1. LegalLife™ Checkup
Part 3. – Previous Marriages
Name of former spouse: Were you divorced? Yes No Date:
→ For Divorce forms see Part 18.
Was termination of marriage due to death of spouse? Yes No Date of Death:
Any children from this marriage? Yes No
Names and Date of Birth:
If children, who has custody of the minor children? You Spouse Joint No Minors
Do you pay child support to this former spouse? Yes No Monthly amount:
Are child support payments current? Yes No n/a
Do you make any other payments to this former spouse, such as alimony or property settlement?
Yes No If yes, please explain:
Do you still own any real property together with this former spouse? Yes No
If yes, please explain:
Are there any insurance policies, retirement accounts, IRA’s, stocks, automobiles, joint bank accounts,
brokerage accounts, or other personal property you own with your former spouse or that your former
spouse is still a beneficiary of? Yes No
If yes, please provide details:
If there was a divorce, have all provisions of the Divorce Decree or Settlement Agreement with this former
spouse been fulfilled (are there any provisions that have not been complied with)? Yes no
If no, please explain:
Is there anything else you need to disclose about this marriage? Yes No
If yes, please do so.
Note: If there was more than one former marriage, please let us know and we will send a supplemental
form for you to complete.