Divorce Intake Form - No Children

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PLEASE READ CAREFULLY BEFORE ANSWERING THE QUESTIONS. This questionnaire is for the use of our office in preparing your divorce case. The answers you provide are for our use only and will be held strictly CONFIDENTIAL.

Email *

Your Full Name: *

Your Complete Address: *

Your Date of Birth *

YYYY

Your Social Security Number: *

Your Cellular Telephone Number: *

Your Work Phone Number (if different):

Your E-mail Address: *

Are you in the military? *

Yes

Is your spouse in the military? *

Yes

Your Emergency Contact: *

How did you hear about us?

Your Spouse's Full Name: *

Your Spouse's Complete Address: *

Have You Lived in Utah for the last 3 months? *

Yes

What City, State, County have you lived in for the last 6 months? *

Date of Your Marriage *

YYYY

Place of Your Marriage (Include: City, County, State) *

Date of Separation: *

YYYY

Are You Requesting a Divorce Based on Irreconcilable Differences? *

Yes

Will Any Aspect Of This Divorce Be Contested By Your Spouse? *

Yes

I don't know

Are you or your spouse expecting the birth of a child? *

Yes

If yes to the question above, is your spouse the parent of the expected child? *

Yes

I don't know

Have you and your spouse already divided all of your personal property and are you okay with the division? *

Yes

If no to the question above, please specify the personal property and include how you want it divided. (Include bank accounts, investments, life insurance, business interests, vehicles, furniture, etc. Do not include retirement benefits here.)

Did you acquire a home during the marriage? *

Yes

If yes, please list the address of all real estate you own, the current property value, the mortgage balance and mortgage payment.

What do you want to see happen with the real estate?

Have you or your spouse earned a pension or other retirement during the marriage?
*

Yes

If yes to the question above, Please note that a Qualified Domestic Relations Order (QDRO) is required to divide retirement benefits. If you want our office to prepare a QDRO to divide a retirement benefit, there are additional charges for the QDRO. Please let us know if you would like us to handle this.

Yes

Clear selection

Are there any outstanding debts incurred during the marriage?

Yes

If yes to the question above, how will the debts be resolved?

I will pay all of the debts incurred during the marriage up to the date of separation

My spouse will pay all of the debts incurred during the marriage up to the date of separation

We both we continue to be responsible to pay all debts incurred during the marriage

My spouse’s payment of debt should be considered as alimony or additional child support

We will pay the debts according the a schedule

Other:

Clear selection

Please list each debt, what the debt is for, what the balance is for the debt, who's debt it is, if you will pay it, your spouse will pay it, or if you will each pay a percentage. Please list the percentage.

How will tax returns be filed?

The parties will file jointly for the year.

The parties will file separately for the year.

Other:

Clear selection

Do you want to request attorney's fees in this divorce? (keep in mind we can ask for them but that does not mean a judge will award them to you). *

Yes

Maybe

If applicable, do you want to be restored to your maiden name?

Yes

Clear selection

If yes to the above, please list your name as you would like it to be on your photo ID going forward:

Please tell us anything else you believe we should know or you believe would be helpful to us in preparing your divorce:

If you have completed this form, please type your name below which will constitute your digital signature to prepare the petition for divorce. *

Submit

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