Form F37 (Rule 10-10(2))

This is the 2nd affidavit

of Elyse Edith Keaton in this case,
and was made on 1 March 2013

Court File No.: E131234

Court Registry: Vancouver

In the Supreme Court of British Columbia

Claimant:

ELYSE EDITH KEATON

Respondent:

STEVEN SIMON KEATON

CHILD SUPPORT AFFIDAVIT

I, ELYSE EDITH KEATON, architect, of 123 Queen Street in the City of Vancouver, in the
Province of British Columbia, SWEAR (OR AFFIRM) THAT:

1. I am the Claimant.

2. The following is true to the best of my information and belief.

(a) Parties:

Claimant’s name Province of residence

Elyse Edith Keaton British Columbia

Respondent’s name Province of residence

Steven Simon Keaton British Columbia

(b) Children

Child now Relationship Relationship to

Child’s name Birthdate Age
living with to Claimant Respondent

Alex Albert Keaton 1 January 2000 13 Both parties Adopted child Adopted child

THIS DOCUMENT IS A SAMPLE DOCUMENT AND IS INTENDED ONLY AS A GENERAL GUIDE.

IT MAY NOT CONTAIN INFORMATION RELEVANT TO YOUR SITUATION.
IT SHOULD NOT BE USED AS A PRECEDENT FOR DRAFTING YOUR OWN DOCUMENT.
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Child now Relationship Relationship to

Child’s name Birthdate Age
living with to Claimant Respondent

Mallory Marie Keaton 1 January 2002 11 Both parties Natural child Natural child

Jennifer Jean Keaton 1 January 2004 9 Both parties Natural child Natural child

Andrew Adam Keaton 1 January 2006 7 Both parties Natural child Natural child

3. The Notice of Family Claim includes a claim for a child support order.

4a. Claimant’s annual income as determined under sections 15 to 20 of the Guidelines:

$75,000

4b. Respondent’s annual income as determined under sections 15 to 20 of the Guidelines:

$150,000

4c. The Claimant and the Respondent have entered into an agreement as to income pursuant to
section 15(2) of the Guidelines, a copy of which agreement is attached.

5. I have completed and attach to this Affidavit Supplementary Child Support Fact Sheet B.

6. The proposed order sets out that $500 is the amount of child support payable by the
Respondent, in accordance with the agreement referred to in section 4(c) of this Affidavit.

7. I have completed and attached to this affidavit Supplementary Child Support Fact Sheet A
(special expenses), and the amount set out in the proposed order for the expenses under
section 7 of the Guidelines is $355.

8b. Medical coverage is available for the children under the Respondent’s medical insurance
plan.

9. There is no order of any court in force dealing with support of the children.

10. Attached as Exhibit A is the written agreement that deals with the support of the children.

THIS DOCUMENT IS A SAMPLE DOCUMENT AND IS INTENDED ONLY AS A GENERAL GUIDE.

IT MAY NOT CONTAIN INFORMATION RELEVANT TO YOUR SITUATION.
IT SHOULD NOT BE USED AS A PRECEDENT FOR DRAFTING YOUR OWN DOCUMENT.
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11. The amount of arrears of child support, as at 1 March 2013, under any existing order or
written agreement is nil.

SWORN (OR AFFIRMED) BEFORE )

ME at Vancouver, British Columbia, this 1st )
day of March, 2013. )
)
)
)
Anne Attorney ) Elyse Keaton
)
A Commissioner for taking Affidavits for ) ELYSE EDITH KEATON
the Province of British Columbia

Anne Attorney
Hope & Despair LLP
123 Main Street
Vancouver, BC V1A 2B3

THIS DOCUMENT IS A SAMPLE DOCUMENT AND IS INTENDED ONLY AS A GENERAL GUIDE.

IT MAY NOT CONTAIN INFORMATION RELEVANT TO YOUR SITUATION.
IT SHOULD NOT BE USED AS A PRECEDENT FOR DRAFTING YOUR OWN DOCUMENT.
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Supplementary Child Support Fact Sheet A:

Special or Extraordinary Expenses

Section 7 expenses (net of tax credits and contribution from child, etc.):

Annual Monthly

A Child care expenses $1,200 $100

B Portion of medical and dental premiums attributable to the $648 $54

child(ren)

C Health related expenses that exceed insurance reimbursement by

at least $100

D Extraordinary primary, secondary or other educational expenses $1,500 $150

E Post-secondary school expenses

F Extraordinary extracurricular activities expenses $2,400 $400

G Total section 7 expenses $5,748 $704

Parties’ respective proportionate shares of the total net monthly section 7 expenses referred to at
Line G above:

Percentage Amount

Claimant’s proportionate share 33% $1,897

Respondent’s proportionate share 67% $4,253

Total monthly child support payable by the Respondent, including the monthly Guidelines table
amount under Schedule 1 of the Guidelines and the section 7 expenses, is $355.

THIS DOCUMENT IS A SAMPLE DOCUMENT AND IS INTENDED ONLY AS A GENERAL GUIDE.

IT MAY NOT CONTAIN INFORMATION RELEVANT TO YOUR SITUATION.
IT SHOULD NOT BE USED AS A PRECEDENT FOR DRAFTING YOUR OWN DOCUMENT.
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Supplementary Child Support Fact Sheet B:

If the Circumstances Described in s. 9 of the Child Support Guidelines Exist

Claimant Respondent

Number of children: 4

Approximate percentage of time children spend with each parent 50% 50%

Annual Guidelines income $75,000 $150,000

Guidelines table amount $1,768 $3,238

Difference between the Guidelines table amount of the Claimant and $1,470
the Guidelines table amount of the Respondent

Section 7 expenses paid directly by each party $1,897 $4,253

Any other relevant information regarding the conditions, means, needs and other circumstances
of each spouse or of any child for whom support is sought:

It is proposed that child support in the amount of $500 per month be paid by the Respondent.

THIS DOCUMENT IS A SAMPLE DOCUMENT AND IS INTENDED ONLY AS A GENERAL GUIDE.

IT MAY NOT CONTAIN INFORMATION RELEVANT TO YOUR SITUATION.
IT SHOULD NOT BE USED AS A PRECEDENT FOR DRAFTING YOUR OWN DOCUMENT.