$____________________
____________________________________________|_|H. . .
|_|W...$____________________
____________________________________________|_|H. .
|_|W ....$____________________
TOTAL OTHER EXPENSES
...............................................................................................
$____________________
GRAND TOTAL MONTHLY EXPENSES (Sum of A, B, C, and
D [optional]).......................$____________________

11. I am currently in bankruptcy. YES ________ NO ________
Chapter ____________ Case No. ________________
Affiant states under penalty of law that the information
contained herein is complete and accurate to the best of his/her
information, knowledge, or belief.
________________________________________
________________________________________
Attorney Affiant |_|Plaintiff
|_|Defendant
Sworn to and subscribed in my presence this ____________ day
of ______________________, 20________.
_________________________________________
My commission expires ______________________
COURT OF COMMON PLEAS DIVISION OF DOMESTIC
RELATIONS
CUYAHOGA COUNTY, OHIO
____________________________________
Date: _____________________________________
Plaintiff
____________________________________

12. Case Number: ______________________________
Social Security Number Date of Birth
____________________________________
Judge: ____________________________________
Address
____________________________________
City, State, Zip Code
vs.
____________________________________
MOTION FOR SUPPORT PENDENTE LITE
Defendant
____________________________________
WITH NOTICE
Social Security Number Date of Birth
____________________________________
Address
____________________________________
City, State, Zip Code
Plaintiff/Defendant moves the Court for an order for support
during the pendency of this action and for cause refers to the
affidavit attached hereto.
CERTIFICATE OF SERVICE
The Motion for Support Pendente Lite with Notice has been sent
by _________________ mail to _________________________
(NAME OF ATTORNEY OR PARTY) located at
_________________________________
__________________________________________ on
________________________ (DATE).

13. __________________________________________
___________________________________________
Signature of Plaintiff/Defendant, if unrepresented
Signature of Attorney for Plaintiff/Defendant
__________________________________________
Attorneys Name and Registration Number
__________________________________________
Address
__________________________________________
City, State, Zip
__________________________________________
Telephone Number
Page 7 of 14
Family Law: Draft the Motion
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