CLIENT INFORMATION
SHEET
DIVORCE
Date: ________________
CLIENT _________________________________
Personal about
you:
Full Name
(Last, First, Middle): _____________________________________________
Date of Birth:
_____________ Age: _____ Birthplace: ____________________
Social Security #:
_________________ Driver’s License #: ______________ State: ____
Full
Current Address: ________________________, _________________, _________
COUNTY OF
RESIDENCE: ________________________
Mailing Address
(if a different from above): ___________________________________
__________________________________________
Home Phone:
_________________ Work Phone: ____________________
Pager:
___________________ Cell: ______________ E-Mail: _____________________
How do you prefer
we contact you ? _________________________________
Have you been a
resident of this county for longer than three months ? Yes No
Have you been a
resident of Texas for longer than six months ? Yes No
Occupation:
___________________________________
Employer:
___________________________________
Address of
Employment: _________________________________________
Education:
___________________________________
Your gross salary
per month or year: $ ____________ Length of Employment: _______
Who referred you
to this office? _____________________________________________
Have you seen a
marriage counselor? _______ State name: _______________________
Have you or your
spouse ever filed for divorce? _________
If so, when and
where? ____________________________________________
Does you spouse or
ex-spouse have an attorney? ______ State name: ________________
Have you ever been
married before? ________ If so, how many times? ________
Will either party
be requesting a name change ? Yes No
If yes, what will
the new name be ? (Full name) _______________________________
What is your
religious preference? ___________________________________________
If none, are you
agnostic or atheist? __________________________________________
INFORMATION REGARDING
YOUR SPOUSE
Name (Last, First,
Middle): _________________________________________________
Date of Birth:
__________ Age: _____ Birthplace: ______________________________
Social Security #:
_________________ Driver’s Lic. #: _________________ State: ____
Full
Current Address: __________________________ , _____________ , ___________
COUNTY OF
RESIDENCE: __________________
Residence
Telephone #: _________________
Occupation:
_______________________________
Employer:
______________________________
Address of
Employment: ___________________________
Employer phone #:
________________________
Education:
____________________________
Spouse’s gross
salary monthly/annual: $ ____________ Length of employment________
Divorce papers can not be filed
without the following information:
Date of Marriage:
________________
Place of Marriage:
________________
Date of
Separation: _______________
What is your
spouse’s or ex-spouse’s religious preference? ________________________
If none, is your
spouse or ex-spouse agnostic or atheist? ________________________
Check as
appropriate if you marital difficulties involve any of the following:
____ drug/alcohol
____ Sexual disappointment ____ infidelity
____ financial
dispute ____ physical violence ____ religion
____
Incompatibility ____ other: ________________________________
Separate Property:
Do you own any separate property (property owned before marriage or property
received during marriage by gift or inheritance)? Y N
Does your spouse
own any separate property? (Circle one) Yes No
Income Tax: Have
you filed for all previous years ? (Circle one) Yes No
INFORMATION REGARDING
CHILDREN
Name:
___________________________________ Sex: _____________
Date of Birth:
_________________ Age: _____ Birthplace: ______________________
Social Security #:
________________________ Drivers Lic. #: ___________________
Name:
___________________________________ Sex: _____________
Date of Birth:
_________________ Age: _____ Birthplace: ______________________
Social Security #:
________________________ Drivers Lic. #: ___________________
Name:
___________________________________ Sex: _____________
Date of Birth:
_________________ Age: _____ Birthplace: ______________________
Social Security #:
________________________ Drivers Lic. #: ___________________
Name:
___________________________________ Sex: _____________
Date of Birth:
_________________ Age: _____ Birthplace: ______________________
Social Security #:
________________________ Drivers Lic. #: ___________________
CHILD CUSTODY AND
SUPPORT
Who will have
primary custody of the children? (Circle one) Father Mother Other
If "Other" please
state name and relationship (if any) ____________________________
Will the parties
have joint custody? (Circle one) Yes No
Which parent will
be paying child support? (Circle one) Father Mother
Amount of child
support (if agreed) $ _________________ per month.
(Note: In an
uncontested divorce, the parties can agree on any figure for child support,
and the judge will
probably approve it. However, the Texas Family Code contains child support
guidelines that are generally used. If the parties wish to base support on the
guidelines, advise the attorney. He will determine that figure for you, based on
the obligor (person paying child support) parent’s income and number of other
children for which the obligor parent is providing support.)
Which parent will
be responsible for the children’s health insurance? Father Mother
(Note: The parent
who pays child support generally is also responsible for maintaining health
insurance on the children. The parents usually split medical expenses not paid
by insurance.)
Do you pay/receive
child support? _______ If so, how much? $_________ per________
Does your spouse
or ex-spouse pay/receive child support? ______________
If so, how much?
_____________ per ____________
Do you or your
spouse or ex-spouse have any other children for which a duty of support
is owed?
__________ If so, please state the following information:
Name:
______________________________ Sex: _____
Date of Birth:
________________ Age: ____ Birthplace: _________________________
Social Security #:
___________________ Driver’s Lic. #:________________ State:____
Name:
______________________________ Sex: _____
Date of Birth:
________________ Age: ____ Birthplace: _________________________
Social Security #:
___________________ Driver’s Lic. #:________________ State:____
Name:
______________________________ Sex: _____
Date of Birth:
________________ Age: ____ Birthplace: _________________________
Social Security #:
___________________ Driver’s Lic. #:________________ State:____
_______________________________________________________________________
FOR OFFICE USE FOR OFFICE USE ONLY
FOR OFFICE USE ONLY
PROPERTY FORM GIVEN TO CLIENT:
š YES š NO
PROPERTY FORM TO BE RETURNED:
š YES š NO
PROPERTY FORM NOT NEEDED:
š YES š NO
ADR STATEMENT: š
YES š NO