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New Client Information – Post Decretal Form
Name
(Required)
First
Last
Mainden Name
Date
MM slash DD slash YYYY
Home Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Email
(Required)
Home Phone
Cell Phone
Work Phone
Social Security Number
Birth date
MM slash DD slash YYYY
How long in Illinois
May we contact you at home?
Yes
No
Alternate Number
Employed by
Occupation
Work Address
Date of Hire
MM slash DD slash YYYY
Gross Pay
Net Pay
Married or Cohabitating?
Opposing Party
Opposing Party’s Name
(Required)
First
Last
Maiden Name
Home Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Email
(Required)
Home Phone
Birth date
MM slash DD slash YYYY
State of birth
How long in Illinois
Work Phone
May we contact them?
Yes
No
Cell Phone
Employed by
Occupation
Work Address
Date of Hire
MM slash DD slash YYYY
Gross Pay
Net Pay
Married or Cohabitating?
Post-Decree Custody and Support Information
Date of Decree
MM slash DD slash YYYY
Do you have physical custody?
Yes
No
Date of last custody/visitation order
MM slash DD slash YYYY
Date of last support order
MM slash DD slash YYYY
Amount of support awarded
Arrearage amount
Arrearage date
MM slash DD slash YYYY
Case No.
County
Court Date
MM slash DD slash YYYY
Court Time
Hours
:
Minutes
AM
PM
AM/PM
Name
DOB
MM slash DD slash YYYY
School/Grade
Does either party, including your children, have any special physical or mental health problems?
Yes
No
If so, describe
Are you paying or receiving child support at this time?
Yes
No
In what amount
Education and Identifying Information
Your Highest Level of Education
Opposing Party’s Highest Level of Education
Physical description of spouse or opposing party for service:
Height
Weight
Hair Color
Distinguishing features
Assets of Both Parties
Marital Residence
Estimated value
Debt
Real Estate
Estimated value
Debt
Vehicle
Estimated value
Debt
Other
Estimated value
Debt
Pensions/IRAs
Estimated value
Debt
Checking/Savings
Estimated value
Indebtedness of Both Parties
To whom
Amount
Referral Information
Who Referred You To Our Office (or how did you hear about us):
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