Divorce Intake Form

Your Name:

Phone Number:

Email:

Address:

Employer Name, Address, Phone:

Name of Spouse:

Marital Residence Address:

Other property owned jointly:

Date and location of marriage:

Date of separation:

Any personal property you wish to keep:

Make and model of any and all vehicles and who’s name the title is held. Also – who will receive the vehicle in the divorce:

Do you still reside in residence?

Does your spouse?

Children's name:

Children's birthdates:

Is the husband the biological father, if not who is?

Is there an open dhs child support case?

Has there ever been a previously adjudicated order of custody?

Children’s addresses for the past 5 years:

Who will receive custody of the children and who will pay child support:

Who will receive the marital residence if any:

What is your goal?