Get Polk County Attorneys Office - Polkcountyiowa

This guide offers a clear and supportive overview on how to fill out the POLK COUNTY ATTORNEYS OFFICE Financial Affidavit for license reinstatement online. Follow the steps outlined below to ensure that all required information is accurately completed.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the Financial Affidavit form and open it in your online editor.
2. Carefully fill in your name, Social Security Number, and address in the designated fields. Ensure you print your name clearly.
3. Provide your phone numbers, including home, work, and cell, as applicable.
4. Indicate your employment status by selecting 'Yes' or 'No' and provide how many hours per week you work.
5. Enter your employer's name and complete the employer’s address, including street, city, state, and zip code.
6. Specify how long you have been employed and your total monthly income before taxes.
7. List any other sources of income along with their corresponding amounts.
8. Answer whether someone helps you pay your monthly expenses, and if so, provide their name.
9. Indicate the number of dependents you have and whether you pay child support, along with the amount.
10. State whether you rent or own property and disclose your monthly payment amount.
11. Indicate if you have any bank accounts and the name of your financial institution.
12. Provide details about any vehicle you own, including the make, model, and year.
13. List any additional assets you have, such as cash, real estate, or others.
14. Calculate and enter your total monthly expenses.
15. Answer if you have any pending criminal charges and indicate which counties you owe fines to.
16. Review the certification statement under penalty of perjury and sign your name, providing the date, Social Security number, and date of birth in the appropriate fields.
17. Once completed, save any changes made to the form. You can then download, print, or share the form as needed.

Complete your form online today for a smooth application process.