Divorce Questionnaire
Today's Date
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Your Full Name *
Phone number (where we can contact you) *
Address *
Secure email address *
Birthdate *
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Date of Marriage *
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City and State of Marriage *
Driver's License Number and Issuing State
Which month and year did you first begin living in Clark County, Nevada?
Information about your spouse
Spouse's Full Name *
Birthdate *
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Phone Number *
Address *
Spouse's Attorney (if any)
Information about children
Do you have minor children (under 18 years of age) with your spouse? *
Full Name of Child 1
Birthdate of Child 1
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Full Name of Child 2
Birthdate of Child 2
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Full Name of Child 3
Birthdate of Child 3
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If there are additional children of the marriage, put their names and birthdates here.
Do you and your spouse agree on where the children should be for each day of the week? *
Visitation Schedule (as desired)
Children should be with Mom or Dad on these days and times:
Assets and Debts
Assets *
List all bank accounts, retirement accounts, properties, vehicles, and any other property, along with their approximate values.
Debts *
List all loans, leases, credit card bills, outstanding balances, etc. with approximate amounts owed.
Have you come to an agreement with your spouse on how to divide assets and debts? *
What are your biggest issues or concerns regarding custody of the children?
Employer Information
Your Employer's Name/Company
Employer's Address
Your Job Title *
Gross Monthly Income *
This amount should be higher than your take-home pay.
How many years have you worked at this job?
What is your work schedule and how many hours do you work per week?
Spouse's Employer and Job Title *
Spouse's work schedule and # of hours worked per week:
Spouse's Gross Monthly Income *
Other Information
Has your spouse been physically abusive to you or to your children?
Clear selection
Have you or your spouse been arrested? *
Is there a Temporary Protective Order (TPO) in place?
Clear selection
What are the biggest issues or concerns that you have regarding the divorce?
Please explain in detail and use this space to provide additional pertinent information.
Other Information
Has anyone previously filed any legal papers regarding this divorce?
Clear selection
Have you consulted with another attorney?
Clear selection
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