Fillable Dissolution (Divorce) Intake Form printable pdf download

Dissolution (Divorce) Intake Form

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Eric Anderson

– Attorney at Law

Phone: 651-321-4977

4782 Banning Ave.

Fax: 651-460-9899

White Bear Lake, MN 55110

Dissolution (Divorce) Intake Form

Instructions. Your answers to these questions will form the basis for my initial advice

regarding your dissolution (divorce) and the initial pleadings filed with the court. Please

complete this form and return it to my office by mail, email, or by uploading it to your

online portal through my website. You can print the form and handwrite your answers or

you can type your answers directly into the form. Although you may not have all the

information at this time, please answer the questions to the best of your ability. If the

information is not accurate and complete, the recommendations I make may not be

appropriate for your circumstances. Your information will be handled with sensitivity and

kept in strict confidence. Don’t hesitate to call or email me if you have questions along the

way.

Your Personal Information

Full Legal Name: ___________________________________________ Birth Date: ________________________

Previous Names: ___________________________________________________________________________________

Do you wish to change your name? _____________________________________________________________

Address: _____________________________________________________________________________________________

How long have you lived at this address? ____________________

How long have you been a resident of Minnesota? ________________________

U.S. Citizen? _________________

Nationality if not a U.S. Citizen: ___________________

Home Phone: ______________________ Cell: ______________________ Work: _________________________

E-Mail Address: _________________________________________

The best way to communicate with me is by: ________________________________________________

Social Security Number: ___________________________

Are you presently a member of the U.S. Military? ____________________________________________

Dissolution (Divorce) Intake Form

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