Divorce Client Intake Form Page 3
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4Client: __________________________________________________________
Spouse: _________________________________________________________
7. ATTORNEY FEES/COURT COSTS:
How will attorney fees be paid? ______________________________________
Who will be responsible for Court costs? (Split, Client, or Spouse) ___________
8. AUTOMOBILES:
Client’s: Make Model Year Amount of Debt Lender Value
Spouse’s: Make Model Year Amount of Debt Lender Value
9. OTHER VEHICLES:
Boats, ATVs, Jet Ski, Tractors, Riding Lawnmowers
Name Debt Who will assume debt and item?
10. RETIREMENT: 401K, IRAs, Stocks and Bonds:
1.
Type of account:
___________________________________________
Name of account:
___________________________________________
Owner of account:
___________________________________________
2.
Type of account:
___________________________________________
Name of account:
___________________________________________
Owner of account:
___________________________________________
11. RESTORATION OF FORMER/MAIDEN NAME?
_____________________
12. INSURANCE:
Husband
Company:
_____________________________________________________
Policy No.:
_____________________________________________________
Wife
Company:
_____________________________________________________
Policy No.:
_____________________________________________________
13. CHILD SUPPORT WORKSHEET and PARENTING PLAN
INFORMATION:
NUMBER OF DAYS IN CUSTODY OF EACH PARENT:
Child’s Name: ____________________________________________________
# of days with Mother: _____________
# of days with Father: ______________
Child’s Name: ____________________________________________________
# of days with Mother: _____________
# of days with Father: ______________
INCOME: (Gross Monthly)
Mother:
______________________
Father:
______________________
HEALTH INSURANCE PREMIUM:
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Parent category: Business