CLIENT INTERVIEW SHEET
Date: ___________________
Lawyer: ___________________ Referred by:
_____________
Hourly Rates: ___________________
Retainer: ___________________
Legal Assistant: ___________________ Client Information
Client’s Full Name:
____________________________________________
Present Address:
____________________________________________
____________________________________________
Mailing Address:
____________________________________________
(If different from above)
___________________________________________
E-mail Address:
___________________________________________
Home Phone: _______________ Work Phone:
______________
Fax: _____________ Cell (or other
contact):___________
Date of Birth: ____________________ Present Age:
__________
Place of Birth:
___________________________________________
Surname at Birth:
_________________________________________________
Surname Before this Marriage:
_________________________________
Marital Status at the Time of Marriage: Single__ Widowed__
Divorced__
Occupation:
_____________________________________________
Employer’s Name and Address:
_________________________________
_____________________________________________________
________________
How Long at that Employer?
_______________________________________
Gross Annual Income: $___________
Frequency of Payment: Bi-Weekly ____ Bi-Monthly: ___
Monthly: ___
Total Income on Last Tax Return: $______________
Net Taxable Income on Last Tax Return: $___________
Occupation at Marriage:
_______________________________________
Do You Have a Valid Will:
_______________________________________
If So, Who Are the Beneficiaries:
_________________________________
Who Is the Executor/Executrix:
_________________________________
Do You Want to Change Your Will:
_____________________________
If your matter is against an ex-spouse and you have a new
spouse, do mention your current spouse’s name and date of
birth:
Name:
_____________________________________________________
_____________
Date of Birth:
_____________________________________________________
_______
Information about Your Spouse (Opposing Party)
Spouse’s Full Name:
____________________________________________
Spouse’s Present Address:
______________________________________
_____________________________________________________
_______________
Spouse’s Home Phone: _____________ Work Phone:
______________
Spouse’s Date of Birth: _____________________Present Age:
______
Place of Birth:
________________________________________________
_
Surname at Birth:
________________________________________________
Surname Before This Marriage:
________________________________
Marital Status at Time of Marriage: Single: ___Widowed:
___Divorced: ___
Occupation:
________________________________________________
__
Employer’s Name and Address:
________________________________
_____________________________________________________
_______________
How Long at That Employer? _____________________
Gross Annual Income: $______________
Frequency of Payment: Bi-Weekly: __ Bi-Monthly: __
Monthly: __
Total Income on Last Tax Return:
$___________________________
Net Taxable Income on Last Tax Return:
$____________________
Spouse’s Occupation at Marriage:
_____________________________
Do You Know That Marriage Counseling, Guidance Facilities,
and Mediation Services are Available to You? Yes: ___ No:
___
Children
Full Name: Birth Date and Current AGE:
Gender:
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Do Any of Your Children Have Special Needs: Yes: ___
No: ___
If Yes, Explain:
_____________________________________________________
___________________
_____________________________________________________
___________________
Proposal for Parenting Arrangements for Children
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Proposal for Child Support:
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Other Expenses for Children:
Child Care Expenses:
_______________________________________________Medica
l/Dental Insurance Premiums:
______________________________
Health-Related Expenses that Exceed Insurance:
________________Extraordinary Expenses for Education:
__________________________Post-Secondary Education:
________________________________________
Extraordinary Expenses for Extracurricular Activities (List by
Individual Activity):
_____________________________________
$_____________________________
_____________________________________
$_____________________________
_____________________________________
$_____________________________
Life InsuranceDo You Have Life Insurance?
________________________________________Death Benefit
Payable ________________________________________Is
There a Cash Surrender Value:
_____________________________Does Your Spouse Have Life
Insurance? _____________________________Death Benefit
Payable ________________________________________Is
There a Cash Surrender Value:
_____________________________
Matrimonial Home
Address:
In Whose Name:
(1) MKT Value
(2) 1st Mortgage
(3) 2nd Mortgage
Equity
(Balance Owing)
(Balance Owing)
1-(2+3)
$
$
$
$
Other Real Estate
Address:
In Whose Name:
(1) MKT Value
(2) 1st Mortgage
(3) 2nd Mortgage
Equity
(Balance)
(Balance)
1-(2+3)
$
$
$
$
Address:
In Whose Name:
(1) MKT Value
(2) 1st Mortgage
(3) 2nd Mortgage
Equity
(Balance)
(Balance)
1-(2+3)
$
$
$
$
Vehicles: (include Motor homes, Motorcycles, Snowmobiles,
etc.)
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Registered Retirement Savings Plans:
Current value:
$
In whose name?
Where held?
Current value:
$
In whose name?
Where held?
Current value:
$
In whose name?
Where held?
Current value:
$
In whose name?
Where held?
Who Is the Beneficiary of RSPs:
__________________________________________
Bank Accounts:
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
Other Investments/Savings/Term Deposits:
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
Your Employment Pensions:
Employer:
_____________________________________________________
_______How Long Have You Been Contributing:
___________________________
Your Spouse’s Employment Pensions:
Employer:
_____________________________________________________
______How Long Have They Been Contributing:
__________________________
Business/Corporate Interest:
Company or Business Name:
Who are Shareholders/Owners and Percentage Owned:
Who are Officers/Directors?
Other Assets:
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Debts:
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
What Assets and Liabilities Did You Have When You Got
Married (And/Or Started Living Together) and What Were They
Worth at that Time:
_____________________________________________________
________
What Assets and Liabilities did Your Spouse have When You
Got Married (And/Or Started Living Together) and What Were
They Worth at that Time:
_____________________________________________________
________
Did Either You or Your Spouse Receive Any Gifts or
Inheritances from Another Person or Receive a Trust, Award, or
Insurance Settlement since You Started Living Together.
If so, Describe it, its Value, When Was it Received, and Advise
What Was Done With the Gift/Inheritance /Other Payment:
Do You Have Any Reason to Claim an Unequal Division of
Property Acquired During Your Marriage?
_____________________________________________________
___________________
_____________________________________________________
___________________
Has Any Property Been Sold or Transferred to Anyone in the
Last Year?
_____________________________________________________
___________________
_____________________________________________________
___________________
If You Were to Look at a Year from Today, What Has to
Happen in Your Personal and Business Life for You to Be
Satisfied with Your Progress?
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Page 1 of 14
Family Law: Client Interview Sheet
© 2012 South University
week 6
Discussion 2
Answer the following questions
1. What are the differences between Social Media, E-mail
and Instant Messaging?
2. List some of the Social Media Risks
3. Provide three best practices for managing Social Media
Records.
300 words APA format with intext citations and references
CLIENT INTERVIEW SHEET
Date: ___________________
Lawyer: ___________________ Referred by:
_____________
Hourly Rates: ___________________
Retainer: ___________________
Legal Assistant: ___________________ Client Information
Client’s Full Name:
____________________________________________
Present Address:
____________________________________________
____________________________________________
Mailing Address:
____________________________________________
(If different from above)
___________________________________________
E-mail Address:
___________________________________________
Home Phone: _______________ Work Phone:
______________
Fax: _____________ Cell (or other
contact):___________
Date of Birth: ____________________ Present Age:
__________
Place of Birth:
___________________________________________
Surname at Birth:
_________________________________________________
Surname Before this Marriage:
_________________________________
Marital Status at the Time of Marriage: Single__ Widowed__
Divorced__
Occupation:
_____________________________________________
Employer’s Name and Address:
_________________________________
_____________________________________________________
________________
How Long at that Employer?
_______________________________________
Gross Annual Income: $___________
Frequency of Payment: Bi-Weekly ____ Bi-Monthly: ___
Monthly: ___
Total Income on Last Tax Return: $______________
Net Taxable Income on Last Tax Return: $___________
Occupation at Marriage:
_______________________________________
Do You Have a Valid Will:
_______________________________________
If So, Who Are the Beneficiaries:
_________________________________
Who Is the Executor/Executrix:
_________________________________
Do You Want to Change Your Will:
_____________________________
If your matter is against an ex-spouse and you have a new
spouse, do mention your current spouse’s name and date of
birth:
Name:
_____________________________________________________
_____________
Date of Birth:
_____________________________________________________
_______
Information about Your Spouse (Opposing Party)
Spouse’s Full Name:
____________________________________________
Spouse’s Present Address:
______________________________________
_____________________________________________________
_______________
Spouse’s Home Phone: _____________ Work Phone:
______________
Spouse’s Date of Birth: _____________________Present Age:
______
Place of Birth:
________________________________________________
_
Surname at Birth:
________________________________________________
Surname Before This Marriage:
________________________________
Marital Status at Time of Marriage: Single: ___Widowed:
___Divorced: ___
Occupation:
________________________________________________
__
Employer’s Name and Address:
________________________________
_____________________________________________________
_______________
How Long at That Employer? _____________________
Gross Annual Income: $______________
Frequency of Payment: Bi-Weekly: __ Bi-Monthly: __
Monthly: __
Total Income on Last Tax Return:
$___________________________
Net Taxable Income on Last Tax Return:
$____________________
Spouse’s Occupation at Marriage:
_____________________________
Do You Know That Marriage Counseling, Guidance Facilities,
and Mediation Services are Available to You? Yes: ___ No:
___
Children
Full Name: Birth Date and Current AGE:
Gender:
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Do Any of Your Children Have Special Needs: Yes: ___
No: ___
If Yes, Explain:
_____________________________________________________
___________________
_____________________________________________________
___________________
Proposal for Parenting Arrangements for Children
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Proposal for Child Support:
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Other Expenses for Children:
Child Care Expenses:
_______________________________________________Medica
l/Dental Insurance Premiums:
______________________________
Health-Related Expenses that Exceed Insurance:
________________Extraordinary Expenses for Education:
__________________________Post-Secondary Education:
________________________________________
Extraordinary Expenses for Extracurricular Activities (List by
Individual Activity):
_____________________________________
$_____________________________
_____________________________________
$_____________________________
_____________________________________
$_____________________________
Life InsuranceDo You Have Life Insurance?
________________________________________Death Benefit
Payable ________________________________________Is
There a Cash Surrender Value:
_____________________________Does Your Spouse Have Life
Insurance? _____________________________Death Benefit
Payable ________________________________________Is
There a Cash Surrender Value:
_____________________________
Matrimonial Home
Address:
In Whose Name:
(1) MKT Value
(2) 1st Mortgage
(3) 2nd Mortgage
Equity
(Balance Owing)
(Balance Owing)
1-(2+3)
$
$
$
$
Other Real Estate
Address:
In Whose Name:
(1) MKT Value
(2) 1st Mortgage
(3) 2nd Mortgage
Equity
(Balance)
(Balance)
1-(2+3)
$
$
$
$
Address:
In Whose Name:
(1) MKT Value
(2) 1st Mortgage
(3) 2nd Mortgage
Equity
(Balance)
(Balance)
1-(2+3)
$
$
$
$
Vehicles: (include Motor homes, Motorcycles, Snowmobiles,
etc.)
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Year:
Make/Model:
Value: $
Debts: $
Who drives it?
Registered in whose name?
Registered Retirement Savings Plans:
Current value:
$
In whose name?
Where held?
Current value:
$
In whose name?
Where held?
Current value:
$
In whose name?
Where held?
Current value:
$
In whose name?
Where held?
Who Is the Beneficiary of RSPs:
__________________________________________
Bank Accounts:
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
Other Investments/Savings/Term Deposits:
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
In whose name?
Value:
$
Where held?
Your Employment Pensions:
Employer:
_____________________________________________________
_______How Long Have You Been Contributing:
___________________________
Your Spouse’s Employment Pensions:
Employer:
_____________________________________________________
______How Long Have They Been Contributing:
__________________________
Business/Corporate Interest:
Company or Business Name:
Who are Shareholders/Owners and Percentage Owned:
Who are Officers/Directors?
Other Assets:
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Description:
Owned By:
Value:
$
Debts:
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
Creditor:
Balance Owing:
$
Security:
Monthly Payment:
$
What Assets and Liabilities Did You Have When You Got
Married (And/Or Started Living Together) and What Were They
Worth at that Time:
_____________________________________________________
________
What Assets and Liabilities did Your Spouse have When You
Got Married (And/Or Started Living Together) and What Were
They Worth at that Time:
_____________________________________________________
________
Did Either You or Your Spouse Receive Any Gifts or
Inheritances from Another Person or Receive a Trust, Award, or
Insurance Settlement since You Started Living Together.
If so, Describe it, its Value, When Was it Received, and Advise
What Was Done With the Gift/Inheritance /Other Payment:
Do You Have Any Reason to Claim an Unequal Division of
Property Acquired During Your Marriage?
_____________________________________________________
___________________
_____________________________________________________
___________________
Has Any Property Been Sold or Transferred to Anyone in the
Last Year?
_____________________________________________________
___________________
_____________________________________________________
___________________
If You Were to Look at a Year from Today, What Has to
Happen in Your Personal and Business Life for You to Be
Satisfied with Your Progress?
_____________________________________________________
___________________
_____________________________________________________
___________________
_____________________________________________________
___________________
Page 1 of 14
Family Law: Client Interview Sheet
© 2012 South University

CLIENT INTERVIEW SHEETDate ______________.docx

  • 1.
    CLIENT INTERVIEW SHEET Date:___________________ Lawyer: ___________________ Referred by: _____________ Hourly Rates: ___________________ Retainer: ___________________ Legal Assistant: ___________________ Client Information Client’s Full Name: ____________________________________________ Present Address: ____________________________________________ ____________________________________________ Mailing Address: ____________________________________________ (If different from above) ___________________________________________ E-mail Address: ___________________________________________ Home Phone: _______________ Work Phone: ______________ Fax: _____________ Cell (or other contact):___________ Date of Birth: ____________________ Present Age: __________ Place of Birth:
  • 2.
    ___________________________________________ Surname at Birth: _________________________________________________ SurnameBefore this Marriage: _________________________________ Marital Status at the Time of Marriage: Single__ Widowed__ Divorced__ Occupation: _____________________________________________ Employer’s Name and Address: _________________________________ _____________________________________________________ ________________ How Long at that Employer? _______________________________________ Gross Annual Income: $___________ Frequency of Payment: Bi-Weekly ____ Bi-Monthly: ___ Monthly: ___ Total Income on Last Tax Return: $______________ Net Taxable Income on Last Tax Return: $___________ Occupation at Marriage: _______________________________________ Do You Have a Valid Will: _______________________________________ If So, Who Are the Beneficiaries: _________________________________ Who Is the Executor/Executrix: _________________________________ Do You Want to Change Your Will: _____________________________ If your matter is against an ex-spouse and you have a new spouse, do mention your current spouse’s name and date of birth: Name: _____________________________________________________ _____________
  • 3.
    Date of Birth: _____________________________________________________ _______ Informationabout Your Spouse (Opposing Party) Spouse’s Full Name: ____________________________________________ Spouse’s Present Address: ______________________________________ _____________________________________________________ _______________ Spouse’s Home Phone: _____________ Work Phone: ______________ Spouse’s Date of Birth: _____________________Present Age: ______ Place of Birth: ________________________________________________ _ Surname at Birth: ________________________________________________ Surname Before This Marriage: ________________________________ Marital Status at Time of Marriage: Single: ___Widowed: ___Divorced: ___ Occupation: ________________________________________________ __ Employer’s Name and Address: ________________________________ _____________________________________________________ _______________ How Long at That Employer? _____________________ Gross Annual Income: $______________ Frequency of Payment: Bi-Weekly: __ Bi-Monthly: __ Monthly: __ Total Income on Last Tax Return: $___________________________
  • 4.
    Net Taxable Incomeon Last Tax Return: $____________________ Spouse’s Occupation at Marriage: _____________________________ Do You Know That Marriage Counseling, Guidance Facilities, and Mediation Services are Available to You? Yes: ___ No: ___ Children Full Name: Birth Date and Current AGE: Gender: _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ Do Any of Your Children Have Special Needs: Yes: ___ No: ___ If Yes, Explain: _____________________________________________________ ___________________ _____________________________________________________ ___________________ Proposal for Parenting Arrangements for Children _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________
  • 5.
    ___________________ _____________________________________________________ ___________________ Proposal for ChildSupport: _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ Other Expenses for Children: Child Care Expenses: _______________________________________________Medica l/Dental Insurance Premiums: ______________________________ Health-Related Expenses that Exceed Insurance: ________________Extraordinary Expenses for Education: __________________________Post-Secondary Education: ________________________________________ Extraordinary Expenses for Extracurricular Activities (List by Individual Activity): _____________________________________ $_____________________________ _____________________________________ $_____________________________ _____________________________________ $_____________________________ Life InsuranceDo You Have Life Insurance? ________________________________________Death Benefit Payable ________________________________________Is There a Cash Surrender Value: _____________________________Does Your Spouse Have Life Insurance? _____________________________Death Benefit Payable ________________________________________Is There a Cash Surrender Value: _____________________________
  • 6.
    Matrimonial Home Address: In WhoseName: (1) MKT Value (2) 1st Mortgage (3) 2nd Mortgage Equity (Balance Owing) (Balance Owing) 1-(2+3) $ $ $ $ Other Real Estate Address: In Whose Name: (1) MKT Value (2) 1st Mortgage (3) 2nd Mortgage Equity (Balance) (Balance) 1-(2+3) $ $ $ $ Address: In Whose Name:
  • 7.
    (1) MKT Value (2)1st Mortgage (3) 2nd Mortgage Equity (Balance) (Balance) 1-(2+3) $ $ $ $ Vehicles: (include Motor homes, Motorcycles, Snowmobiles, etc.) Year: Make/Model: Value: $ Debts: $ Who drives it? Registered in whose name? Year: Make/Model: Value: $ Debts: $ Who drives it? Registered in whose name? Year: Make/Model: Value: $ Debts: $ Who drives it? Registered in whose name? Year: Make/Model: Value: $
  • 8.
    Debts: $ Who drivesit? Registered in whose name? Registered Retirement Savings Plans: Current value: $ In whose name? Where held? Current value: $ In whose name? Where held? Current value: $ In whose name? Where held? Current value: $ In whose name? Where held? Who Is the Beneficiary of RSPs: __________________________________________ Bank Accounts: In whose name? Value:
  • 9.
    $ Where held? In whosename? Value: $ Where held? In whose name? Value: $ Where held? In whose name? Value: $ Where held? Other Investments/Savings/Term Deposits: In whose name? Value: $ Where held? In whose name? Value: $ Where held? In whose name?
  • 10.
    Value: $ Where held? In whosename? Value: $ Where held? Your Employment Pensions: Employer: _____________________________________________________ _______How Long Have You Been Contributing: ___________________________ Your Spouse’s Employment Pensions: Employer: _____________________________________________________ ______How Long Have They Been Contributing: __________________________ Business/Corporate Interest: Company or Business Name: Who are Shareholders/Owners and Percentage Owned: Who are Officers/Directors?
  • 11.
    Other Assets: Description: Owned By: Value: $ Description: OwnedBy: Value: $ Description: Owned By: Value: $ Description: Owned By: Value: $ Description: Owned By: Value:
  • 12.
    $ Debts: Creditor: Balance Owing: $ Security: Monthly Payment: $ Creditor: BalanceOwing: $ Security: Monthly Payment: $ Creditor: Balance Owing: $ Security: Monthly Payment: $ Creditor: Balance Owing: $ Security: Monthly Payment: $
  • 13.
    Creditor: Balance Owing: $ Security: Monthly Payment: $ WhatAssets and Liabilities Did You Have When You Got Married (And/Or Started Living Together) and What Were They Worth at that Time: _____________________________________________________ ________ What Assets and Liabilities did Your Spouse have When You Got Married (And/Or Started Living Together) and What Were They Worth at that Time: _____________________________________________________ ________ Did Either You or Your Spouse Receive Any Gifts or Inheritances from Another Person or Receive a Trust, Award, or Insurance Settlement since You Started Living Together. If so, Describe it, its Value, When Was it Received, and Advise What Was Done With the Gift/Inheritance /Other Payment:
  • 14.
    Do You HaveAny Reason to Claim an Unequal Division of Property Acquired During Your Marriage? _____________________________________________________ ___________________ _____________________________________________________ ___________________ Has Any Property Been Sold or Transferred to Anyone in the Last Year? _____________________________________________________ ___________________ _____________________________________________________ ___________________ If You Were to Look at a Year from Today, What Has to Happen in Your Personal and Business Life for You to Be Satisfied with Your Progress? _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ Page 1 of 14 Family Law: Client Interview Sheet © 2012 South University week 6 Discussion 2 Answer the following questions 1. What are the differences between Social Media, E-mail
  • 15.
    and Instant Messaging? 2.List some of the Social Media Risks 3. Provide three best practices for managing Social Media Records. 300 words APA format with intext citations and references CLIENT INTERVIEW SHEET Date: ___________________ Lawyer: ___________________ Referred by: _____________ Hourly Rates: ___________________ Retainer: ___________________ Legal Assistant: ___________________ Client Information Client’s Full Name: ____________________________________________ Present Address: ____________________________________________ ____________________________________________ Mailing Address: ____________________________________________
  • 16.
    (If different fromabove) ___________________________________________ E-mail Address: ___________________________________________ Home Phone: _______________ Work Phone: ______________ Fax: _____________ Cell (or other contact):___________ Date of Birth: ____________________ Present Age: __________ Place of Birth: ___________________________________________ Surname at Birth: _________________________________________________ Surname Before this Marriage: _________________________________ Marital Status at the Time of Marriage: Single__ Widowed__ Divorced__ Occupation: _____________________________________________ Employer’s Name and Address: _________________________________ _____________________________________________________ ________________ How Long at that Employer? _______________________________________ Gross Annual Income: $___________ Frequency of Payment: Bi-Weekly ____ Bi-Monthly: ___ Monthly: ___ Total Income on Last Tax Return: $______________ Net Taxable Income on Last Tax Return: $___________ Occupation at Marriage: _______________________________________ Do You Have a Valid Will: _______________________________________ If So, Who Are the Beneficiaries:
  • 17.
    _________________________________ Who Is theExecutor/Executrix: _________________________________ Do You Want to Change Your Will: _____________________________ If your matter is against an ex-spouse and you have a new spouse, do mention your current spouse’s name and date of birth: Name: _____________________________________________________ _____________ Date of Birth: _____________________________________________________ _______ Information about Your Spouse (Opposing Party) Spouse’s Full Name: ____________________________________________ Spouse’s Present Address: ______________________________________ _____________________________________________________ _______________ Spouse’s Home Phone: _____________ Work Phone: ______________ Spouse’s Date of Birth: _____________________Present Age: ______ Place of Birth: ________________________________________________ _ Surname at Birth: ________________________________________________ Surname Before This Marriage: ________________________________ Marital Status at Time of Marriage: Single: ___Widowed: ___Divorced: ___ Occupation: ________________________________________________
  • 18.
    __ Employer’s Name andAddress: ________________________________ _____________________________________________________ _______________ How Long at That Employer? _____________________ Gross Annual Income: $______________ Frequency of Payment: Bi-Weekly: __ Bi-Monthly: __ Monthly: __ Total Income on Last Tax Return: $___________________________ Net Taxable Income on Last Tax Return: $____________________ Spouse’s Occupation at Marriage: _____________________________ Do You Know That Marriage Counseling, Guidance Facilities, and Mediation Services are Available to You? Yes: ___ No: ___ Children Full Name: Birth Date and Current AGE: Gender: _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ Do Any of Your Children Have Special Needs: Yes: ___ No: ___ If Yes, Explain: _____________________________________________________ ___________________ _____________________________________________________
  • 19.
    ___________________ Proposal for ParentingArrangements for Children _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ Proposal for Child Support: _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________ ___________________ Other Expenses for Children: Child Care Expenses: _______________________________________________Medica l/Dental Insurance Premiums: ______________________________ Health-Related Expenses that Exceed Insurance: ________________Extraordinary Expenses for Education: __________________________Post-Secondary Education: ________________________________________ Extraordinary Expenses for Extracurricular Activities (List by Individual Activity): _____________________________________ $_____________________________ _____________________________________ $_____________________________
  • 20.
    _____________________________________ $_____________________________ Life InsuranceDo YouHave Life Insurance? ________________________________________Death Benefit Payable ________________________________________Is There a Cash Surrender Value: _____________________________Does Your Spouse Have Life Insurance? _____________________________Death Benefit Payable ________________________________________Is There a Cash Surrender Value: _____________________________ Matrimonial Home Address: In Whose Name: (1) MKT Value (2) 1st Mortgage (3) 2nd Mortgage Equity (Balance Owing) (Balance Owing) 1-(2+3) $ $ $ $ Other Real Estate Address: In Whose Name: (1) MKT Value (2) 1st Mortgage (3) 2nd Mortgage
  • 21.
    Equity (Balance) (Balance) 1-(2+3) $ $ $ $ Address: In Whose Name: (1)MKT Value (2) 1st Mortgage (3) 2nd Mortgage Equity (Balance) (Balance) 1-(2+3) $ $ $ $ Vehicles: (include Motor homes, Motorcycles, Snowmobiles, etc.) Year: Make/Model: Value: $ Debts: $ Who drives it? Registered in whose name? Year: Make/Model: Value: $ Debts: $
  • 22.
    Who drives it? Registeredin whose name? Year: Make/Model: Value: $ Debts: $ Who drives it? Registered in whose name? Year: Make/Model: Value: $ Debts: $ Who drives it? Registered in whose name? Registered Retirement Savings Plans: Current value: $ In whose name? Where held? Current value: $ In whose name? Where held? Current value: $ In whose name? Where held? Current value: $
  • 23.
    In whose name? Whereheld? Who Is the Beneficiary of RSPs: __________________________________________ Bank Accounts: In whose name? Value: $ Where held? In whose name? Value: $ Where held? In whose name? Value: $ Where held? In whose name? Value: $ Where held? Other Investments/Savings/Term Deposits: In whose name?
  • 24.
    Value: $ Where held? In whosename? Value: $ Where held? In whose name? Value: $ Where held? In whose name? Value: $ Where held? Your Employment Pensions: Employer: _____________________________________________________ _______How Long Have You Been Contributing: ___________________________ Your Spouse’s Employment Pensions: Employer: _____________________________________________________ ______How Long Have They Been Contributing: __________________________ Business/Corporate Interest: Company or Business Name:
  • 25.
    Who are Shareholders/Ownersand Percentage Owned: Who are Officers/Directors? Other Assets: Description: Owned By: Value: $ Description: Owned By: Value: $ Description: Owned By: Value: $
  • 26.
    Description: Owned By: Value: $ Description: Owned By: Value: $ Debts: Creditor: BalanceOwing: $ Security: Monthly Payment: $ Creditor: Balance Owing: $ Security: Monthly Payment: $ Creditor: Balance Owing: $ Security:
  • 27.
    Monthly Payment: $ Creditor: Balance Owing: $ Security: MonthlyPayment: $ Creditor: Balance Owing: $ Security: Monthly Payment: $ What Assets and Liabilities Did You Have When You Got Married (And/Or Started Living Together) and What Were They Worth at that Time: _____________________________________________________ ________ What Assets and Liabilities did Your Spouse have When You Got Married (And/Or Started Living Together) and What Were They Worth at that Time: _____________________________________________________ ________
  • 28.
    Did Either Youor Your Spouse Receive Any Gifts or Inheritances from Another Person or Receive a Trust, Award, or Insurance Settlement since You Started Living Together. If so, Describe it, its Value, When Was it Received, and Advise What Was Done With the Gift/Inheritance /Other Payment: Do You Have Any Reason to Claim an Unequal Division of Property Acquired During Your Marriage? _____________________________________________________ ___________________ _____________________________________________________ ___________________ Has Any Property Been Sold or Transferred to Anyone in the Last Year? _____________________________________________________ ___________________ _____________________________________________________ ___________________ If You Were to Look at a Year from Today, What Has to Happen in Your Personal and Business Life for You to Be Satisfied with Your Progress? _____________________________________________________ ___________________ _____________________________________________________ ___________________ _____________________________________________________
  • 29.
    ___________________ Page 1 of14 Family Law: Client Interview Sheet © 2012 South University