Uncontested Divorce intake Form
Intake Form
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Your First Name
Your Middle Name
Your Last Name
Today's date
How did you hear about this law Firm
Your complete address
If not listed above, your city + zip code
Your phone number
County you reside in
Your email address
Your date of birth
Number of marriages
How long a Georgia resident
Date of this Marriage
Date of Separation
Spouse's Full Name, Middle Name, Last Name
Spouses Full Address
If not listed above, spouse's city + zip code
How long has spouse lived in Georgia
Spouse's Date of Birth
County Spouse resides in
Spouse's number of marriages
Wife's maiden name
Does Wife want maiden or former name restored
Clear selection
If so, what will be Wife's full name
Are there any minor children of this marriage
Clear selection
If so, please list all minor children giving full names and birth year
Is there an agreement as to custody and visitation
Clear selection
If so, explain the custody and visitation agreement
Do the minor children have health insurance?
Clear selection
If the minor children have health insurance, who provides
Are there any vehicles in either party's Name
Clear selection
Vehicles Husband is retaining
Vehicles Wife is retaining
Is there any real estate owned by either party
Clear selection
If so, list all real estate and the party retaining said property
Are there any retirement, pensions, 401(k)s or other investments owned by the parties
Clear selection
If so, list all plans and how they are to be dived
Are there any individual debts owned by either party
Clear selection
Are there any joint debts
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If so, list specifically how debt is to be divided
Is there any other personal property owned by the parties that needs to be divided? If so, how divided
Is this a MetLife Legal Insurance Covered case
Clear selection
If so please list your case Number + Member Number
Are there any other provisions in agreement or questions for the attorney
Clear form
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