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Divorce Intake Form
for Couples with Children

Contact Person: Contact Number:
 
Wife's Information:
Name:
 
Last:
 
First:
 
Middle:
 
Maiden:
Home Address:
 
Street:
 
City:
 
State:
 
Zip Code:
Telephone Numbers:
 
Home:
 
Work:
 
Cell:
Employer's Name:
 
Monthly Gross Salary:
 
Employer Address:
  Street:
  City:
  State:
  Zip Code:
Do you live inside the city limits?
 
Have you been an Alabama resident for the last 6 months?
 
Number of Previous Marriages:
 
How last marriage ended:
Highest Level of education you completed.
 
What is your race?
 
Email address:
 
 
Husband's Information
Name:
 
Last:
 
First:
 
Middle:
     
Home Address:
 
Street:
 
City:
 
State:
 
Zip Code:
Telephone Numbers:
 
Home:
 
Work:
 
Cell:
     
Employer's Name:
 
Monthly Gross Salary:
 
Employer Address:
 
Street:
 
City:
 
State:
 
Zip Code:
Do you live inside the city limits?
 
Have you been an Alabama resident for the last 6 months?
 
Number of Previous Marriages:
 
How last marriage ended:
 
Highest Level of education you completed.
 
What is your race?
 
Email address
 
 
General Information
Date of Marriage:
 
Date of Separation:
 
Place of Marriage:
  City:
  County:
  State:
 
Name of Person that is over 19 that can be a witness:
 
Amount of monthly alimony. If none enter n/a.
 
 
 
Children:
Name of First Child:
 
First
 
Middle
 
Last
 
DOB
Name of Second Child:
 
First
 
Middle
 
Last
 
DOB
Name of Third Child:
 
First
 
Middle
 
Last
 
DOB
Name of Fourth Child:
 
First
 
Middle
 
Last
 
DOB
Who gets custody of children:
 
 
What type of 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.