New Client Paternity And Related Matters Form
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1We know your time is extremely valuable to you. Therefore filling out this form prior to, and bringing it with you to your
appointment, allows for more time to discuss the particulars of your case during your consultation and less time spent on
gathering personal information on the parties involved. Please take a few moments to fill out the following form with as much
information as possible and bring it with you to your appointment. Thank you!
Type of case:
Paternity
Parenting Time
Custody
Support
Medical Expenses
Education Expenses
_______________________________
Has your case been filed with any Court already?
yes
no
If so, Cty/State
Is there a hearing date & time currently scheduled?
yes
no
If so, Date/Time?____________________________________
Personal Information:
__________________________________________________
__________________________________________________
Your Name (include maiden name)
Opposing Party’s Name (include maiden name)
__________________________________________________
__________________________________________________
Your Home Address
Opposing Party’s Home Address
__________________________________________________
__________________________________________________
Your City, State, Zip
Opposing Party’s City, State, Zip
__________________________________________________
__________________________________________________
Your Home Phone
Opposing Party’s Home Phone
__________________________________________________
__________________________________________________
Your Cell Phone
Opposing Party’s Cell Phone
__________________________________________________
__________________________________________________
Your email address
Opposing Party’s email address
_____/_____/______
_______-______-_______
_____/______/_______
_____-_______-________
Your DOB
Your SSN
Opposing Party’s DOB
Opposing Party’s SSN
Employment Information:
___________________________________________________
__________________________________________________
Opposing Party’s Employer’s Name
Your Employer’s Name
___________________________________________________
__________________________________________________
Your Employer’s Address
Opposing Party’s Employer’s Address
___________________________________________________
__________________________________________________
Your Employer’s City, State Zip
Opposing Party’s Employer’s City, State ZIP
________________________
____________
____________________________
_______________
Position
How long?
Position
How long?
$___________
$_____________
$______________
$___________
$__________
$____________
Wkly gross pay
commissions
bonuses
Wkly gross pay
commissions
bonuses
Is health Insurance available through employer?
yes
No Is health Insurance available through employer?
yes
No
hildren
:
C
(please use back page if needed)
_________________________
_____
____/____/____
___________________________
___________
Name of child
Age
DOB
Daycare/ School
Cost
_________________________
_____
____/____/____
___________________________
___________
Name of child
Age
DOB
Daycare/ School
Cost
_________________________
_____
____/____/____
___________________________
___________
Name of child
Age
DOB
Daycare/ School
Cost
Are you or your Opposing Party currently pregnant?
Yes
No
If yes, when is the baby due? __________________________
Do you have an order of support for any other born children? Yes
No If yes, what is the weekly support amount? ___________
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