Divorce

DIVORCE INFORMATION SHEET (WITH CHILDREN)

INSTRUCTIONS: HELP US TO HELP YOU TO PROCESS YOUR CASE EFFICIENTLY)
4. Please print clearly.
5. Please give accurate answers – incorrect answers will cause problems in your case.
6. Please answer all questions – all answers are required to process your case properly.
YOUR FULL NAME: _______________________________________________ (Male / Female)
(first, middle, last)
ADDRESS: _________________________________________________________________ APT#_____________________ (I rent / own) ________________________, TEXAS, ZIP: _________________
WHAT COUNTY DO YOU LIVE IN? ___________________________ OVER 6 MONTHS? _________

HOME PHONE: _____________________ Answering Machine ? Yes No (Normally home by _______)
WORK PHONE: ___________________ PAGER or CELL: _________________ RACE: ____________
DATE OF BIRTH: ________________ AGE: _______ CITY & STATE OF BIRTH: _________________
(month, day, year)
SOCIAL SECURITY #________________________ TX DRIVER’S LICENSE #____________________

DATE OF MARRIAGE:_____________________ PLACE OF MARRIAGE: ______________________
(month, day, year) (city and state)
DATE OF SEPARATION: _____________________ REMINDER: PLEASE PRINT CLEARLY
(month, day, year)
Have you or your spouse filed a divorce on each other before? _______________

YOUR SPOUSE’S NAME: ________________________________________________________
(first, middle, last)
ADDRESS: STREET ________________________________________ APT#________________
______________________________, STATE _______________ ZIP: __________
RACE_________________
DATE OF BIRTH: _________________ AGE: ________ CITY & STATE OF BIRTH: _______________
(month, day, year)
SOCIAL SECURITY #__________________________ DRIVER’S LICENSE# __________________
WIFE’S MAIDEN NAME: _______________________________________________________
WIFE WANT HER NAME CHANGED TO: (first, middle, last) __________________________________
PROPERTY: I will keep this car(s): (year, make, model) _____________________________________
He/she will keep this car(s): (year, make, model) ________________________________
We currently do not own any real estate. (True or False) _______________
We did not accumulated any 401k, pension, or retirement benefits during the marriage (T/F) ____

CHILDREN: During the marriage, wife had ___________ child(ren) with husband.
During the marriage, wife had ___________ child(ren) with other person(s).
Wife is not pregnant. (True or False) ______________
We have grown children _________ (True or False) If true, their age(s)______________

We have __________ child(ren) during our marriage.

1. CHILD’S NAME: ______________________________________________
Date of birth: _________________________________ Place of birth: __________________
Social Security #_______________________ Sex: _______ Custody with: ______________

2. CHILD’S NAME: ______________________________________________
Date of birth: _________________________________ Place of birth: __________________
Social Security #_______________________ Sex: _______ Custody with: ______________

3. CHILD’S NAME: ______________________________________________
Date of birth: _________________________________ Place of birth: __________________
Social Security #_______________________ Sex: _______ Custody with: ______________

4. CHILD’S NAME: ______________________________________________
Date of birth: _________________________________ Place of birth: __________________
Social Security #_______________________ Sex: _______ Custody with: ______________

5. CHILD’S NAME: ______________________________________________
Date of birth: _________________________________ Place of birth: __________________
Social Security #_______________________ Sex: _______ Custody with: ______________

There is an Attorney General Order regarding child support payments for my child(ren). ______ (yes or no)
If yes, provide copy of the Order or additional information.

Who will have custody of the child(ren)? ____________________
Who will have standard visitation righs? ____________________
We agreed to set child support at $__________________ per month?
Who will maintain health insurance for the child(ren)? ) _________________
My spouse has committed violence against me (T/F) _________
My spouse has a criminal record (T/F) __________

I understand that State Law requires that all child support payments be made through the Dept. _________
Are there any abuse to you or to your child(ren)? _______________ (initial)
Do you agree that both spouses should live within 100 miles of each other to facilitate visitation rights? ___

MY EMPLOYMENT INFORMATION: (REQUIRED)

COMPANY NAME: _______________________________________________
ADDRESS: _______________________________________________________ SUITE #____________
____________________________________________, TEXAS, ZIP: _________________
PHONE # ____________________________ EXT. ________

MY SPOUSE’S EMPLOYMENT INFORMATION:

COMPANY NAME: _______________________________________________
ADDRESS: _______________________________________________________ SUITE #____________
____________________________________________, TEXAS, ZIP: _________________
PHONE # ____________________________ EXT. ________
PHONE (HOME) ___________________________________

NOTE: YOU MUST TAKE A PARENT-CHILD SEMINAR .