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Get IA Form 124 2013-2024

Ash value Cash value Minus loan owed Total amount still owed on loan (1) $ $ $ (2) $ $ $ (3) $ $ $ Check this box if you have attached a sheet with additional information on life insurance. November 2013 Rule 17.100 Form 124 Page 2 of 9 Rule 17.100 Form 124: Financial Affidavit for a Dissolution of Marriage with no Minor or Dependent Adult Children, continued E. Bank accounts *Owner (Whose name is on the checking or savings account?): P Petitioner R Respondent J Jo.

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