Anyone getting a divorce should fill out this worksheet for his or her attorney.  Whether you use my office or another attorney, the information is needed in your attorney's file.

        Print it from your browser and fill it in, or cut and paste the text to your word processor and fill it in there.  Then take it with you the first time you go to see your attoney.

        In Items 11, 12, 22, and 23, the information about former names is primarily for women who want to take this easy opportunity to have their name legally changed to their maiden name or to a former married name.  In Item 29, if a child does not yet have a social security number, get one.  It is important to the enforcement of support orders and necessary for tax exemptions.  Also indicate at the end of 29 whether you do or do not expect any argument over paternity and in 32(c) circle whether you believe their will or will not be a custody fight.  Items 16 and 27 request information on the financial arrangements you and your spouse have with anyone you might live with (this is asking if any of the people named are dependents or are otherwise being supported, or if any of them contribute to the household expenses).
 

Date filling out form: ____________

Re: Marriage of: ________________________
                                (names)
1. About the marriage:

Date of Marriage: _____________

Place of Marriage: _________________

3. Residence:  ____________________________________

I have resided in this state for __ years and in the County of __________ for __ years.

My spouse resided in this state for ___ years and in the County of ____________ for __ years.

5. There are ___ children born or adopted into this marriage (further information below).

6. Description of any acts of harassment or violence:
 
 
 
 

ABOUT MYSELF

7. Name: ___________________________________

8. Telephones:

Home: (_____) ___________________

Work: (_____) ___________________ OK to phone at work? ___ Yes ___ No

Other: (_____) ___________________ OK to leave message? ___ Yes ___ No

10. Addresses:

Mailing address: ________________________________________________________

Residence address: _____________________________________________________

County of residence: ______________ How long?

12. I do not wish a former name restored.  ___ yes     ____ no

I want my former name restored as follows: __________________________

13. Employer's name: _____________________________

Address: ____________________________________

Days and times at work:

Length of this employment: _____

Approximate monthly gross pay: $ ___________

 There is medical/dental coverage through my employer:

 ____ for me ____for my spouse ____for children ____No coverage

Monthly cost: $___________

My Social Security number: ___________________

My driver's license number: __________________

Cost of child care enabling me to work is $_____________ per month.

a)

b)

c)

16. Other than my spouse or children, I am currently residing with (name, age, relationship to you):
 
 
 
 

Monetary arrangements with people listed above:
 
 

17. Will

___ I have a will and my most recent will was made on roughly the following date: ______________
 

___ I have no will.

18. Name:

19. Telephones:

 Home: (_____) ___________________

Work: (_____) ___________________ OK to phone at work? ___ Yes ___ No
Other: (_____) ___________________ OK to leave message? ___ Yes ___ No

 21. Addresses:

Mailing address: ___________________________________________________

Residence address: _________________________________________________

County of residence: ______________ How long? ______

23. Spouse does ____ or does not ____ wish a former name restored.

Former name spouse wants restores is as follows: _________________

24. Spouse's employer: ___________________________
                                    (employer's name)

Address: _________________________________

Days and times at work: __________________________

Length of this employment: _____

Approximate monthly gross pay: $ ___________  (PLEASE do not put you don't know.  You have a better idea than I will.
                                                                                                                If you have to guess, do so and indicate it's a guess.)

There is medical/dental coverage through my spouse's employer:
 

 ____ for me ____for my spouse ____for children ____No coverage

Monthly cost: $________

Spouse's Social Security number: _________________

Spouse's driver's license number: _________________

Cost of child care enabling spouse to work is $______ per month.

a)

b)

c)

27. Other than our children, my spouse is currently residing with (name, age, relationship to you):
 
 
 
 

Monetary arrangements with people listed above:
 
 

28. Spouse's attorney is: ________________________
                                        (Name)

Address: ____________________________
 

CHILDREN BORN OR ADOPTED INTO THIS MARRIAGE

29. For each child, list name, age, birthdate, Social Security number, and who the child resides with:
 
 
 
 
 
 
 

There (is) (is not) likely to be any dispute about the paternity of any of the children.
 

30. Special health care problems (indicate by child):
 
 
 

31. Income or property owned by any dependent children:
 
 
 

32. Custody and visitation of children:

a) is currently arranged and is working out as follows:

 

b) I want the judgment to order custody and visitation rights as follows:
 
 

c) I anticipate that there (will) (will not) be a dispute over custody and visitation.

MY PREVIOUS MARRIAGES & RELATIONSHIPS

33. I was previously married ____ times before this marriage.

 List name of each former spouse, when the marriage was terminated, and how (death, divorce, etc.)

a)

b)

c)

35. Children from a non-marital relationship (for each, list name, age, birthdate, Social Security number, and who the child resides with):
 
 
 
 

36. Support paid or received (including any overdue) by me or by the above children, or other income (such as Social Security) received by or on behalf of the above children, is as follows:
 
 
 
 

MY SPOUSE'S PREVIOUS MARRIAGES & RELATIONSHIPS

 37. My spouse was previously married ____ times before this marriage.

 List name of each former spouse, when the marriage was terminated, and how (death, divorce, etc.)

a)

b)

c)

39. My spouse's children from a non-marital relationship (for each, list name, age, birthdate, Social Security number, and who the child resides with):
 
 
 
 

40. Support paid or received (including any overdue) by my spouse or by the above children, or other income (such as Social Security) received by or on behalf of the above children, is as follows:
 
 
 
 

CURRENT ARRANGEMENTS

 41. Separation:

____ We are not yet separated

____ We are separated but have no financial arrangements at this time.

____ We have separated and now live apart under the following financial arrangements:
 
 

Periodic payments (who pays, how much, for what, how often):
 
 

Direct payments (Mortgage, bills, et cetera.) (List each item, who pays, how much and how often paid):
 
 

Other arrangements:
 
 

____ We have made no written agreements and have no oral understandings.

____ We have a written agreement which is attached.

____ We have oral agreements or understandings as follows:
 
 

 43. I foresee the following problems in dealing with my spouse (i.e., fear, distrust, dishonesty, unwillingness to compromise, using children as a weapon, violence, et cetera):
 
 

44. I have some questions and issues I would like to explore, as follows:
 
 

45. I have already made some decisions about what outcome I would like with respect to property, children, support, or goals and conduct of this case, as follows:
 
 
 
 
 
 

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