Please Complete Brandon Legal Group's Family Law Intake Form.

FAMILY LAW QUESTIONNAIRE

Please complete this questionnaire and return it to our office before your first appointment. If you will spend the time to complete all items, we will then have the necessary background information to understand the complexity of the personal aspects of your situation. All information will be held in the strictest confidence. Some of this information may not apply to you; if so, simply indicate N/A (not applicable) where appropriate. Thank you!

Please feel free to attach additional pages should it become necessary

Step 1 of 6

Occupation
Your Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number
Job Title
Gross Income
Net Income
Other Party’s Employer
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number
Job Title
Gross Income
Net Income

Financial Information
Please provide the following information concerning any bank accounts that you own either individually or jointly with your spouse or with another individual (such as a parent, sibling, or child(ren)), as well as any accounts that you have closed within the last two (2) years
Bank 1
Location 1
Current Balance 1
Joint/Individual 1
Bank 2
Location 2
Current Balance 2
Joint/Individual 2
Bank 3
Location 3
Current Balance 3
Joint/Individual 3
Do you jointly or individually own any safety deposit boxes?
- Yes
- No
If yes, please provide the following information
Bank 1
Location 1
Contents 1
Joint/Individual 1
Bank 2
Location 2
Contents 2
Joint/Individual 2
Bank 3
Location 3
Contents 3
Joint/Individual 3
Do you own any stocks or bonds either jointly or individually?
- Yes
- No
If yes, please provide the following information
Bank 1
Location 1
Value 1
Joint/Individual 1
Bank 2
Location 2
Value 2
Joint/Individual 2
Bank 3
Location 3
Value 3
Joint/Individual 3
Debts
Please list those debts, such as car loans and credit cards, for which you are either jointly or individually responsible
To Whom Owed 1
Monthly Payment 1
Balance 1
Joint/Individual 1
To Whom Owed 2
Monthly Payment 2
Balance 2
Joint/Individual 2
To Whom Owed 3
Monthly Payment 3
Balance 3
Joint/Individual 3
Automobiles/Vehicles/Boats
Please list all vehicles (motorcycles, motor homes, boats, jetskis, or other vehicles included) owned by you and/or the other party
Make 1
Year 1
Lender 1
Loan Balance 1
Joint/Individual 1
Make 2
Year 2
Lender 2
Loan Balance 2
Joint/Individual 2
Joint/Individual 3
Year 3
Lender 3
Loan Balance 3
Joint/Individual 3
Retirement Accounts, Pension Plan, Insurance Policies, and Annuities
Company 1
Policy Number 1
Face Amount 1
Premium 1
Owner 1
Beneficiary 1
Cash Value 1
Company 2
Policy Number 2
Face Amount 2
Premium 2
Owner 2
Beneficiary 2
Cash Value 2
Company 3
Policy Number 3
Face Amount 3
Premium 3
Owner 3
Beneficiary 3
Cash Value 3
Other
Please provide any additional information that we may not have addressed
consent*
- I consent to my submitted data being collected and stored

FAMILY LAW QUESTIONNAIRE

Step 1 of 6

Occupation

Level of Education

Marital Background

Marriage/Relationship History

Children from current marriage and/or relationship

Military

Religious, Social and Fraternal Background

Property

Financial Information

Debts

Automobiles/Vehicles/Boats

Retirement Accounts, Pension Plan, Insurance Policies, and Annuities

Other

Pin It on Pinterest