Grand Traverse County, MI · Grand Traverse County
Verified Statement
This court form collects information about a parent and minor children for a case, and is completed by a party or their attorney.
At a glance
- Issued by
- City of Grand Traverse County · Grand Traverse County, Grand Traverse County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- gtcountymi.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The Verified Statement collects identifying, contact, employment, income, and public assistance information about you and the other parent, along with details about minor children and their health care coverage. It also includes a declaration under penalties of perjury. The form lists distribution to the Friend of the Court and the parties or their attorneys.
Who needs it
A party in the case, or their attorney, completes this statement with information about the parties and minor children.
How to submit it
The form lists the Friend of the Court and the plaintiff/attorney and defendant/attorney for distribution, but provides no completed mailing address or submission method.
About notarization
This form is signed and dated without a notary; it includes a declaration under penalties of perjury, but no separate notarized attachment or step is stated.
How to submit this form
- 1
Download the Form
Download the Verified Statement PDF.
- 2
Complete the Form
Enter the requested information about yourself, the other parent, and the minor children.
- 3
Sign and Date
Sign and date the declaration under penalties of perjury.
- 4
Distribute the Form
The form lists the Friend of the Court and the parties or their attorneys for distribution.
Frequently asked questions
- What information does the Verified Statement ask for?
- It asks for identifying, contact, employment, income, and public assistance information about both parents, plus details about minor children, health care coverage, and possible caregivers.
- Who completes the Verified Statement?
- A party in the case or their attorney completes the form. It has sections for information about the person completing it, the other parent, and the minor children.
- How do I submit the Verified Statement?
- The form lists the Friend of the Court and the plaintiff or defendant and their attorneys for distribution. It does not provide a completed address or submission method.
- Do I need a notary for the Verified Statement?
- No. The form is signed and dated without a notary. It includes a declaration under penalties of perjury, but does not state a separate notarized attachment or step.