New Client Questionnaire

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Please fully complete this questionnaire. We will contact you with any questions we may have. If we may be able to assist/handle your case, you will be contacted within 2 business days via phone or email.
*IF YOU DO NOT FULLY COMPLETE THE QUESTIONNAIRE, WE WILL NOT RESPOND*
**Mr. Williams does not handle cases involving the Department of Children & Families or Adoptions**
***Please note that this Questionnaire is designed to determine if we can help. We will not provide legal advice (even if the email option is chosen), unless you schedule a paid Case Strategy Session, or retain our services. ***
****All child related questions should be answered if your child(ren) are under the age of 18.****
*****Please note that we will only accept cases in Pinellas County (however, if you are not a resident of Pinellas County, and your case is currently filed in Pinellas, or we have determined that Pinellas County is the appropriate venue, we would be open to possibly being retained in your case)*****

Thank you.

Email *

PREFIX *

MS.

MRS.

MR.

DR.

Other:

FIRST NAME *

MIDDLE NAME *

LAST NAME *

GENDER *

Female

Male

Prefer not to say

PHONE NUMBER *

MAILING ADDRESS *

CITY *

STATE *

ZIP CODE *

Consultation Request *

Zoom (fee applies)

Phone (fee applies)

Office (fee applies)

Email (free)

TYPE OF CASE *

DIVORCE

CHILD SUPPORT

CHILD CUSTODY

MODIFICATION OF FAMILY LAW CASE (PLEASE EXPLAIN IN DETAIL UNDER "BRIEF SUMMARY OF YOUR CASE" WHY YOU WANT TO CHANGE THE ORDER/FINAL JUDGMENT.)

Required

NEW OR EXISTING CASE? *

NEW CASE

EXISTING CASE

CASE NUMBER *IF APPLICABLE*

IF IT'S AN EXISTING CASE, DID YOU HAVE AN ATTORNEY PREVIOUSLY?

Yes

My Attorney withdrew from the case.

I fired my previous Attorney.

Clear selection

IF THIS IS A DIVORCE CASE, IS IT CONTESTED OR UNCONTESTED? *

CONTESTED

UNCONTESTED

UNSURE

NOT A DIVORCE CASE

*IF THIS IS A DIVORCE CASE, PLEASE LIST THE CITY & STATE THE WHERE YOU LAST RESIDED WITH YOUR SPOUSE.*

HAVE PAPERS BEEN SERVED? IF SO, WHEN? *

COUNTY OF CASE *

DATE OF BIRTH *

YYYY

DRIVER LICENSE NUMBER *

ISSUING STATE OF LICENSE *

WHEN WAS YOUR FL LICENSE ISSUED?*DIVORCE CASES ONLY*

SOCIAL SECURITY NUMBER *

PLACE OF EMPLOYMENT *

GROSS MONTHLY INCOME *

TOTAL HOUSEHOLD GROSS MONTHLY INCOME *

OPPOSING PARTY'S NAME *

OPPOSING PARTY'S ADDRESS (INCLUDE CITY & STATE) *

WIFE/SPOUSE'S MAIDEN NAME *IF IT'S A DIVORCE CASE & APPLICABLE*

DOES WIFE/SPOUSE WISH TO RESTORE THEIR MAIDEN NAME? DIVORCE CASES ONLY*

Yes

Maybe

Clear selection

OPPOSING PARTY'S GROSS MONTHLY INCOME

DATE OF MARRIAGE *IF APPLICABLE*

YYYY

CITY AND STATE OF MARRIAGE (DIVORCE CASES ONLY)*

DATE OF SEPARATION (DIVORCE CASES ONLY)*

YYYY

REASON FOR DISSOLVING THE MARRIAGE *DIVORCE CASES ONLY*

INFIDELITY

FINANCIAL ISSUES

MENTAL/PHYSICAL/PSYCHOLOGICAL ABUSE

INCOMPATIBILITY

OTHER

Other:

Clear selection

WILL SPOUSAL SUPPORT BE REQUESTED? (DIVORCE CASES ONLY)*

Yes (For Me)

Yes (For Spouse)

Maybe

Clear selection

PROPERTY INVOLVED *DIVORCE CASES ONLY* -PLEASE SPECIFY HUSBAND'S/WIFE'S

DEBT INVOLVED *DIVORCE CASES ONLY*

WERE THERE CHILDREN BORN OR ADOPTED DURING THIS RELATIONSHIP/MARRIAGE? *

YES

Other:

CHILDREN INVOLVED (NAME & DATE OF BIRTH) *

CITY/STATE OF BIRTH OF CHILDREN

*If children are involved* Is the Father's name on the child's birth certificate?

Yes

Clear selection

WITH WHOM DO THE CHILDREN RESIDE?

MOTHER/WIFE

FATHER/HUSBAND

GRANDPARENT

OTHER RELATIVE

OTHER

Other:

Clear selection

VISITATION SCHEDULE FOR CHILDREN

HOW WILL HOLIDAYS BE DIVIDED FOR CHILDREN?

WHICH PARTY WILL CLAIM THE CHILDREN ON TAXES?

LIST THE ADDRESSES AND DATES WHERE THE CHILD(REN) HAS/HAVE RESIDED FOR THE PAST 5 YEARS.

WHO WILL PROVIDE MEDICAL/DENTAL INSURANCE FOR THE CHILDREN?

WHICH PARTY WILL PAY CHILD SUPPORT? *IF APPLICABLE*

IS EITHER PARTY COURT ORDERED TO PAY OR RECEIVE CHILD SUPPORT? IF YES, HOW MUCH? *

IS EITHER PARTY CURRENTLY SERVING IN THE MILITARY? *

Yes

IF YES, WHERE ARE THEY STATIONED?

DO YOU JOINTLY OR SEPARATELY OWN ANY PROPERTY? IF YES, PLEASE LIST. (DIVORCE CASES ONLY) *

IF YES, WAS THIS PROPERTY OBTAINED BEFORE OR DURING THE MARRIAGE/RELATIONSHIP? (DIVORCE CASES ONLY)*

HAS THERE BEEN A HISTORY OF ABUSE WITH THE OPPOSING PARTY? *

Yes

BRIEF SUMMARY OF YOUR CASE *

WOULD YOU HAVE THE MEANS TO PAY THE INITIAL RETAINER, IF YOU DECIDED TO MOVE FORWARD WITH REPRESENTATION? (FOR MOST OF OUR FAMILY LAW CASES, WE REQUEST $1,500-$3,500 DOWN TO BEGIN). *

Yes

I would need a payment plan (legal financing available through Affirm)

Family/Friends would assist in paying my legal bill

IF YOU ARE SEEKING A CASE STRATEGY SESSION, WILL THERE BE ANYONE THAT YOU WOULD LIKE TO BE PRESENT WITH YOU DURING SAID SESSION? IF YES, PLEASE PROVIDE HIS/HER FULL NAME, ADDRESS, AND PHONE NUMBER. *

IF YOU ARE IN A TIME ZONE OTHER THAN EASTERN TIME ZONE, PLEASE SPECIFY.

Referred to our office by (AVVO, Google, Facebook, Friend, etc.): *

A copy of your responses will be emailed to the address you provided.

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