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Additional Health Insurance (Financial Affidavit)

Illinois · Illinois Supreme Court · Effective June 1, 2025

This form is an add-on sheet to a Financial Affidavit used to list details about extra health insurance. It asks for information like the insurance company's name, the type of coverage, and the monthly costs.

Open the official PDFfrom Illinois Supreme Court

Where this fits in a case

Motions

Stage: Motions

This form is used when a person needs to provide extra details about health insurance that could not fit on the main Financial Affidavit form in a divorce or child support case.

Either party may file.

Official instructions

How-to guides published by the court for this form.

Common questions

What is this form for?
This form is used to provide extra information about health insurance that needs to be included with a Financial Affidavit. It is an add-on sheet to the main Financial Affidavit.
Who must file this form?
The form is used when a person needs to list more than two health insurance policies and has attached additional forms.
Is there a fee to file this?
The form text does not mention any filing fees.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect June 1, 2025.

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