Fillable Confidential Custody Questionnaire Template printable pdf download

Confidential Custody Questionnaire Template

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CONFIDENTIAL CUSTODY QUESTIONNAIRE

Date: ___________________

Your answers to the following questions is completely confidential and falls under attorney-

client privilege. This information will not be shared with anyone other than those working on

your case. Your response to these questions now will help organize your case and save litigation

expenses in trying to gather and assemble information after the case is in progress.

Please fill out this questionnaire completely and honestly and return it to our office as soon as

possible. It is imperative that you are open and honest with your answers so that we may serve

you to the best of our abilities. You should answer all questions relevant to your case. If a

question is not relevant, please mark the question “N/A”. If you require more space, please

complete your answer on a separate sheet, indicate the section and question to which you are

answering, and attach it to this questionnaire

BACKGROUND INFORMATION

CLIENT INFORMATION:

Client Name: _______________________________________ Social Security Number: ___________________________

Mailing Address: ___________________________________ Home Telephone: _________________________________

___________________________________ Cellphone: ________________________________________

Driver’s License #: _____________________

E-mail Address: ___________________________________

Date of Birth: __________________________

City of Birth: __________________________

Employer: ______________________________________

Employers Phone Number: ________________________

Employers Address: ________________________________________________________________________________________

Salary: _____________________

Position: __________________

Length of Time with Present Employer: ________________________

Please state your employment history for the last five (5) years, including place of employment,

position, ending salary, dates of employment and reason for leaving: ___________________________________

______________________________________________________________________________________________________________

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Confidential Custody Questionnaire Template

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