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New Client Information – Divorce 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
State of birth
Birth date
MM slash DD slash YYYY
How long in Illinois
May we contact you at home?
Yes
No
Alternate Number
What is the best way to communicate with you?
Mail
Email
Phone
Employed by
Occupation
Work Address
Date of Hire
MM slash DD slash YYYY
Gross Pay
Net Pay
Cohabitating?
Yes
No
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
Cohabitating?
Yes
No
Divorce and Family Information
Date of Marriage
MM slash DD slash YYYY
City and County
Date of Separation
MM slash DD slash YYYY
Who left?
Case No
County
Court Date
MM slash DD slash YYYY
Court Time
Hours
:
Minutes
AM
PM
AM/PM
Opposing Attorney(s)
Children of Parties
Name
DOB
MM slash DD slash YYYY
School/Grade
Is DCFS involved?
Yes
No
Caseworker and Agency
Guardian Ad Litem
Does either party, including your children, have any special physical or mental health problems? If so, describe:
Are you paying or receiving child support at this time?
Yes
No
In what amount
Is Visitation or Parenting Time being exercised?
Yes
No
what schedule?
Identifying Information of the Parties
Your Highest Level of Education
Opposing Party’s Highest Level of Education
Number of Marriages – Husband
Number of Marriages – Wife
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
Retirement Account
Estimated value
Debt
Checking/Savings Account
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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