Family Law

FAMILY LAW QUESTIONNAIRE

Please have this Information Packet completed prior to our initial meeting. We would appreciate your providing us with the information prior to our meeting so that we have enough time to understand the specifics of your situation before our meeting. Don’t worry if you are not able to complete this packet prior to our meeting. If you need assistance completing the information, call our office at (925) 933-9047 and we will help you.

DON’T WORRY ABOUT TOTAL ACCURACY - JUST DO THE BEST YOU CAN

WE LOOK FORWARD TO SEEING YOU!!!

ALL INFORMATION IS STRICTLY CONFIDENTIAL

Personal Profile

Client Full name

Home Address

City

State

Zip Code

Home Phone Number

Work Phone

Cell Phone

Email Address

Occupation

Employer

Social Security Number

Date Of Birth

Period of Residence in California

County Of Residence

Spouse (or Other Parent) Full name

Other names used

Home Address

Address 2

City

State

Zip Code

Home Phone Number

Work Phone

Cell Phone

Email Address

Occupation

Employer

Social Security Number

Date Of Birth

Period of Residence in California

County Of Residence

Any Agreements

Is there a prenuptial (premarital) agreement?

Yes No

Do you have a copy of this agreement?

Yes No

If NO, who does?

Is there a nuptial (ante-nuptial) agreement?

Yes No

Do you have a copy of this agreement?

Yes No

If NO, who does?

County Of Residence

Marriage Information

Date of Marriage

Place

Date of Separation:

Why that date?

County of Residence:

How Long?

You: Been a Resident of California for the Last Six Months?

Yes No

You: Been a Resident of CC for the Last Three Months?

Yes No

Spouse: Been a Resident of California for the Last Six Months?

Yes No

Spouse: Been a Resident of CC for the Last Three Months?

Yes No

Any previous marriage for Client?

Yes No

Any previous marriage for Spouse?

Yes No

What do you want to do?

I want to get divorced?

Yes No

I want a legal separation?

Yes No

I want an annulment?

Yes No

I want child support?

Yes No

I want spousal support?

Yes No

I want our assets divided?

Yes No

I want our debts divided?

Yes No

I want to make custody orders?

Yes No

I want to make visitation orders?

Yes No

I want the other person kicked out?

Yes No

I want a restraining order?

Yes No

I want to change a prior order?

Yes No

Anything else

Other Items to Include or Discuss: Your divorce lawyer should try to address all your questions, fears, needs and wants. Please list any other items you would like addressed or covered.

Is there anything unique about your situation that the attorney should know about?

Anything else

Physical Description of Spouse (or other Parent) for Service of Documents:

Height

Weight

Eye Color

Hair Color

Distinguishing Features:

Car Make

Model

Color

Year

Can you provide me with a picture of your spouse?

Yes No

May I give the picture of your spouse to the process server?

Yes No

Children

Child(1)

Yes No

Name

Child of

Client/Spouse Client Spouse

Address

Street Address

City

State

Zip Code

Phone

BirthDate

Child(2)

Yes No

Name

Child of

Client/Spouse Client Spouse

Address

Street Address

City

State

Zip Code

Phone

BirthDate

Child(3)

Yes No

Name

Child of

Client/Spouse Client Spouse

Address

Street Address

City

State

Zip Code

Phone

BirthDate

Child(4)

Yes No

Name

Child of

Client/Spouse Client Spouse

Address

Street Address

City

State

Zip Code

Phone

BirthDate

Child(5)

Yes No

Name

Child of

Client/Spouse Client Spouse

Address

Street Address

City

State

Zip Code

Phone

BirthDate

Are there any deceased children?

Yes No

Did they leave any surviving children?

Yes No

Names and ages of any surviving children of the deceased children

If Your Children Are Minors

How would you like to address custody and visitation:

Financial Profile

Income	Husband	Wife	Joint
Monthly Earned Income
Monthly Social Security Income
Monthly Pension Income
Other Monthly Income

List all Real Property (i.e., land or homes) owned by you and how title is held:

- Please provide “Grant Deeds” for all California real property.

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

Total Gross:

Total Net:

Cash (checking accounts, savings accounts, CDs, or money markets)

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

Total Gross:

Total Net:

Securities (common stock, preferred stock, corporate bonds, mutual funds)

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

Total Gross:

Total Net:

Retirement or other employee benefits including 401(k), IRA or Keogh accounts, include the names of the beneficiaries of these benefits.

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

Total Gross:

Total Net:

Life Insurance which you own

Face value

Cash value

Type of Policy (term, whole life)

Name and address of each insurance company and policy number.

Business Interests

FMV:

Owe:

FMV:

Owe:

Are you the holder of any promissory notes?

Yes No

If yes, for each, list name of payor , the name of the payee and the current outstanding balance

Are you the beneficiary of any will or trust?

Yes No

Name of the trust

Name of the trustee

Value of trust principal and income

List your tangible personal property of significant value

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

FMV:

Owe:

Total Gross:

Total Net:

Anticipated Gifts or Lawsuit Judgment (Please describe)

Total Gross:

Other Assets

FMV:

Owe:

FMV:

Owe:

Total Gross:

Total Net:

Summary of Values

Real Property

Cash

Automobiles

Securities

Retirement

Life Insurance

Business Interests

Notes

Inheritance

Power of Appointments

Personal Property

Gifts of Judgments

Other Assets

TOTAL

Advisor

	Name	Telephone
Personal Attorney
Accountant
Financial Advisor
Life Insurance Agent

Do you need a referral for any of the above?

Yes No

Would you like any of the following:

Do you want your former name restored

Yes No

What was your former name?

Do you want to revoke a joint tenancy?

Yes No

Do you want to revoke a trust?

Yes No

Do you want to create new estate planning documents such as Wills, Trusts, Durable Powers of Attorney, or Health Care Directives?

Yes No

Anything else?