New Client Intake Form

People's Justice LLC

Uncontested Divorce Application
Location
Section 1: Plaintiff's Information
Plaintiff's Formal Legal Name *

Prefix First Name Middle Name Last Name
Plaintiff's Former Name (Before Marriage)
Plaintiffs Residential (HOME) Address: *

Street Address

Street Address Line 2

City State

Zip Code Country
Plaintiff's Daytime Phone Number: *

Area Code Phone Number
Plaintiff's Email
example@example.com
Section 2: Defendant's Information
Defendant's Formal Legal Name *

Prefix Spouse's First Name Spouse's Middle Name Spouse's Last Name
Defendant's (HOME) Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Defendant's Former Name (Before Marriage)
Defendant's Daytime Phone Number *

Area Code Phone Number
Defendant's Email Address
example@example.com
Is the Defendant an active Member of any Division of the USA Armed Forces or National Guard? *

Yes No
Section 3: Marriage Information
What is the EXACT Date of your Marriage? *

Month Day Year
Date
If you are SEPARATED-What day were you separated? *

Month Day Year
Date
Where were you married? (City, State, Country) *
Section 4: General Information
Has at least one Spouse resided in PA for the past six (6) months *

Yes No
Did you start a file for Divorce in any court? *

Yes No
Will you be dividing a Work-Related Pension/401k? *

Yes No
Do you or your spouse own a home? Or pay a Mortgage on any property whatsoever? *

Yes No
Does either Party Wish to: Resume their Former Legal Surname, i.e. a Birth name / Maiden Name. If "Yes" Additional Fee of $97.50 each will apply. *

Yes No
Will either spouse need their documents mailed to them for signing? [Out of office signing requires certain documents to be notarized on 2 occasions- No Carry Out] Additional fee of $125.00 *

Yes No
How did you hear about us?
Section 5: Acknowledgment
People’s Justice, LLC. is NOT A LAWFIRM & WE ARE NOT ATTORNEYS or PARALEGALS! Therefore, we do not and will not represent either party in this process, and we may only collect factual and basic personal information from you, which PJ will INSERT onto pre-written [divorce] forms that are specifically required by the State's Rules of Court. *

I understand
THE MINIMUM PAYMENT DUE IS $595.00 I have carefully reviewed and agree to the Terms and Conditions set forth in this Application and its attachments. I understand that this submission is for the Divorce application only; and that if for any reason this divorce file is cancelled or voided for any reason whatsoever; then this will be terminated. ALLSALES ARE FINAL – NO REFUNDS. *

I understand and agree to the terms.
By signing here, you agree to the above terms: *

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