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APPENDIX 5


CAUSE NO. __________

IN THE MATTER OF THE MARRIAGE OF X IN THE DISTRICT COURT OF
X
____________________ X
AND X JEFFERSON COUNTY, TEXAS
____________________ X
X
AND IN THE INTEREST OF THEIR X
MINOR CHILDREN X 279th/317th JUDICIAL COURT

PETITIONER'S/RESPONDENT'S INVENTORY AND APPRAISEMENT

Comes Now, _________________________, Petitioner/Respondent, and files this her/his Inventory and Appraisement of all assets and liabilities, community and separate property, as attached.

Respectfully submitted
BY: _______________________
__________________________
State Bar No. _______________
ATTORNEY'S FOR PETITIONER/RESPONDENT










CERTIFICATE OF SERVICE

I certify that a true and correct copy of the attached Inventory and Appraisement was duly served upon Petitioner's/Respondent's attorney of record,

_____________________________________________________________________________,

on this the ______ day of _______________, ________.

_________________________

_________________________

APPENDIX 5


CAUSE NO. __________

IN THE MATTER OF THE MARRIAGE OF X IN THE DISTRICT COURT OF
X
____________________ X
AND X JEFFERSON COUNTY, TEXAS
____________________ X
X
AND IN THE INTEREST OF THEIR X
MINOR CHILDREN X 279th/317th JUDICIAL COURT

AFFIDAVIT

STATE OF TEXAS X
COUNTY OF JEFFERSON X

I, ____________________, state on oath that, to the best of my knowledge and belief, the foregoing inventory and appraisement contains

  1. a full and complete list of all properties in my possession or subject to my control that I claim belong to the community estate of myself and my spouse, with the values thereof;

  2. a full and complete list of all properties in my possession or subject to my control that I claim or admit as my or my spouse's separate property or estate, with the values thereof; and

  3. a full and complete list of debts that I claim are community indebtedness.

I make this affidavit with the following reservations and qualifications:

  1. Any omission from this inventory is not intentional but is done through mere inadvertence and not for the purpose of misleading my spouse.

  2. There may be other assets and liabilities of which my spouse is aware, and their ommission from this inventory should not be construed as a waiver of my interest in those items

SIGNED on this the _____ day of _______________, ______.

_________________________

_________________________

SIGNED under oath before me on the _____ day of _______________, ______.

_________________________

Notary Public, State of Texas

APPENDIX 5




CAUSE NO. __________
IN THE MATTER OF THE MARRIAGE OF X IN THE DISTRICT COURT OF
X
___________________________________ X JEFFERSON COUNTY, TEXAS
X
___________________________________ X 279th/317th JUDICIAL DISTRICT

NO. REQ'D
BY
DESCRIPTION OF ASSETS/LIABILITIES WIFE'S VALUES HUSBAND'S VALUES JUDGE'S COMMENTS AWARDED
TO W/H
    COMMUNITY ASSETS          
               
               
               
               
               
               
               
               
               
               
               
               
               


APPENDIX 5





CAUSE NO. __________
IN THE MATTER OF THE MARRIAGE OF X IN THE DISTRICT COURT OF
X
___________________________________ X JEFFERSON COUNTY, TEXAS
X
___________________________________ X 279th/317th JUDICIAL DISTRICT

NO. REQ'D
BY
DESCRIPTION OF ASSETS/LIABILITIES WIFE'S VALUES HUSBAND'S VALUES JUDGE'S COMMENTS AWARDED
TO W/H
    COMMUNITY DEBTS          
               
               
               
               
               
               
               
               
               
               
               
               
               


APPENDIX 5





CAUSE NO. __________
IN THE MATTER OF THE MARRIAGE OF X IN THE DISTRICT COURT OF
X
___________________________________ X JEFFERSON COUNTY, TEXAS
X
___________________________________ X 279th/317th JUDICIAL DISTRICT

NO. REQ'D
BY
DESCRIPTION OF ASSETS/LIABILITIES WIFE'S VALUES HUSBAND'S VALUES JUDGE'S COMMENTS AWARDED
TO W/H
    SEPARATE PROPERTY - WIFE          
               
               
               
               
               
               
               
               
               
               
               
               
               


APPENDIX 5





CAUSE NO. __________
IN THE MATTER OF THE MARRIAGE OF X IN THE DISTRICT COURT OF
X
___________________________________ X JEFFERSON COUNTY, TEXAS
X
___________________________________ X 279th/317th JUDICIAL DISTRICT

NO. REQ'D
BY
DESCRIPTION OF ASSETS/LIABILITIES WIFE'S VALUES HUSBAND'S VALUES JUDGE'S COMMENTS AWARDED
TO W/H
    SEPARATE PROPERTY - HUSBAND          
               
               
               
               
               
               
               
               
               
               
               
               
               


APPENDIX 5



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