DIVORCE
INFORMATION SHEET
YOUR COMPLETE
LEGAL NAME ________________________________________
Are you the Husband _____ or Wife _____
Former/maiden names, if any____________________
Current Address
____________________________City:____________, State:
_____ Zip _______
County________________ How long have you resided in
New York State? __________
Phone Number (Day) ________________ Phone Number (Eve.)
________________
E-mail _______________________
Date of Birth ______________ State/Country of Birth
______________
Social Security Number____________________
SPOUSE'S COMPLETE LEGAL NAME
________________________________________
Former/maiden names, if any____________________
Current Address
____________________________City:____________, State:
_____ Zip _______
County________________ How long has your spouse
resided in New York State? __________
Phone Number (Day) ________________ Phone Number (Eve.)
________________
E-mail _______________________
Date of Birth ______________ State/Country of Birth
______________
Social Security Number____________________
Date of marriage
______________ City, State, County of
marriage_____________________________
Were you married in a religious or civil ceremony?
______________
Are you presently separated? _______ If so approx. date
of separation___________
Who will be Plaintiff (initiating divorce)?
_________________________________
What are the grounds for divorce?
_______________________________________________________
__________________________________________________________________________________
Is the wife pregnant? no ____ yes ____ If so when
is the child due_______________
Is spouse the father of the expected child?__________
How many children have been born to this marriage?
__________
Does either party wish to return to use of a
former/maiden name? If so
which?_________________________________
Please supply the children's information:
NAME:
DATE OF BIRTH:
_________________________________
____________________ SS #_______________
_________________________________
____________________ SS #_______________
_________________________________
____________________ SS #_______________
_________________________________
____________________ SS #_______________
Will one parent
have sole custody of the children? __________, or
Will the parents
share custody (joint) or split custody of the children?
______________
If so, who shall the children reside with primarily
(custodial parent)? ______________ or
Which children
with which parent
___________________________________________________
(this must be
agreeable by both parents).
If you do not have a written agreement, regarding
visitation, what is the visitation arrangement?
(please be specific with times, days of week/weekends,
holidays and birthdays.)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Which holidays will the children spend with the
non-custodial parent?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Which holidays will the children spend with the
non-custodial parent?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
What vacation time, school break periods with the
children be with the non-custodial parent?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Who will provide medical insurance for the children?
Father _________ Father _________
Please provide the
medical insurance policy information:
Company:
_________________________________
Address:
__________________________________
__________________________________
Group:
_________________________________
ID#
_________________________________
Who will pay deductibles and uninsured costs?
Father____ Mother_____ Both_____
Who will maintain life insurance with the child as
beneficiary? Father____ Mother_____ Both_____
IF THERE ARE
CHILDREN, A CHILD SUPPORT WORKSHEET SHOULD BE FILLED
OUT AND A COPY OF THE MOST RECENT W-2 FORM SUPPLIED FOR
BOTH PARTIES
DOES YOUR SPOUSE AGREE TO SIGN THE DIVORCE PAPERS?
Yes______ No______
Property
Division: Please list all property that each person
shall take from the marriage:
(PLEASE LIST ADDRESSES FOR REAL ESTATE AND MAKE OF
CARS).
The Husband should be awarded the following
property:__________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
The Wife should be awarded the following
property:_______________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
OUTSTANDING DEBTS
TO BE PAID BY EACH SPOUSE
(include account numbers and balances):
The Husband shall be responsible for the following
bills:
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
The Wife shall be responsible for the following bills:
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
IMPORTANT INFORMATION REQUIRED IF CHILDREN ARE INVOLVED:
Does either party receive spousal support from a
previous marriage? If so, who__________
How much per
month? $_______________.
Does either party receive child support from a previous
marriage or relationship?
If so, who?__________ How much per month?
$_______________.
Does either party pay child support from a previous
marriage or relationship?
If so, who?__________ How much per month?
$_______________.
Are there any day care costs relating to the children of
this marriage for a spouse to maintain employment?
If so, how much?: $___________ Which spouse need day
care so they can work? ___________
Who pays?___________
Does either spouse receive social services or welfare? If so, who?
Father_________ Mother____________
How much per
month? $___________.
_______________________________________________
In addition to this form, please complete the HUSBAND
and
WIFE sections on the
Certificate of Dissolution
and return the
form with this document
_______________________________________________
I/We request
RUSH SERVICE. I understand there is an additional
$200 fee _________
(RUSH SERVICE entitles you to priority service. If
both parties consent to the divorce and no unusual
circumstances arise, your divorce documents will be
prepared upon receipt and filed in court in
approximately two weeks.)
I/We understand that the New York State Court charges
filing fees separate than those
charged by NYParalagals.
I/We are unable to
afford the Court filing fees and would like to apply for
Poor Person Status ____
Where did you hear about our service? Internet____
Referral____
Printed Ad ____ Other ____
I/We
hereby request that New York Paralegal
Services prepare our uncontested divorce.
I/We understand that New York Paralegal Services are
not lawyers, but a legal document
preparation service. I/We attest that no legal advice has
been given to us. I/We have chosen of our
own free will to have New York Paralegal Services fully
prepare the uncontested divorce
documents in our matter for a fee. I/We have provided all
the information used in our divorce documents.
I/We understand that the preparation fee for work performed
is non-refundable. Should we terminate the services
of New York Paralegal Services and any work has been
done on our behalf, that the fee shall be forfeited by me/us.
Signed:_____________________________ Date:__________
Signed:_____________________________ Date:__________
Upon completion
of this form, please mail the signed document to:
New York
Paralegal Services
PO Box 107
White Plains,
New York 10602
Please include
a money order in the sum of $450 payable to New York
Paralegal Services, or
Complete the
following authorization for credit card processing:
IF RUSH SERVICE
IS REQUESTED, PLEASE ADD A $200 RUSH FEE TO YOUR
PAYMENT.
I authorize New
York Paralegal Services to charge my credit card for
preparation of
my divorce documents:
Card:
______________________________ Account #
_____________________________
Expiration
Date:______________
Billing Address:
______________________________
______________________________
______________________________
Name exactly as on card:
______________________________
Amount
authorized: $________________
Signed:_____________________________
Date:______________
Where did you hear
about our service? Internet____ Referral____
Printed Ad ____ Other ____
PLEASE CALL US IF
YOU HAVE QUESTIONS