DIVORCE QUESTIONNAIRE NO MINOR CHILDREN
CLIENT
First, middle, last name ______
Home address ______
Can we send mail there? ______Alternate Address ______
______
County of Residence ______
Social Security number ______
Home phone number ______Can we call you there? ______
Contact number ______Work phone______
Can we call you at work? ______Email address ______
Driver's license number ______
Occupation ______Employer ______
Work address ______
Gross income ______Hourly income ______
How many hours per week? ______
Gross wages to date ______
Birthplace ______Birthdate ______Age ______
Health? ( Excellent, good, fair, poor) ______
Resident of State of Michigan for at least 6 months? ______
Resident of County for ten days? ______
Education level ______
SPOUSE
First, middle, last name ______
Current address ______
Current phone number ______
County of Residence ______
Social Security number ______
Driver's license number ______
Occupation ______Employer ______
Work address ______
Gross income ______Hourly income ______
How many hours per week? ______
Birthplace ______Birth date ______Age ______
Health? ( Excellent, good, fair, poor) ______
Education level ______
Marriage
Place of Marriage (City, County, State)______
Date of Marriage ______Date separated ______
Length of marriage ______
Maiden name of wife ______Restored? ______
Previous marriages ______How many? ______
Previous marriages of Spouse ______How many?______
Have you or your spouse ever filed for divorce previously? ______Was a Notice
of Reconciliation/Dismissal filed? ______Name of County and Judge assigned: ______
Any immediate problems?
Abuse:______
______Has a PPO been filed? ______
Removing, depleting, destroying, concealing marital assets ______
______
How do you want Defendant served? Process server/ certified restricted delivery______
______
MARITAL ASSETS
Real property
Resident Address ______
Date purchased ______Purchased during or before marriage ______
Purchase price ______Value of property______
Debt on property ______Mortgage Co. and Acct. #______
Monthly payments ______Paid by whom ______
Home equity loan______Acct. # ______
Additional real property
Resident Address ______
Date purchased ______Purchased during or before marriage ______
Purchase price ______Value of property______
Debt on property ______Mortgage Co. and Acct. #______
Monthly payments ______Paid by whom ______
Home equity loan______Acct. # ______
Please provide your legal assistant (the office) with copies of the legal descriptions of all real property listed above.
Vehicles (Car, boat, trailer, motorcycle, snowmobile, etc.)
Year/make______
Vehicle Identification number ______
In whose name______Who has possession ______
Purchase price ______Value of vehicle______
Debt on vehicle ______Monthly payments ______
Year/make______
Vehicle Identification number ______
In whose name______Who has possession ______
Purchase price ______Value of vehicle______
Debt on vehicle ______Monthly payments ______
Year/make______
Vehicle Identification number ______
In whose name______Who has possession ______
Purchase price ______Value of vehicle______
Debt on vehicle ______Monthly payments ______
Year/make______
Vehicle Identification number ______
In whose name______Who has possession ______
Purchase price ______Value of vehicle______
Debt on vehicle ______Monthly payments ______
Bank Accounts
Name of bank and branch ______
Account number ______
Type of account ______
Name of account holder(s) ______
Balance of account ______
Name of bank and branch ______
Account number ______
Type of account ______
Name of account holder(s) ______
Balance of account ______
Name of bank and branch ______
Account number ______
Type of account ______
Name of account holder(s) ______
Balance of account ______
Retirement plans, pensions, 401 k, stocks, profit sharing plans, etc. (Both parties)
Employer or financial institution ______
Name and type of plan ______
Value ______Account Number ______
In whose name ______
Employer or financial institution ______
Name and type of plan ______
Value ______Account Number ______
In whose name ______
Employer or financial institution ______
Name and type of plan ______
Value ______Account Number ______
In whose name ______
Employer or financial institution ______
Name and type of plan ______
Value ______Account Number ______
In whose name ______
Corporate stocks, bonds, notes, securities, bills, brokerage accounts
Name of broker and firm holding investments ______
Type of investment ______
Account number ______
In whose name ______
Type of account ______Purchase price ______
Current value ______
Name of broker and firm holding investments ______
Type of investment ______
Account number ______
In whose name ______
Type of account ______Purchase price ______
Current value ______
Name of broker and firm holding investments ______
Type of investment ______
Account number ______
In whose name ______
Type of account ______Purchase price ______
Current value ______
Life Insurance
ClientSpouse
Name of insurer ______Name of insurer______
Name of insured ______Name of insured ______
Name of beneficiary ______Name of beneficiary ______
Type of insurance ______Type of insurance ______
Policy # ______Policy # ______
Amount of policy ______Amount of policy ______
Cash surrender value ______Case surrender value ______
Loans against policy ______Loans against policy ______
Business Interests (corporations, partnerships, sole proprietor ships, etc.
Name and type of business interest ______
Type of ownership interest ______
Value of interest ______
Initial investment and when ______
Additional amounts vested and when ______
Miscellaneous Assets
Jewelry______
Give values of all pieces of jewelry ______
Art work ______
Give values of all pieces of art work ______
Antiques ______
Give values of all antiques ______
Coins and other collectibles ______
Give values of all collectibles ______
Inheritances ______
Value ______
Annuities ______
Value ______
Safe Deposit Box ______Location ______
Accounts receivable ______
Marital debts
Please list all of the debts including credit card debt. Please include account numbers, monthly payment amounts, total amount owed.
______
______
______
______
______
______
______
______
______
Please list all items, assets, household goods that you believe will become an issue between you and your spouse
______
______
______
______
______
Please provide a "wish list" and/ or your idea of how you would like to see the marital assets separated
PROPOSED PROPERTY DISTRIBUTION
ITEM / VALUE / DEBT / WIFE / HUSBAND1