Form 3a: Assets and Debts

Form 3(a): Assets and Debts

Please read these instructions carefully.
This form will help us determine your net worth on the following three dates. It will ask you to provide all the information on your assets and debts as of these three distinct dates:
- Today (Current Assets + Debts Entered on Page 1)
- Date of Separation (Your Separation Date Assets + Debts Entered on Page 2)
- Date of Marriage (Your Marriage Date Assets + Debts Entered on Page 3)
The form is designed so that you will start with today's information as it is easiest to access, and then work your way backwards toward the date of marriage. You may need to contact your bank to obtain the required information/documentation. You can save your progress in the form at the bottom of each page, and you will receive a copy of your answers by email when you submit the form. If you need to many any changes, click "edit responses" when you receive this email.

If you have any questions about filling in this form, please do not hesitate to contact Gabriel Bidner by email at bidner@dolginfamilylaw.ca. All other inquiries on your matter should be directed to Mr. Dolgin.
Your Name:

First NameLast Name
Your Email Address:
example@example.com
Please enter the following dates:

The form will help us assess your net worth on each of the dates below.
Today

MonthDayYear
Date
Your Date of Separation:

MonthDayYear
Date
Your Date of Marriage:

MonthDayYear
Date

Part 1: Calculating Your Net Worth Today

Please list your assets and debts as they stand today, and provide supporting documents backing up these figures. Please do not enter any values from the past as these will be entered on pages 2 and 3 of this form.
Assets

In this section, please exclude any accounts that have been closed, items sold, or other assets you no longer hold, as well as assets you expect to hold in the future. It is important that you only write down the values of the assets you hold today.

Land
Include any interest in land owned today, including leasehold interests and mortgages. Show estimated market value of your interest, but do not deduct encumbrances or costs of disposition; these encumbrances and costs should be shown at the bottom of this section under "Debts".

General Household Items & Vehicles
Show estimated market value today, not the cost of replacement for the items you list below. Do not deduct encumbrances or costs of disposition; these encumbrances and costs should be shown at the bottom of this section under "Debts".

Bank Accounts, Savings, Securities, Pensions
Show the items owned today by category, for example, cash, accounts in financial institutions, pensions, registered retirement or other savings plans, deposit receipts, any other savings, bonds, warrants, options, notes and other securities. Give your best estimate of the market value of the securities if the items were to be sold on the open market.
Please upload all the bank statements supporting the numbers in this section.

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Life & Disability Insurance
List all policies in existence today.

Business Interests
Show any interest in an unincorporated business owned today. An interest in an incorporated business may be shown here or under "Bank Accounts, Savings, Securities, Pensions" above. Give your best estimate of market value of your interest.

Money Owed to You
Give details of all money that other persons owe to you today, whether because of business or from personal dealings. Include any court judgments in your favour, any estate money and any income tax refunds owed to you.

Other Property
Show other property or assets owned today. Include property of any kind not listed above. Give your best estimate of today's market value.

(Debts Header)
Debts

Please only include your portion of any currently held debts, and upload the documents supporting these figures below.

Debts
Show your debts and other liabilities today. List them by category such as mortgages, charges, liens, notes, credit cards, and accounts payable. Don't forget to include any money owed to the Canada Revenue Agency; contingent liabilities such as guarantees or warranties given by you (but indicate that they are contingent); and any unpaid legal or professional bills as result of this case.
Please upload all the documents necessary to support these figures.

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Part 2: Calculating Your Net Worth on Date of Separation

Please list your assets and debts as they stood on your date of separation, and provide supporting documents backing up these figures on this date. Please do not enter any values from before or after the date of separation.
Assets

Please only include figures from the date of separation.

Land
Include any interest in land on the date of separation, including leasehold interests and mortgages. Show estimated market value of your interest, but do not deduct encumbrances or costs of disposition; these encumbrances and costs should be shown at the bottom of this section under "Debts".

General Household Items & Vehicles
Show estimated market value on the date of separation, not the cost of replacement for the items you list below. Do not deduct encumbrances or costs of disposition; these encumbrances and costs should be shown at the bottom of this section under "Debts".

Bank Accounts, Savings, Securities, Pensions
Show the items owned by category, for example, cash, accounts in financial institutions, pensions, registered retirement or other savings plans, deposit receipts, any other savings, bonds, warrants, options, notes and other securities. Give your best estimate of the market value of the securities if the items were to be sold on the open market.
Please upload all the bank statements supporting the numbers in this section. Generally you can find this information by contacting your bank.

Cancelof

Life & Disability Insurance
List all policies in existence on the date of separation.

Business Interests
Show any interest in an unincorporated business owned on the date of separation. An interest in an incorporated business may be shown here or under "Bank Accounts, Savings, Securities, Pensions" above. Give your best estimate of market value of your interest.

Money Owed to You
Give details of all money that other persons owe to you on the date of separation, whether because of business or from personal dealings. Include any court judgments in your favour, any estate money and any income tax refunds owed to you.

Other Property
Show other property or assets owned on the date of separation. Include property of any kind not listed above. Give your best estimate of the market value on the separation date.

(Debts Header)
Debts

Please only include your portion of any debts from the date of separation, and upload the documents supporting these figures below.

Debts
Show your debts and other liabilities on the date of separation. List them by category such as mortgages, charges, liens, notes, credit cards, and accounts payable. Don't forget to include any money owed to the Canada Revenue Agency; contingent liabilities such as guarantees or warranties given by you (but indicate that they are contingent); and any unpaid legal or professional bills as result of this case.
Please upload all the documents necessary to support these figures.

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Part 3: Calculating Your Net Worth on the Date of Marriage

Please list your assets and debts as they stood on your date of marriage, and provide supporting documents backing up these figures on this date. Please do not enter any values from before or after the date of marriage.
Assets

Please only include figures from the date of marriage.

Land
Include any interest in land owned on the date of marriage, including leasehold interests and mortgages. Show estimated market value of your interest, but do not deduct encumbrances or costs of disposition; these encumbrances and costs should be shown at the bottom of this section under "Debts".

General Household Items & Vehicles
Show estimated market value on the date of marriage, not the cost of replacement for the items you list below. Do not deduct encumbrances or costs of disposition; these encumbrances and costs should be shown at the bottom of this section under "Debts".

Bank Accounts, Savings, Securities, Pensions
Show the items owned by category, for example, cash, accounts in financial institutions, pensions, registered retirement or other savings plans, deposit receipts, any other savings, bonds, warrants, options, notes and other securities. Give your best estimate of the market value of the securities if the items were to be sold on the open market.
Please upload all the bank statements supporting the numbers in this section.

Cancelof

Life & Disability Insurance
List all policies in existence on the date of marriage.

Business Interests
Show any interest in an unincorporated business owned on the date of marriage. An interest in an incorporated business may be shown here or under "Bank Accounts, Savings, Securities, Pensions" above. Give your best estimate of market value of your interest.

Money Owed to You
Give details of all money that other persons owe to you on the date of marriage, whether because of business or from personal dealings. Include any court judgments in your favour, any estate money and any income tax refunds owed to you.

Other Property
Show other property or assets owned on the date of marriage. Include property of any kind not listed above. Give your best estimate of the market value on the date of marriage.

(Debts Header)
Debts

Please only include your portion of any debts from the date of marriage, and upload the documents supporting these figures below.

Debts
Show your debts and other liabilities on the date of marriage. List them by category such as mortgages, charges, liens, notes, credit cards, and accounts payable. Don't forget to include any money owed to the Canada Revenue Agency; contingent liabilities such as guarantees or warranties given by you (but indicate that they are contingent); and any unpaid legal or professional bills as result of this case.
Please upload all the documents necessary to support these figures.

Cancelof

Submit
Should be Empty:

Form 3(a): Assets and Debts

Please enter the following dates:

Part 1: Calculating Your Net Worth Today

Assets

Debts

Part 2: Calculating Your Net Worth on Date of Separation

Assets

Debts

Part 3: Calculating Your Net Worth on the Date of Marriage

Assets

Debts