Full Name:

Opposing Party's Name:

Current Address:

Opposing Party's Address:

Is there already a case on file?   If so, what county is the case filed in and what is the case number?

Date of Marriage:

Are you currently separated?  If so, for how long?

Assets/ Debts:

For real estate, please list the date the real estate was purchased and the amount of equity it currently has (current value minus what you owe on the mortgage).

Real Estate:

Vehicles:

Bank Accounts:

Retirement Accounts:

Life Insurance Policies:

Other Investment Accounts (stocks, crypto currency, etc.):

Other Significant Assets:

For each item of debt incurred by you and/or your spouse, please list the amount of the debt and who you would like to see pay each debt (your or your spouse):

Student Loans:

Medical Debts:

Tax Debts:

Other Loans:

Other Debts:

Are you requesting spousal maintenance (alimony)?

Are you and your spouse presently employed? If so, who is your employer and what is your job title?

What is your average gross monthly income?

What is your spouse’s average gross monthly income?

Do you and/or your spouse own a business or have any interest in a business? If so, please list the name of the business, the type of business conducted, and what you would like to see happen with the business:

If you have children, please complete the following:

If you and the opposing party are separated, please describe the parenting time each of you are currently exercising with your children:

What is your ideal parenting schedule?

Who covers health insurance for your child(ren)?

Do you have any childcare costs for your child(ren)? Who covers these costs?

Are you requesting joint or sole custody? If you are requesting sole custody, please describe in detail the reasons for your request:

Are you making any allegations of child abuse or neglect against the opposing party and/or has the opposing party made any allegations of child abuse or neglect against you? If yes, please describe in detail including any involvement with the police or Children’s Division:

Do you or the opposing party have any current or past issues with substance abuse? If yes, please describe:

Do you or the opposing party have any current or past mental health diagnosis and/or are either of you currently undergoing treatment for any mental health issues? If yes, please describe:

Are you requesting child support from the opposing party?

Do you have any other children not of this relationship? If so, please list their ages, whether they live with you or their other parent primarily, and whether you receive or pay child support for each child:

Please add anything else you believe I should know about your case: