Financial Disclosure Form Examples: Assets, Debts, and Income

A financial disclosure form is a sworn statement of everything you own, owe, earn, and spend, filed at a specific point in time and signed under penalty of perjury. Courts use it in divorce and civil cases to divide property and set support. Government agencies use it to flag conflicts of interest. Whatever the setting, the form breaks your finances into the same four categories — assets, liabilities, income, and expenses — and expects each item to be specific enough that someone else can verify it.

The rest of this article walks through what belongs in each category, what documentation you need behind the numbers, how to protect sensitive information when you file, and what happens if the disclosure is wrong or incomplete.

Where Financial Disclosure Forms Are Used

In a divorce, the form forces both spouses to negotiate from the same set of facts, so neither side is working from hidden wealth or inflated expenses. In civil litigation, it grounds damages calculations in verified numbers. For federal officials, the OGE Form 278e requires reporting assets over $1,000, income sources over $200, and liabilities over $10,000 so the public can see potential conflicts.1Office of Government Ethics. OGE Form 278e Public Financial Disclosure Report

Exact form names and thresholds vary by jurisdiction, but the four buckets are consistent, and so is the expectation of specificity.

Assets and Ownership Interests You Must Report

Every asset you own or hold an interest in belongs on the form. Vague descriptions and round-number estimates invite challenges, so identify each asset well enough that its existence and current fair market value can be verified.

Cash and Bank Accounts

List each account by institution, account type (checking, savings, money market, certificate of deposit), and the exact balance as of the disclosure date. Accounts at different banks go on separate lines. Joint accounts belong on the form too, noted as shared.

Real Estate

For each property, report the street address, the acquisition date, and the current fair market value, along with how you arrived at that value. A recent professional appraisal carries more weight than a county tax assessment, which often understates market value. The mortgage itself goes in the liabilities section, but the property is listed here at its gross value.

Investment Accounts

Report the brokerage name, each specific holding (stock ticker, fund name, or bond description), the number of shares or units, and the market value on the disclosure date. Don’t collapse an account into a single lump sum unless it’s a diversified mutual fund or similar pooled vehicle; individual holdings need to be itemized.

Investment income gets disclosed too. Banks and brokerages issue Form 1099-DIV for dividends and distributions and Form 1099-INT for interest.2Internal Revenue Service. About Form 1099-DIV, Dividends and Distributions3Internal Revenue Service. About Form 1099-INT, Interest Income Those forms back up your numbers, but the disclosure itself should list the income amounts directly.

Retirement Accounts

Retirement savings are often the second-largest asset people own after their home, and omitting them is one of the most common disclosure mistakes. Report each account separately: 401(k), 403(b), IRA, Roth IRA, pension, deferred compensation, and any other employer plan. For each, include the institution, current balance, and vested amount if it differs from the total.

In divorce cases, federal law generally prohibits assigning your interest in a retirement plan to someone else, but a Qualified Domestic Relations Order allows a court to divide those benefits between spouses.4U.S. Department of Labor. QDROs – The Division of Retirement Benefits Through Qualified Domestic Relations Orders Full disclosure of the account type, plan administrator, and balance is what makes that division possible. Unvested stock options and restricted stock units go on the form too, with grant dates, vesting schedules, and current values.

Business Interests

If you own all or part of a business, list the entity name, the type of entity, your ownership percentage, and the valuation method used. Publicly traded shares are straightforward because the market sets the price. Closely held businesses usually need a valuation from a qualified professional rather than the owner.

Cryptocurrency and Other Digital Assets

Cryptocurrency, tokens, and NFTs are property for federal tax purposes and must be disclosed like any other asset. For each holding, list the type (Bitcoin, Ethereum, and so on), the wallet or exchange, the quantity, and the fair market value on the disclosure date. If you received, sold, or exchanged digital assets during the tax year, you’re already required to answer a yes-or-no question about it on Form 1040.5Internal Revenue Service. Digital Assets

Vehicles and Personal Property

Identify vehicles by year, make, model, and VIN. Kelley Blue Book and similar guides provide a fair market value based on those details, mileage, and condition.

High-value items like jewelry, artwork, collectibles, and antiques may need a formal appraisal, particularly when their value is disputed or exceeds a few thousand dollars. Household furniture and furnishings are usually reported as a single estimated lump sum based on what they’d bring at a garage sale, not what they’d cost to replace.

Life insurance with a cash surrender value is a commonly overlooked asset. For whole life or universal life policies, report the insurer, policy number, death benefit, and current cash value. Term life with no cash value doesn’t get listed as an asset, though the premium may appear as a monthly expense.

Debts and Financial Obligations You Must Report

Every debt needs enough detail that someone can verify it independently: creditor name, purpose of the debt, current balance, interest rate, and required monthly payment.

Secured Debts

Secured debts are backed by collateral. For a mortgage, list the lender, property address, original loan amount, remaining principal, interest rate, and monthly payment. Auto loans follow the same pattern, with the vehicle’s year, make, and VIN tying the debt to the asset. Home equity lines of credit, boat loans, and any other debt secured by a specific asset also belong here. The original loan amount and the date you took on the debt help a court determine whether the obligation is marital or separate.

Unsecured Debts

Credit cards, medical bills, personal loans, and student loans have no collateral behind them. For credit cards, list the issuer, the last four digits of the account number, the balance, and the minimum monthly payment. For medical debt, include the provider and the date of service. The total unsecured figure feeds directly into net worth and any calculation of your ability to pay support or satisfy a judgment.

Tax Obligations

Any outstanding tax liability owed to federal, state, or local authorities must be reported, with the tax year and the agency. Unpaid estimated taxes for the current year count too.

If the IRS has filed a Notice of Federal Tax Lien against you, that goes on the form. A federal tax lien attaches to all your property, including real estate, personal property, and financial assets, and it alerts other creditors that the government has a legal claim.6Internal Revenue Service. Understanding a Federal Tax Lien The lien can affect your ability to sell or refinance real estate, and other parties need to know about it.7Internal Revenue Service. Publication 1468 – Guidelines for Processing Notice of Federal Tax Lien Documents If a tax liability is under audit or appeal, note that status, because the final amount could change.

Contingent Liabilities

Contingent liabilities are potential debts that depend on something that hasn’t happened yet. A personal guarantee on a business loan is the classic example; a pending lawsuit where you’re the defendant is another. For each, describe the obligation, identify the case or creditor, and estimate the range of potential loss. Courts understand these numbers are uncertain, but they still need to see them.

Income and Monthly Expenses

Cash flow is where disclosures become most actionable. Income drives child support and alimony. Expenses determine how much someone actually needs to maintain their standard of living.

Income Sources

Start with employment income: the employer’s name and address, and gross monthly pay before deductions. If your pay varies because of commissions, bonuses, or overtime, average the last twelve months to smooth the fluctuation.

Self-employment income is reported as net profit: gross receipts minus ordinary business expenses. Your Schedule C from the most recent tax return is the standard reference for this calculation.8Internal Revenue Service. About Form 1040, U.S. Individual Income Tax Return

Other income sources get their own lines:

  • Investment income: dividends, interest, capital gains, and rental income
  • Retirement income: pensions, Social Security, and retirement account distributions
  • Government benefits: disability payments and unemployment compensation
  • Other recurring payments: alimony received, trust distributions, and royalties

Lumping these together defeats the purpose. Each source needs its own line and monthly amount.

Mandatory Deductions

Mandatory deductions bridge gross and net income and must be listed separately so the court can verify take-home pay. Standard items include federal and state withholding, FICA taxes (Social Security and Medicare, which employers are required to withhold), and any mandatory retirement contributions.9Social Security Administration. What Are FICA and SECA Taxes? Health insurance premiums deducted from your paycheck belong here too. Voluntary 401(k) contributions are treated differently depending on jurisdiction, so check local rules on whether they count as mandatory or discretionary.

Monthly Expenses

Expenses must be itemized by category. Housing comes first: rent or mortgage, property taxes, homeowner’s or renter’s insurance, and utilities. Then transportation, food, clothing, medical costs not covered by insurance, childcare, and education.

For expenses that aren’t monthly, like semi-annual insurance premiums or annual property tax bills, divide the annual total by twelve. Courts see inflated expense lists constantly, and exaggeration is one of the fastest ways to damage your credibility. Report what you actually spend.

Documents That Back Up the Form

Every figure on the disclosure should have paper behind it. Courts don’t take your word for balances, income, or expenses, and missing documentation can get a disclosure rejected or create an inference that you’re hiding something.

Standard supporting documents include:

  • Bank and brokerage statements, typically the last three to twelve months
  • Pay stubs from the last two to three months
  • W-2 and 1099 forms cross-referencing what you reported as income
  • Federal Form 1040 and supporting schedules for the last one to three years8Internal Revenue Service. About Form 1040, U.S. Individual Income Tax Return
  • Deeds, titles, and registration documents showing ownership and acquisition dates
  • Appraisals and valuation reports for assets where market price isn’t obvious
  • Loan statements and credit card bills confirming balances and payment terms

Self-employed filers carry a heavier documentation load: profit and loss statements, business bank statements, and business tax returns. If your business income fluctuates, be ready to explain why recent months differ from what the tax returns show.

Tax returns act as a cross-reference for almost everything else. If your reported income doesn’t match your 1040, or your claimed assets don’t line up with the interest and dividend income on your return, expect questions. Reviewing your own returns before completing the disclosure catches discrepancies before the other side does.

Redacting Sensitive Information Before You File

A disclosure contains exactly the personal data identity thieves look for: Social Security numbers, bank account numbers, and dates of birth. Federal Rule of Civil Procedure 5.2 requires that a court filing with these identifiers include only the last four digits of a Social Security number, the year of a person’s birth, a minor’s initials, and the last four digits of any financial account number.10Legal Information Institute. Federal Rules of Civil Procedure Rule 5.2 – Privacy Protection for Filings Made with the Court

The responsibility for redacting falls on the person filing, not the clerk. Most state courts have adopted similar rules, though specifics vary. If full numbers are necessary to trace assets or verify accounts, you can provide an unredacted copy to opposing counsel under a protective order while filing the redacted version with the court.

Your Duty to Update the Disclosure

Filing once isn’t the end of the obligation. Under Federal Rule of Civil Procedure 26(e), you must supplement or correct your disclosure in a timely manner whenever you learn it’s incomplete or incorrect in some material respect.11Legal Information Institute. Federal Rules of Civil Procedure Rule 26 – Duty to Disclose; General Provisions Governing Discovery A raise, the sale of an asset, a new debt, or a significant change in monthly expenses can trigger the duty. Failing to update is treated the same as failing to disclose in the first place.

What Happens if the Disclosure Is Incomplete or False

Signing the form under oath means you’re certifying it’s true. Deliberately lying or hiding assets carries real consequences.

Under federal rules, a party who fails to provide required disclosure information can be barred from using that information as evidence at trial, at a hearing, or on a motion. The court can also order the non-disclosing party to pay the other side’s attorney’s fees, inform the jury of the failure, strike pleadings, or enter default judgment.12Legal Information Institute. Federal Rules of Civil Procedure Rule 37 – Failure to Make Disclosures or to Cooperate in Discovery In divorce cases, many state courts can award a hidden asset entirely to the other spouse once concealment is discovered.

At the extreme end, knowingly making a false statement under oath is perjury, which under federal law carries a fine and up to five years in prison.13Office of the Law Revision Counsel. 18 USC 1621 – Perjury Generally Criminal prosecution for perjury in financial disclosure is uncommon, but contempt-of-court sanctions for discovery abuse happen regularly. And if hidden assets surface after a case is resolved, the other party may be able to reopen the matter.

When finances are complex or one party suspects concealment, a forensic accountant can trace funds through bank records, analyze statements for anomalies, and identify assets that never made it onto the form. The cost is real, but it’s a fraction of what’s at stake when significant assets go unaccounted for.