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Divorce Intake Form

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Divorce Intake Form 

Contact Person:
Wife's Information:
Last Name:	First Name:	Middle Name:
Maiden Name:	Home Address:	Home Phone Number:
Number of Previous Marriages:	How last marriage ended:   N/A Death Divorce Dissolution Annulment	Employer's Name
Employer's Address	Employer's Phone Number	Monthly Salary
Telephone Number for Messages	Do you live inside the city limits?   Yes No	Have you been an Alabama resident for the last 6 months?   Yes No
Highest Level of education you completed.	What is your race?   American Indian White Africian American Hispanic	Email address
Husband's Information
First Name:	Middle Name:	Home Address:
Home Phone Number:	Number of Previous Marriages:	How last marriage ended:   N/A Divorce Death Annulment
Employer's Name	Employer's Address	Employer's Phone Number
Monthly Salary	Telephone Number for Messages	Do you live inside the city limits?   Yes No
Have you been an Alabama resident for the last 6 months?   Yes No	Highest Level of education you completed.	What is your race?   African American White Hispanic American Indian
Email address
General Information
Date of Marriage:	Place of Marriage (City, County and State)	Date of Separation:
Name of Person that is over 19 that can be a witness:	Amount of monthly alimony. If none enter n/a.
Children:
Full name and date of birth:	Full name and date of birth:	Full name and date of birth:
Full name and date of birth:
Who gets custody of children:   Husband Wife
What type of custody?   Husband has sole custody Wife has sole custody Husband and Wife have joint custody with Wife having primary physical custody Husband and Wife have joint custody with the Husband having primary custody
Assets and Debts
Make and Model of Wife's vehicle:	Make and Model of Husband's vehicle:
List any other assets to be divided between the parties.
List any debts to be divided between the parties.
List any other information:
You agree that submitting the above information does not create an attorney client relationship.

 

The Alabama Rules of Professional Conduct Rule 7.2 requires the following language: “No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.”

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