Name: _________________________________________
Date/Birth: _______________
Maiden Name: _________________________________________
Do you want your maiden name restored by the Court?: __________
Is either you or your spouse a resident of Florida for more than 6 months?: __________
What is the issuance date of your Florida Driver License?: __________
Do you want your maiden name restored by the Court?: __________
Address:
______________________________________________Phone:____________ Home:____________ Work:____________ Beeper:____________ Other:____________
Date of Marriage: _________________________________________
City/State of Marriage: _________________________________________
Date of Separation: _________________________________________
Spouse's Name:_________________________________________
__________________________________Spouse's Address:
____________________________________________Does anyone in family have any health problems or disabilities? (including drug or alcohol abuse)_________
Spouse's Phone Numbers & Employment Information:
___________________________________________________________Are you seeking alimony, either temporary or permanent? (In general alimony is awarded where one party has a need for financial assistance, i.e. can't pay their monthly expenses on their income, and the other party has the ability to chip in)
______________________________________________Have you ever entered into a Pre or Post Nuptial agreement with your spouse before, or does either of you have a trust?
___________________________________________________________Have you come to an agreement with your spouse on any of the issues in your case, such as division of property or debt, spousal support or waiver thereof, or child related issues such as timesharing, child support or provision of health insurance?
_______________________________________________Have you ever married and divorced your present spouse before?
_______________________________________________Spouse's salary:_____________________
Spouse's educational background: __________________________
Is Spouse in school now or in line for raises: _________________
What is the best job Spouse has ever had:
_____________________________________________________________What are your Spouse's skills:
___________________________________________________________Anyone have a part time job or under the table income or other income:
____________________________________________________Your educational background:
_______________________________________________________Are you in school now or in line for raises or promotion:
_____________________________________________________Do you plan to go to school or otherwise do anything to "rehabilitate" yourself:
_____________________________________________What is the best job you ever had:
_________________________________________________________List your skills:
_______________________________________________________Your current salary:____________________________
Your current position:_________________________________________
Your place of Employment:
_____________________________________________________Have you ever been married before? ________________
Do you receive alimony or child support _____________
Do you or your spouse receive regular gifts of money or other assets from anyone, or have any expenses paid by anyone? Does anyone chip in for or contribute to your expenses or your spouse's expenses?
___________________________________________________Children conceived or born during the marriage
Name of Child:
Date of Birth:
Is your spouse the natural parent of the above children?:
Have any children been conceived or born during the marriage that are not your husband's?
Is child(ren) in good heath?
Does the child(ren) have any special needs? (educational, health, etc.)
Is there any threat of violence by your spouse?:
Has there been violence in the past in your marriage?:
Please indicate the desired child visitation arrangement:
Do you feel that there is a need for supervised visitation because of your spouse's behaviors that could harm your child?:
How is your child covered by health insurance and who pays for it?:
Do you or your spouse have life insurance, and if so, how much?:
Who pays for the life insurance?
Do you have any day care expenses for your child?:
Do you have any desire to leave the area with your children?:
Non-Child Related Issues
What real property (land and buildings) do you and/or your spouse own? (Please list all property regardless of whose name it's in, and regardless of whether it was bought before or during marriage)
Is there any real (ie land or houses or buildings) or personal property in joint names? (that need to be put in one parties' name)
Please list current value, purchase price, mortgage balance, monthly payment, and date of purchase of above property, as well as the down payment amount and where the down payment came from.
Please indicate whose name the above property is in now, and who purchased it.
Please indicate if any improvements were made to the home during the marriage which has increased it's value.
Please indicate what you want done with the above property.
Do you and/or your spouse own a business?
How many employees are there?
How much do you think that the business could be sold for?
Would the business generate any income if neither you nor your spouse worked at it?
Please indicate the value of any pension, IRA, 401-k or retirement type programs that you or your spouse have.
Please describe all personal property (i.e. assets, stocks, bank and investment accounts, valuables, jewelry, cars, etc.) that you and your spouse have. (regardless of whose name it's in and regardless of whether it was acquired before or during marriage)
Please indicate the value of the above personal property and date of acquisition, as well as where the funds came from to make the acquisition.
As to all of the above asset both real (ie land and houses) and personal, how did you acquire each asset, ie did you make an extraordinary contribution such that you may be entitled to more than a presumptive 50% share.
Please indicate all debts which you and your spouse have, no matter whose name they are in. This includes IRS debts.(please specify which if any debts were incurred before the marriage) Which of the debts are in joint names?
Please specify which if any property was inherited by either party, or received during the marriage as a gift from a third party.(to only one of the parties of the marriage).
As to any inherited or gifted property please indicate whose name it's in now.
Please indicate what property was owned separately by one party before the marriage. (and whose name that property is in.)
Has there been any increase in value during the marriage to any property that was inherited, gifted as stated above, or owned by one party before the marriage?
Did any of the above increase occur because of contributions of marital funds, (i.e. funds earned by either party during the marriage) or because of efforts made by either party during the marriage? (note that "efforts" include investment activities)
Do you think your spouse is hiding any money or assets?
Where and how much?
Has your spouse wasted or given away any significant monies or assets in the past several years?
Have you done a credit check on yourself to make sure your spouse hasn't run up bills in your name?
Is your spouse guilty of adultery during the marriage?
Can you prove that your spouse spent money during your marriage on the third party?