Family - Divorce Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth Spouse's Name First Name Last Name Spouse's Phone (###) ### #### Spouse's Address Address 1 Address 2 City State/Province Zip/Postal Code Country Spouse's Date of Birth MM DD YYYY Date of Marriage MM DD YYYY Date of Separation MM DD YYYY Employer name, phone, and address Spouse's employer name, phone, and address Name, Date of Birth, and Residence of each minor child Do you have health insurance? Is so, name of carrier and policy number Will there be a dispute over cusotdy? Real Property # 1: address, year bought, market value, and current amount you owe Real Property # 2: address, year bought, market value, and current amount you owe Real Property # 3: address, year bought, market value, and current amount you owe Real Property # 4: address, year bought, market value, and current amount you owe Real Property # 4: address, year bought, market value, and current amount you owe Name of Bank Accounts, Savings Accounts, C.D.’s, Credit Union, Savings Bonds: Account #1 (provide last 4 digits of each account) Name of Bank Accounts, Savings Accounts, C.D.’s, Credit Union, Savings Bonds: Account #2 (provide last 4 digits of each account) Name of Bank Accounts, Savings Accounts, C.D.’s, Credit Union, Savings Bonds: Account #3 (provide last 4 digits of each account) Name of Bank Accounts, Savings Accounts, C.D.’s, Credit Union, Savings Bonds: Account #4 (provide last 4 digits of each account) Name of Bank Accounts, Savings Accounts, C.D.’s, Credit Union, Savings Bonds: Account #5 (provide last 4 digits of each account) Name of Bank Accounts, Savings Accounts, C.D.’s, Credit Union, Savings Bonds: Account #6 (provide last 4 digits of each account) Name of Bank Accounts, Savings Accounts, C.D.’s, Credit Union, Savings Bonds: Account #7 (provide last 4 digits of each account) Credit Card # 1: Name, balance, and last 4 digits Credit Card # 2: Name, balance, and last 4 digits Credit Card # 3: Name, balance, and last 4 digits Credit Card # 4: Name, balance, and last 4 digits Credit Card # 5: Name, balance, and last 4 digits Motor Vehicle, Boat, Airplane, Motorcycle, Trailer # 1 (Year, make, and model) Motor Vehicle, Boat, Airplane, Motorcycle, Trailer # 2 (Year, make, and model) Motor Vehicle, Boat, Airplane, Motorcycle, Trailer # 3 (Year, make, and model) Motor Vehicle, Boat, Airplane, Motorcycle, Trailer # 4 (Year, make, and model) List of all pension, 401k, and/or saving plans Debt # 1 other than credit card (mortgage, car loan, student loan, other loans or judgments) Debt # 2 other than credit card (mortgage, car loan, student loan, other loans or judgments) Debt # 3 other than credit card (mortgage, car loan, student loan, other loans or judgments) Debt # 4 other than credit card (mortgage, car loan, student loan, other loans or judgments) Debt # 5 other than credit card (mortgage, car loan, student loan, other loans or judgments) Home monthly expenses: gas, light, trash, rent, mortgage, health care insurance, auto insurance, phone, groceries, clothes, internet, education, and/or any other monthly expenses. What is your monthly salary? What is your spouses monthly salary? Is there anything else you would like us to know? Thank you! Mr. Sandoval will be in contact with you.
