Emancy FLQ Input

Please input your information so we can prepare your documents.

Information About You
Every state in the United States will require this information about you on any domestic relations or family law matter. If you leave items blank it will slow down the preparation of your documents.
First Name		Address line 1
Middle Name		Address line 2
Last Name		City
Daytime phone		State
Evening phone		Zip Code
Email Address
How long have you lived at current address?
Your Age		Your Date of Birth
County Where you Live		Your Social Security Number
Your driver's license number		Issuing State of your driver's license

Are you currently employed?		Yes No
How many hours per week do you work		How much per week do you make (before taxes)
Name of your employer		Address of employer line 1
Employer's Phone number		Address of employer line 2
Dates worked (start-finish)		Does your job make certian visits impossible?	Yes No
Are you in the military	Yes No	If yes, where are you currently stationed
Are you a veteran of Iraq, Afghanistan, or Gulf War		Yes No

Information About the Other Party
We need information about the other party is this matter, whether they are a spouse or not, whether you are married or not. If you leave fields blank it can slow down the creation of your documents.
First Name		Address line 1
Middle Name		Address line 2
Last Name		City
Daytime phone		State
Evening phone		Zip Code
Email Address		How long have they lived at current address?
Their Date of Birth		County Where they Live
Their Age		Their Social Security Number
Their driver's license number		Issuing State of their driver's license
Are they in the military	Yes No	If yes, where are they currently stationed
Are they a veteran of Iraq, Afghanistan, or Gulf War		Yes No
Is this person your spouse?	Yes No	Was this person your spouse?	Yes No
Are you separated?	Yes No	Are you divorced?	Yes No
When did you marry?		Where did you marry?
When did you separate?

Information About Your Family
If there are children involved the court will require this information. This means any children born to or adopted by you and the other party.
Child 1
Name		Age
Where born (county and state)		Date of Birth
SSN		Who does the child live with?
It is required we provide information on who and where the child has lived for the last five years.
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Child 2
Name		Age
Where born (county and state)		Date of Birth
SSN		Who does the child live with?
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Child 3
Name		Age
Where born (county and state)		Date of Birth
SSN		Who does the child live with?
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Where did they live?		Who did the child live with?
From what date to what date did the child live there
Where did they live?		Who did the child live with?
From what date to what date did the child live there

What is your goal in this case?
Please mark all that apply. You may mark more than one. We need to know all you wish to accomplish so the right documents can be prepared.
Divorce		Yes No
Custody		Yes No
What type of custody? Full,Primary,Joint etc..
Full or sole legal and physical custody?		Yes No
Joint Legal Custody		Yes No
Joint Physical Custody		Yes No
Primary Physical Custody		Yes No
Primary Legal Custody		Yes No
Standard Visitation Schedule		Yes No
Custom Visitation Schedule		Yes No
Child Support		Yes No
Alimony		Yes No
Guardianship		Yes No
Conservatorship		Yes No
Modification		Yes No
You have been served and need to file a Response		Yes No
Establish Paternity		Yes No

Your Income: Fill out as accurately as possible
How are you paid, weekly, bi-weekly or monthly		Weekly Bi-weekly Monthly
Monthly Gross Income		Are you in a union?	Yes No
Are there any deductions from your Paycheck		Yes No
If so, list the type and amount

Monthly Expenses
Whenever child support can possibly be an issue, or when the court must decide issues of financial matters, they require a great deal of information on your finances. If you don't have a particular expense, mark the field with a "no". This way we don't have to asked you if you missed a question and slow down the preparation of your documents.
Rent		Property Taxes (if not included in mortgage payment)
Mortgage		Insurance (Home or Rental)
Maintenance & repair		Health care & medical costs not paid by insurance
Child Care		Groceries & household supplies
Dining out		Utilities (gas, water electric, trash)
Home telephone and cell phone		Laundry and cleaning
Clothing expenses		Education
Entertainment, gifts & vacation
Auto expenses & transportation (insurance, gas, bus, etc.)
Savings and investments (monthly contributions)
Insurance (life, accident, etc. ONLY; do NOT included auto, home or health here)
Charitable contributions
Creditor Debts	Please list all creditors, the balance owed, the date of the balance, minimum monthly payments, and the source of the debt

Monthly child support for the child(ren) in this case
Spousal support for the family in this case
Do you pay child support for other children not involved in this case? If so, how many children and what is the monthly payment?

Spousal support for another family
Do you have other expenses (other than child support) for minor children who are from other relationships and are living with you? If so, what?
Please list any other expenses not listed above

Current situation
Are there any upcoming court dates?		Yes No
Are there currently any court orders in place?		Yes No
Are there any restraining orders between you and the other party?		Yes No
Do you feel the other parent is unfit?		Yes No
If so, why?
How long has it been since you've seen/visited with your kid(s)?
Does the other party withhold visitations?		Yes No
Does the other party interfere with your parenting time?		Yes No

Your assets: Fill out as accurately as possible
Real Estate	List addresses, estimated value & amount owed

Vehicles	List year, make, model, estimated value and the amount owed

Recreational vehicles
Cash on hand
Bank Accounts	List name of bank, type of account, and balance

Value of furniture, household goods, jewelry, antiques,collectibles, art, tools, etc.

Personal Property	Identify the items and their estimated value

Stocks value
Bonds value
Mutual Funds value
Other	Please indicate the type of asset & value


Summary
In summary, please explain what your final goal in this case is, and why it's in the best interest of the children involved:

We can only make you look as good as we can with the information you provide to us. If you don't, it wont be input into the paperwork and the judge wont have the opportunity to consider the information. "This is your opportunity to provide specific information regarding your case. Don't forget,the judge bases their decision on the information in the documents you file with the courts. Please include any dates and specific timelines about the situation and why they're important. If there have been any significant changes in your circumstances (lost job,child abuse,other party now in jail,) please tell us about them so we can help to provide that information to the courts. We build your case based on information you give to us.
Acknowledge that court documents are based upon accuracy of information:		I, acknowldge this fact.
I acknowledge and understand that no attorney-client relationship was established:		I, acknowldge this fact.
Please fax us the most recent court orders, if any.