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Uncontested Divorce intake Form
Intake Form
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Your First Name
Your answer
Your Middle Name
Your answer
Your Last Name
Your answer
Today's date
MM
/
DD
/
YYYY
How did you hear about this law Firm
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Your complete address
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If not listed above, your city + zip code
Your answer
Your phone number
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County you reside in
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Your email address
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Your date of birth
Your answer
Number of marriages
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How long a Georgia resident
Your answer
Date of this Marriage
Your answer
Date of Separation
Your answer
Spouse's Full Name, Middle Name, Last Name
Your answer
Spouses Full Address
Your answer
If not listed above, spouse's city + zip code
Your answer
How long has spouse lived in Georgia
Your answer
Spouse's Date of Birth
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County Spouse resides in
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Spouse's number of marriages
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Wife's maiden name
Your answer
Does Wife want maiden or former name restored
Yes
No
Clear selection
If so, what will be Wife's full name
Your answer
Are there any minor children of this marriage
yes
No
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If so, please list all minor children giving full names and birth year
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Is there an agreement as to custody and visitation
Yes
No
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If so, explain the custody and visitation agreement
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Do the minor children have health insurance?
Yes
No
N/A
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If the minor children have health insurance, who provides
Your answer
Are there any vehicles in either party's Name
Yes
No
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Vehicles Husband is retaining
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Vehicles Wife is retaining
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Is there any real estate owned by either party
Yes
No
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If so, list all real estate and the party retaining said property
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Are there any retirement, pensions, 401(k)s or other investments owned by the parties
Yes
No
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If so, list all plans and how they are to be dived
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Are there any individual debts owned by either party
Yes
No
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Are there any joint debts
Yes
No
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If so, list specifically how debt is to be divided
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Is there any other personal property owned by the parties that needs to be divided? If so, how divided
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Is this a MetLife Legal Insurance Covered case
Yes
No
N/A
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If so please list your case Number + Member Number
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Are there any other provisions in agreement or questions for the attorney
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