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Divorce Form

Name*
Place of Birth*
Social Security Number*
Drivers License Number*
Email Address*
May we Contact you via Email*
 Yes 
 No 
Which Method of Communication do you Prefer*
 Email 
 Phone 
Where Are you Living Now*
Address*
City,State,Zip*
May we send mail to you at this address?(please
ensure that your mail is secure and protected from
your spouse)*
 Yes 
 No 
Home*

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Cell*

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Work*

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If There is an Extension for you work phone please
specify it here*

Emergency Contact

How we can contact you at all times
How can we contact you at all times( A relative or
friend who can always locate you)*
Name*
Relationship*
Address*
City,State,Zip*
Phone Number*

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Your Employment Details

Please complete the following concerning your employment
Employer*
Length of Employment*
Job Title*
Street Address*
City,State,Zip*
Phone Number*

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Gross Salary Per month or Year(please Specify
After Amount)*
Describe your education(schools attended, dates
attended, degrees obtainer)*

Spouse's Information

Information About your Spouse
Spouse's Full Name*
Spouse's Date of Birth*
Spouse's Social Security Number*
Spouse's Driver's License Number*
Where is your Spouse currently living(address)*
City,State,Zip*
Phone Number

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Spouse's Employment Information

Please complete the following concerning your Spouse's employment
Employer*
Length of Employment*
Job Title*
Street Address*
City,State,Zip*
Phone Number*

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Gross Salary Per month or Year(please Specify
After Amount)*
Describe your Spouse's education(schools attended,
dates attended, degrees obtainer)*

Marriage

Please Give the Date And Place of Your Marriage
Date
City,State

Children

Please Provide the Information Below on All Children

Child 1

(If Applicable)
Name
Sex
 Male 
 Female 
Birth Place
Driver's License Number ( If Applicable)
State
Social Security Number

Child 2

(If Applicable)
Name
Sex
 Male 
 Female 
Name
Birth Place
State
Driver's License Number ( If Applicable)
Social Security Number

Child 3

(If Applicable)
Name
Sex
 Male 
 Female 
Birth Place
Driver's License Number ( If Applicable)
State
Social Security Number

Child 4

(If Applicable)
Name
Sex
 Male 
 Female 
Birth Place
Driver's License Number ( If Applicable)
State
Social Security Number

Child 5

(If Applicable)
Name
Sex
 Male 
 Female 
Birth Date
Driver's License Number ( If Applicable)
State
Social Security Number

Living Information

A description of the section goes here.
Are you now seperated from your spouse*
 Yes 
 No 
If so, Give the date of separation (MM,DD,YY)
Which spouse will live in the family home during
the divorce*
 Me 
 Spouse 
Who will pay for the house*
 Me 
 Spouse 
Have you or your spouse seen any marriage
counselors*
 Yes 
 No 

If So Please Provide information Below

A description of the section goes here.
Name

First
Last
Phone Number

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Address

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country

Religous Preference

A description of the section goes here.
What Is your Religous Preference*
Spouse's Religious Peference*
Children Religious Preference

Marital Difficulties

A description of the section goes here.
Maritial Difficulties*
 Drugs/Alchohol 
 Physical Violence 
 Sexual Dysfunction 
 Religion 
 Sexual Infedility 
 Financial disputes 
 Other 
If you Chose Other please Specify here

Custody

A description of the section goes here.
Will there be a dispute over custody of the
children*
 Yes 
 No 
If Not, Who will have primary custody*
 Me 
 Spouse 
Should there be a geographical restriction on
where the children will live*
 Yes 
 No 
If Yes Please specify
Where are the children living at this time
List Any property owned by the children(other than
furniture, clothing and toys)
How Long have you lived in New York
What county do you reside in and how long htere
Have you or your spouse ever filed for a divorce*
 Yes 
 No 
If So When and Where
Does your spouse now have an attorney
 Yes 
 No 
Spouse's Attorney's Name

First
Last
Phone Number

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Previous Divorces

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Have you been married before*
 Yes 
 No 
If so, how many times