Premarital Agreement Questionnaire Premarital Agreement 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. 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 CONFIDENTIALPersonal ProfileClient Full name* First Last Other names used Other names used Home address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is it OK to send mail to the above address?* Yes No please provide a mailing address*County of Residence*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificHome Phone*Work Phone*Facsimile* Is it OK to send faxes to the above fax number?* Yes No please provide a fax number* Cell Phone*Email address* Is it OK to send email to the above email?* Yes No please provide an email address* Occupation* Employer Social Security Number*Date of Birth* MM slash DD slash YYYY Period of Residence in California*Less than a month1-6 months1-3 yearsOver 3 yearsAre you a U.S. Citizen?* Yes No Contemplated Spouse Full nameClient Full name* First Last Other names used* Other names used Home address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County of Residence Home Phone*Work Phone*Facsimile* Cell Phone*Email address* Occupation* Social Security Number*Date of Birth* MM slash DD slash YYYY Period of Residence in California*Less than a month1-6 months1-3 yearsOver 3 yearsAre you a U.S. Citizen?* Yes No Date of Contemplated Marriage* MM slash DD slash YYYY Place of Contemplated Marriage* Marital Relationships Prior marriages of Client / Contemplated SpouseHas Client or Contemplated Spouse been married before?* Yes No give the following information for each former marriage:Name of former spouse* First Last Date of marriage* MM slash DD slash YYYY Was marriage ended by death or divorce (and final date)?* ChildrenChild(1) Male Female Name* First Child of* Client/CSpouse Client Contemplated Spouse Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone NoBirthdate* MM slash DD slash YYYY Special Needs of Child* Yes No DescribeChild(2) Male Female Name* First Child of* Client/CSpouse Client Contemplated Spouse Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone NoBirthdate* MM slash DD slash YYYY Special Needs of Child* Yes No Describe*Child(3) Male Female Name* First Child of* Client/CSpouse Client Contemplated Spouse Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone No*Birthdate* MM slash DD slash YYYY Special Needs of Child* Yes No Describe*Child(4) Male Female Name Name Child of* Client/CSpouse Client Contemplated Spouse Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone No*Birthdate* MM slash DD slash YYYY Special Needs of Child* Yes No Describe*Child(5) Male Female Name* Name Child of* Client/CSpouse Client Contemplated Spouse Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone No*Birthdate* MM slash DD slash YYYY Special Needs of Child* Yes No Describe*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 childrenWhat is your main reason for wanting a premarital agreement?Is there anything unique about your situation that the attorney should know about?Anything else?There are time requirements and disclosure requirements that need to be complied with in order to have a valid premarital agreement. Please return this questionnaire immediately. You cannot validly waive spousal support unless both sides are represented by an attorney. Just because both sides are represented does not mean that a court cannot set aside an invalid waiver. Spousal support waivers may still not apply if a court finds them unconscionable at the time of the dissolution (or at the time one party tries to enforce the waiver). Premarital agreement document review and signing appointments are typically available Monday through Friday starting at 8:30 a.m. Afternoon appointments must usually commence by 4:30 p.m. Exceptions are made for emergencies and special circumstances. Thank you for allowing us to be of service with your family law needs!CAPTCHA Δ