Client Information Form

In order to get started, I need to collect some basic information about you.

Please fill the form below and type in your answers. Then submit the form.

Questions

1. Your Information

Full legal name (MUST include middle name if you have one) *

Gender *

Male

Female

Address *

Address

City

State/Province

Zip/Postal

County of residence *

Driver license number (if known)

Phone *

Date of birth *

Social security number *

Email Address

Leave blank if you don't have an email address

Highest education level attained

For statistical purposes, I am required to report your race *

2. Your Spouse's Information

Full legal name (including middle name) *

Gender *

Male

Female

Address *

Address

City

State/Province

Zip/Postal

County of residence *

Phone *

Driver license number (if known)

Date of birth *

Social security number *

If you don't know, please enter 999-99-9999 for now, but I will need this before I can file the divorce.

Email address

Leave blank if they don't have an email address

Highest education level attained

For statistical purposes, I am required to report your spouse's race *

3. Additional Information

What was the wife's maiden name? *

Does she want her maiden name restored? *

Yes

What date were you married? *

What city were you married in? *

What county were you married in? *

What state were you married in? *

Including this one, how many marriages have you been in?

How many times, including this marriage, have you been married?

How and when did the marriage before this one end?

Including this one, how many marriages has your spouse been in?

How many times, including this marriage, has your spouse been married?

How and when did the marriage before this one end?

4. Children

Have any minor children (under the age of 18) been born from this relationship? (Or, has either party adopted the minor children of the other spouse?) *

Yes

If yes, please provide the full name, date of birth, and social security number of any minor children you have with your spouse. If the child was adopted, please indicate this. *

Please provide a history of the last 5 years showing where the children lived, and which parent/guardian lived with them. For each address, please list the month/year the children lived there (beginning and ending date), and list the guardians who lived with them at that time. *

Who will have primary residential custody of the child(ren) referenced above? (Even if you have joint custody, usually the children will live with one parent slightly more than with the other. If you are going to split the time 50/50 please indicate this). *

Has there been any proceeding—whether in Kansas or elsewhere—regarding the custody of the children? *

Yes

Has either party been ordered to pay child support? *

Yes

Is the order still in force? *

Yes

Please list the case number and county where the order was entered. If it was entered outside of Kansas, please list the state where it was entered. *

Please tell me what kind of parenting plan you want. If you do not have a specific arrangement, the default parenting plan is for the non-custodial parent to have visitation every other weekend and half of holidays. *

5. Property and Debt

Do either you or your spouse own any real property (land and/or a house)? *

Yes

If yes, what is the address of the property? Please include city, state, and zip. *

If yes, what are you going to do with it? *

Please tell me how you have decided to divide any property you may have. Some people are very specific and list every item each spouse will have, while others just say something like, “Husband gets the 1995 Chevy truck, Wife gets the 2002 Nissan, each party keeps his/her personal property, Wife gets the furniture, Husband gets the boat.” Your property division agreement can be as detailed or as general as you wish. *

If you listed vehicles above, please provide year, make, model and last 4 digits of VIN. If you do not currently have this information, please write "Unavailable at this time" and we can proceed for now, but you will need to obtain that information before I can finish the paperwork.

Do you and/or your spouse have any debt, either together or individually? If so, list the creditor, the last 4 digits of the account number, the amount of debt, and which party will be responsible for how much of the debt. *

EXAMPLE: Creditor: Discover Card Account: 8397 Amount: $5,000 Responsible party: Husband ($2,500), Wife ($2,500).

Will either spouse be paying alimony to the other? If so, who will be paying? (Most people prefer to agree to no alimony being paid to either spouse, but I need to know what your arrangement is). *

Do either one of you have a 401(k), IRA, or any other kind of retirement or pension account? *

Yes

If yes, do you want to access and divide it up? *

Yes

7. Miscellaneous

Bankruptcy

Does either party currently have a bankruptcy proceeding pending? *

Yes

If yes, what is the bankruptcy case number? Please provide the contact information for your bankruptcy attorney. If you do not have one please state that.

Pregnancy

Is the wife currently pregnant? *

Yes

Has the wife had any children DURING THE MARRIAGE with anyone besides the husband? *

Yes

If yes, please provide more information

Kansas Taxes

Do you owe any taxes to the State of Kansas?

Yes

If yes, please explain: *

Previous Legal Action?

Have you or your spouse been to court for any reason related to your marriage? *

Yes

If yes, please explain *

Are either of you currently represented by a lawyer? *

Yes

If yes, who's represented by a lawyer? *

My Spouse

Legal Competence

Do you have any reason to believe that your spouse may not understand the divorce papers, such as dementia, mental illness, or any other reason?

Yes

Please provide more information

Language Spoken

Does your spouse speak any language besides English?

Yes

Is English your spouse’s primary language? If not, please explain.

Payment Information

Are you ready to pay now?

Yes

Payment Amount

Credit Card

Billing Address

City

State/Province

Zip/Postal

1. Your Information

2. Your Spouse's Information

3. Additional Information

4. Children

5. Property and Debt

6. Military Service

7. Miscellaneous

Bankruptcy

Pregnancy

Kansas Taxes

Previous Legal Action?

Legal Competence

Language Spoken

Payment Information

About Randy

Navigation

Get In Touch