Family Law Questionnaire - Law Offices of Thomas P. Miller, P.C.
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Today's Date
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DD
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YYYY
How did you find us? Please provide name of person who referred you or website.
Your answer
Which of the following do you authorize us to send you the following by e-mail
I. Your Information
Full name
Your answer
E-mail
Your answer
Alternate telephone number
Your answer
Home address
Your answer
Date of birth
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YYYY
Employer name
Your answer
Employment position
Your answer
Gross annual income
Your answer
Date of marriage/civil union
MM
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DD
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YYYY
Place of marriage
Your answer
Still living with your spouse/partner?
If no longer living together, date of seperation
MM
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DD
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YYYY
II. Your Spouse/Partner/Ex's Information
Full name
Your answer
E-mail
Your answer
Telephone number
Your answer
Home address
Your answer
Date of birth
MM
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DD
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YYYY
Employer name
Your answer
Employment position
Your answer
Gross annual income
Your answer
III. Children
Name
Your answer
Date of birth
MM
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DD
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YYYY
Above child living with you?
Name
Your answer
Date of birth
MM
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DD
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YYYY
Above child living with you?
Name
Your answer
Date of birth
MM
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DD
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YYYY
Above child living with you?
Name
Your answer
Date of birth
MM
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DD
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YYYY
Above child living with you?
IV. Representation
Your attorney's name
Your answer
Your attorney's telephone number
Your answer
Your attorney's e-mail address
Your answer
Your child's attorney's name
Your answer
Your child's attorney's telephone number
Your answer
Your child's attorney's e-mail
Your answer
V. Miscellaneous
Is there a domestic violence issue
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