Basic Information

DIVORCE--BASIC INFORMATION (INITIAL INTERVIEW)

DATE:_________________

CLIENT:

FULL NAME: ___________________________________________________________

RESIDENCE ADDRESS:__________________________________________________

CITY: ____COUNTY: STATE:_____________
HOME PHONE: OFHCE PHONE:________________

MAILING ADDRESS (IF DIFFERENT):______________________________________

CITY: _____________________COUNTY: STATE:___________

BIRTHDATE:__________________PLACE OF BIRTH:_________________________

EMPLOYER: ____________________________________________________________

POSITION: _____________________________________________________________

MONTHLY TAKE-HOME PAY:____________________________________________

SOCIAL SECURITY NO.__________________________________________________

DRIVER’S LICENSE NUMBER AND STATE OF ISSUANCE:

_______________________________________________________________________

SPOUSE:

FULL NAME: ___________________________________________________________

RESIDENCE ADDRESS:__________________________________________________

CITY: ____COUNTY: STATE:_____________
HOME PHONE: OFHCE PHONE:________________

BIRTHDATE:__________________PLACE OF BIRTH:_________________________

EMPLOYER: ____________________________________________________________

POSITION: _____________________________________________________________

MONTHLY TAKE-HOME PAY:____________________________________________

WIFE PREGNANT?_____________WIFE’S MAIDEN NAME:___________________

DOES WIFE WISH TO HAVE HER MAIDEN NAME RESTORED?_______________

SOCIAL SECURITY NO.__________________________________________________

DRIVER’S LICENSE NUMBER AND STATE OF ISSUANCE:

_______________________________________________________________________

RESIDENCE:

HAVE YOU LIVED IN TEXAS FOR THE PAST 6 MONTHS?_______________ HAVE YOU LIVED IN THIS COUNTY FOR THE PAST 90 DAYS?_______________

HAS YOUR SPOUSE LIVED IN TEXAS FOR THE PAST 6 MONTHS?_________ HAS YOUR SPOUSE LIVED IN THIS COUNTY FOR THE PAST 90 DAYS?______

MARRIAGE AND SEPARATION:

DATE OF MARRIAGE:___________________________________________________

PLACE OF MARRIAGE:__________________________________________________

DATE OF LAST SEPARATION:____________________________________________

ATTORNEYS:

IF YOU HAVE CONSULTED WITH ANOTHER ATTORNEY ON THIS MATTER, GIVE HIS NAME:________________________________________________________

IF YOUR SPOUSE HAS, THEN GIVE THE ATTORNEY’S NAME:

_______________________________________________________________________

CHILDREN:

FULL NAME GENDER BIRTHDATE BIRTHPLACE LIVES WITH

______________________________________________________________________________

IF THE CHILDREN HAVE EVER BEEN THE SUBJECT OF OR INVOLVED IN A COURT ROOM ACTION BEFORE THEN STATE WHEN, WHERE, WHAT IT CONCERNED, WHO WAS INVOLVED AND ANY OTHER RELEVANT DETAILS:

______________________________________________________________________________

IF ANY OF THE CHILDREN HAVE PHYSICAL OR MENTAL DISABILITIES TO THE POINT THAT HE OR SHE REQUiRES SPECIAL CARE, GIVE THE CHILD’S NAME, DiSABILITY, AND CURRENT ARRANGEMENTS FOR CARE WHICH PARENT DESIRE CUSTODY OF THE CHILDREN?

______________________________________________________________________________

IS ANY PROPERTY OWNED BY THE CHILDREN?___________________________

IF SO, DESIGNATE WHAT AND WHERE IT IS LOCATED AND WHAT INTEREST THE CHILD HAS IN IT:

______________________________________________________________________________

ARE ANY OF THE CHILDREN STEP CHILDREN?____________________________ IF SO, THEN TO WHOM? _______________________________________________________

______________________________________________________________________________

ARE ANY OF THE CHILDREN ADOPTED OR IS AN ADOPTION PENDING?

______________________________________________________________________________

IF SO, GIVE RELEVANT DETAILS: ________________________________________

______________________________________________________________________________

PROPERTY SKETCH:

ARE YOU RENTING OR BUYING YOUR HOME? ____________________________

IF BUYING:

ESTIMATE IT’S VALUE: ___________________________________________

ESTIMATE YOUR MORTGAGE LOAN BALANCE:_____________________

ESTIMATE VALUE OF CASH ASSETS (CHECKING AND SAVINGS ACCOUNTS, CERTIFICATES OF DEPOSIT ALSO):_____________________

DO YOU OWN STOCKS, BONDS, OR OTHER SECURITIES?_____________

IF SO, ESTIMATE THEIR PRESENT VALUE:__________________________

OTHER INVESTMENTS:

ITEM ESTIMATED VALUE

______________________________________________________________________________

DESIGNATE THE LOCATION AND THE PERSON IN POSSESSION OF THE

ABOVE LISTED PROPERTY:

______________________________________________________________________________

WHAT AMOUNT OF RETIREMENT, PROFIT-SHARING OR OTHER EMPLOYEE

BENEFITS WOULD YOU AND YOUR SPOUSE RECEIVE IF YOU LEFT EMPLOYMENT TODAY?

______________________________________________________________________________

LIST ANY INTEREST THAT YOU OR YOUR SPOUSE HAS IN ANY ABOVE MENTIONED BENEFITS WHETHER MATURED OR NOT:

______________________________________________________________________________

ESTIMATE THE TOTAL OF ALL YOUR DEBTS. EXCLUDING MORTGAGE LOAN BALANCE: _____________________________________________________________

COUNSELING:

IF YOU HAVE EVER SOUGHT MARRIAGE COUNSELING, GiVE DATES AND COUNSELORS:

______________________________________________________________________________

WOULD COUNSELING HELP NOW?______________________________________ IS YOUR SPOUSE WILLING TO PARTICIPATE IN COUNSELING?_____________

IF YOU HAVE ANY URGENT PROBLEMS OR CONCERNS THAT NEED TO BE ADDRESSED IMMEDIATELY THEN PROVIDE THAT INFORMATION IN THE FOLLOWING SPACE ALONG WITH ANY ADDITIONAL COMMENTS:

______________________________________________________________________________

INVENTORY OF PROPERTY:

REAL PROPERTY:

(PLEASE ATTACH A COPY OF DEED AND OTHER LEGAL PAPERS CONCERNING EACH PIECE OF REAL ESTATE LISTED, IF POSSIBLE. IF ADDITIONAL SPACE IS REQUIRED, PLEASE USE THE BACK OF THIS SHEET).

ADDRESS: _____________________________________________________________

DESCRIPTION OF HOME OR OTHER STRUCTURE(S) LOCATED ON THE REAL

ESTATE: _____________________________________________________________________

______________________________________________________________________________

DATE OF PURCHASE: ________________ PURCHASE PRICE: _________________ PRESENT MARKET VALUE:____________________________________________________

METHOD OF ESTIMATING MARKET VALUE (SUCH AS PRICE PAID ON RECENT SALE OF COMPARABLE PROPERTY IN SAME LOCALE. OPINION OF REALTOR, FORMAL APPRAISAL OR PERSONAL GUESS BASED ON AVERAGE RATES OF APPRECIATION AND INFLATION): ___________________________________

______________________________________________________________________________

TOTAL CURRENT OUTSTANDING INDEBTEDNESS: $ ____________________________

MONTHLY PAYMENTS $_______________________________________________________

NUMBER OF YEARS REMAINING: ______________________________________________

HAS ANY OF THE PROPERTY BEEN DECLARED “HOMESTEAD”? __________________

IF SO, WHICH ONE? ___________________________________________________________

IS ANY OF THE PROPERTY INCOME-PRODUCING?_______________________________

IF SO, GIVE DETAILS: _________________________________________________________

______________________________________________________________________________

PERSONAL PROPERTY

VEHICLE(S): (PLEASE FURNISH CERTIFICATE OF TITLE)

YEAR _______________ MAKE___________________    MODEL______________________
YEAR _______________ MAKE___________________    MODEL______________________
YEAR _______________ MAKE___________________    MODEL______________________
YEAR _______________ MAKE___________________    MODEL______________________
2 DOOR OR 4 DOOR: V8, 6,4; SPECIAL FEATURES

______________________________________________________________________________

VIN NO._________________________ MILEAGE_________________________________

PURCHASE DATE:_____________________________________________________________

TOTAL CURRENT OUTSTANDING INDEBTEDNESS: $ ____________________________

MONTHLY PAYMENT $________________________________________________________

MONTHS REMAINING ON NOTE: _______________________________________________

IN WHOSE POSSESSION: ______________________________________________________

WHICH VEHICLE(S) DO YOU WANT?____________________________________________

RECORD OWNER:

FURNITURE

(THE DIVISION OF HOUSEHOLD FURNITURE AND APPLIANCES ISORDINARILY BETTER LEFT TO TILE HUSBAND AND WIFE AFTER BRIEFCONSULTATION WITH YOUR ATTORNEY. THIS IS BECAUSE MOST FURNITURE AND APPLIANCES DO NOT HAVE SIGNIHCANT RESALE VALUE, AND THE QUESTIONS “WHO USES THIS MOST?” AND “WHO NEEDS THIS MOST?” ARE MORE IMPORTANT THAN “HOW MUCH IS THIS WORTH?” WHEN IT COMES TIME TO DIVIDE THE ITEMS. HOWEVER, THE FOLLOWING INFORMATION SHOULD BE SUPPLIED FOR ITEMSTHAT HAVE INTRINSIC VALUE SUCH AS ANTIQUES, ART, SILVER, AND CRYSTAL.) AS TO ANY PIECE OF FURNITURE OR APPLIANCE WHICH HAS A PRESENT RESALE VALUE IN EXCESS OF $500.00, PLEASE PROVIDE:

ITEM PURCHASE PRICE RESALE VALUE HOW ACQUIRED

1. ____________________________________________________________________________

2. ____________________________________________________________________________

3. ____________________________________________________________________________

4. ____________________________________________________________________________

5. ____________________________________________________________________________

6. ____________________________________________________________________________

7. ____________________________________________________________________________

ESTIMATE RESALE VALUE OF ALL OF YOUR HOUSEHOLD FURNISHINGS AND FIXTURES, EXCLUDING THE ABOVE: $_________________________________________

CHECKING ACCOUNTS

BANK NAME ON ACCT PERSON IN CONTROL ACCT # AMT IN ACCT

1. ____________________________________________________________________________

2. ____________________________________________________________________________

3. ____________________________________________________________________________

SAVINGS ACCOUNTS

FINANCIAL INSTIT NAME ON ACCT PERSON IN CONT ACCT# AMT

1. ____________________________________________________________________________

2. ____________________________________________________________________________

3. ____________________________________________________________________________

CERTIFICATES OF DEPOSIT (PROVIDE THE SAME INFORMATION AS ABOVE):

1. ____________________________________________________________________________

2. ____________________________________________________________________________

3. ____________________________________________________________________________

DO YOU HAVE THESE?

______________________________________________________________________________

WHERE ARE THEY? ___________________________________________________________

______________________________________________________________________________

STOCKS, BONDS, AND OTHER SECURITIES:

COMPANY NAME IN WHICH HELD #OF SHARES DATE PURCH VALUE

1. ____________________________________________________________________________

2. ____________________________________________________________________________

3. ____________________________________________________________________________

4. ____________________________________________________________________________

DO YOU HAVE THESE?________________________________________________________

WHERE ARE THEY? ___________________________________________________________

______________________________________________________________________________

INSURANCE

POLICY #1 POLICY #2 POLICY#3 POLICY #4

COMPANY: __________________________________________________________________

POLICY #: ____________________________________________________________________

NAME OF INSD: ______________________________________________________________

OWNER: _____________________________________________________________________

BENEFICIARY: _______________________________________________________________

AMT OF COVER: ______________________________________________________________

AMT OF PREM: _______________________________________________________________

CASH VALUE: ________________________________________________________________

DO YOU HAVE THESE POLICIES? ______________________________________________

WHERE ARE THEY?___________________________________________________________

RETIREMENT, PENSION, PROFIT-SHARING, OR OTHER EMPLOYEE BENEFITS

EMPLOYER: __________________________________________________________________

NAME OR DESCRIPTION OF BENEFIT PLAN: ____________________________________

______________________________________________________________________________

TOTAL AMOUNT OF EMPLOYEE’S CONTRIBUTIONS TO FUND TO DATE: __________

PRIOR TO MARRIAGE $ _______________________________________________________

SUBSEQUENT TO MARRIAGE: $ _______________________________________________

TOTAL AMOUNT OF EMPLOYER’S CONTRIBUTIONS TO FUND TO DATE: __________

PRIOR TO MARRIAGE $ _______________________________________________________

SUBSEQUENT TO MARRIAGE: $________________________________________________

PRESENT BALANCE OF EMPLOYEE’S INTEREST IN FUND $ ______________________

DATE EMPLOYEE IS ENTITLED TO RECEIVE RETIREMENT OR PENSION BENEFITS:

______________________________________________________________________________

AMOUNT OF BENEFITS RECEIVABLE PER MONTH ON RETIREMENT: ______________________________________________________________________________

BALANCE PAYABLE ON DEATH OF RETIRED EMPLOYEE: _______________________

BENEFITS AVAILABLETO EMPLOYEE WITHOUT RETIREMENT: __________________

____________________________________________________________________________________________________________________________________________________________

OTHER ASSETS (SPECIFY):

ITEM PURCHASE PRICE HOW ACQUIRED CURRENT VALUE

1. ____________________________________________________________________________

2. ____________________________________________________________________________

3. ____________________________________________________________________________

4. ____________________________________________________________________________

5. ____________________________________________________________________________

6. ____________________________________________________________________________

7. ____________________________________________________________________________

8. ____________________________________________________________________________

PERSONAL INJURY AWARD:

DO YOU OR YOUR SPOUSE HAVE ANY CLAIM PENDING FOR PERSONAL INJURIES, OR HAVE YOU OR YOUR SPOUSE RECEIVED ANY COMPENSATION FOR PERSONAL INJURIES WITHIN THE PAST FIVE YEARS? IF SO, DESCRIBE:

____________________________________________________________________________

TAX REFUND:

ARE ANY TAX REFUNDS EXPECTED?___________________________________________

IF SO, HOW MUCH? $__________________________________________________________

DO YOU HAVE COPIES OF YOUR INCOME TAX RETURNS FOR THE PAST FIVE YEARS? ______________________________________________________________________

ACCRUED BONUS, COMMISSIONS:

ARE YOU DUE ANY WAGES, BONUSES, COMMISSIONS, OR ACCRUED PAY OF ANY TYPE? IF SO, DESCRIBE: _______________________________________________________

______________________________________________________________________________

IS YOUR SPOUSE? ____________________________________________________________

IF SO, DESCRIBE: _____________________________________________________________

SAFE DEPOSITS BOXES:

DO YOU OR YOUR SPOUSE HAVE ACCESS TO A SAFE DEPOSIT BOX? IF SO, DESCRIBE CONTENTS AND WHERE THE BOX IS LOCATED: ______________________

______________________________________________________________________________

INSTALLMENT DEBTS:

(THIS WILL BE SOMEWHAT REPETITIOUS OF THE INCOME AND EXPENSE STATEMENT. GIVE INFORMATION AS TO ANY INSTALLMENT PAYMENTS OTHER THAN MORTGAGE PAYMENTS, IF ANY, AND REVOLVING CHARGE ACCOUNTS ON WHICH THERE IS A CONTINUING BALANCE. COMMON EXAMPLES INCLUDES LARGE MEDICAL BILLS, BLANK NOTES, AND CAR PAYMENTS.)

CREDITOR REASON OUTSTANDING PAY-OFF MONTHLY
INCURRED BALANCE DATE PAYMENTS