Confidential Divorce Questionnaire Form
ADVERTISEMENT
1
2
3
4
5CONFIDENTIAL DIVORCE QUESTIONNAIRE
It is important to complete this questionnaire as fully and accurately as possible. You will be
paying for the time we spend on your case and you will save expenses by providing us with
complete information.
This form is designed to alert us to items to which we should give attention, as well as to provide
necessary information. We do not know the facts of your case as well as you do. Tell us as much
as you know so that we can do a better job for you.
If you are already divorced and are seeking a modification of your divorce decree (for instance,
a change of custody, increase or decrease in support), all references to "spouse" mean your
former spouse, not the person to whom you may now be married.
1.
What is your full name?
What is your spouse's full name?
a.
First_____________________
a.
First__________________________
b.
Middle___________________
b.
Middle________________________
c.
Last_____________________
c.
Last__________________________
d.
Maiden__________________
d.
Maiden_______________________
e.
Former married names:
e.
Former married names:
________________________
______________________________
________________________
______________________________
2.
Please give the following vital
Please give the following vital
statistics about yourself:
statistics about your spouse:
a.
Soc. Sec. No.______________
a.
Soc. Sec. No. __________________
b.
Driver's License No. ________
b.
Driver's License No. ____________
c.
Date of Birth______________
c.
Date of Birth___________________
d.
Place of Birth_____________
d.
Place of Birth__________________
e.
Current Age_______________
e.
Current Age____________________
f.
Race____________________
f.
Race _________________________
g.
Number of this marriage ____
g.
Number of this marriage _________
(specify 1st, 2nd, etc.)
(specify 1st, 2nd, etc.)
h.
Education Level ___________
h.
Education Level _______________
3.
Marriage: Date___________ City__________ County____________ State___________
Date of Separation __________________
4.
Where are you living and what is your telephone number?
a.
Address___________________________________________________________
b.
City, State, Zip_____________________________________________________
c.
Home telephone number__________________________
d.
E-mail address (secure and private) _____________________________________
e.
Cellular/mobile number ________________ How long in Oregon? ___________
f.
If you want mail from this office sent to a different address, please furnish the
desired address here: ________________________________________________
5.
Are you currently employed? Yes_____ No_____ If yes, please provide:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal