Court use only:	Submission Date: _______/_______/_______

COURT OF COMMON PLEAS

DIVISION OF DOMESTIC RELATIONS

HAMILTON COUNTY, OHIO

Case No.
Plaintiff	Judge
Magistrate
-vs/and-
Defendant
NEUTRAL EVALUATION
FINANCIAL PERSPECTIVE BRIEF

Submitting Party: Plaintiff Defendant

Date of NE Session:

Date of Filing:

Date of Marriage:	Date of Separation:

Outstanding Financial Issues (please check all those applicable)

Real Estate

Household Goods

Automobiles

Funds on Deposit

Stocks and Bonds

Retirement Plans

Tax Refunds and Deductions

Life Insurance

Expectancies and Inheritances

Liabilities/Debt

Attorney Fees

Court Costs

Child Support

Spousal Support

Tuition

Other

Plaintiff’s Employer, Address, and Position:

Defendant’s Employer, Address, and Position:

Plaintiff’s Gross Annual Income and Source (include bonus amounts):

Defendant’s Gross Annual Income and Source (include bonus amounts):

Summary of monthly budget expenses (for the party preparing this form):

Mortgage/Rent
Equity Line
Food
Telephone
Heat
Sewer/Water/Garbage
Electricity
Cable TV
Medical Expenses
Health/Life Insurance
Home Insurance
Car Insurance
Car Payment
Car Repair/Fuel
Child Care
School Expenses
Donations
Other

Who in your home is responsible for managing the daily finances?

Summary of Debts:

Loans
Credit Card Bills (itemize)
Other (itemize)

Marital Residence:

(name on mortgage, name on deed, and address)

Marital Residence Equity:

Value
Date of Purchase
Last Appraisal Date and Amount
Amount of Outstanding Property Taxes

Checking Accounts and Balances:

Savings Accounts and Balances:

Health, Vision and Dental Insurance:

(specify what insurance coverage is available to you and the cost of the coverage)

Pensions and Retirement Plans:

(account name, approximate value, how it is owned and by whom)

Investment Accounts:

(type, company name, and approximate value)

Automobiles:

(make, model, year, approximate mileage, approximate value, and titled owner)

Recreational Equipment:

(boats, guns, motorcycles, etc. with make, model, year, and approximate value)

Other Assets of Value:

(do not include normal household goods and furnishings)

Are there non-marital claims?

If yes, itemize:

Do you believe that spousal support should be paid? If so, why? Please refer to the factors in ORC 3105.18 (C) (1). What amount are you requesting? Please provide a range.

Is there a need for a business appraisal or valuation? If yes, please explain.

What are your goals for the NE session?

Who might you call as witnesses should this case proceed to trial, what is your relationship to them, and to what will they testify? (if known at this time)

Bring the following documents to the NE session:

Pay stubs for the last three months of employment. If self-employed, please attach a statement of receipts and expenses for the past six months.

Federal Tax Returns with all attachments including W-2s and 1099s for the last three years.

Any unemployment compensation statements or worker’s compensation statements, and all other income received during the last three months, including any public financial assistance in money or in-kind services (grants, heating assistance, medical assistance, etc.).

Proof of assets acquired during the marriage, assets acquired before the marriage, assets acquired by gifts or inheritance during the marriage, liabilities acquired during the marriage, and liabilities acquired before the marriage.

Signature of Party / Attorney
Typed Name
Date