Client In-Take Form

New Client Intake

Divorce, Paternity, Stepparent Adoption, Name Change, Child Support Reduction & More!
The Court Wants To Know EVERY Address You've Lived At Since Birth.
Case Type
About You
Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Address

Street Address

Street Address Line 2

CityState

Zip Code
Address

Street Address

Street Address Line 2

CityState

Zip Code
I have lived at the above address since Date and I still live there.
What is your preferred method of contact?
If Referral, please list name
Other? Please Explain...
Other Party's Info

Ex: Your Spouse or the Other Parent
Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Other Party’s Email
example@example.com
Other Party's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Marriage

MonthDayYear
Date
Location of Marriage
Please include City, State, County & Country
How many children will you need to include in your petition?
Include unborn, under 18 and disabled
Child # 1

First NameLast Name
Date of Birth

MonthDayYear
Date
Child # 2

First NameLast Name
Date of Birth

MonthDayYear
Date
Child # 3

First NameLast Name
Date of Birth

MonthDayYear
Date
Child # 4

First NameLast Name
Date of Birth

MonthDayYear
Date
Child # 5

First NameLast Name
Date of Birth

MonthDayYear
Date
Child # 6

First NameLast Name
Date of Birth

MonthDayYear
Date
Child Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please Provide More Detailed Information About Your Situation
i.e. Child(ren) name(s) , Date of Birth, City/State of birth and Sex
File Upload

Please attach a copy of your Driver's License, Passport Birth, Certificate, Marriage License etc. (All that Apply)
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How did you hear about us?
I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or improper court case filing and the quality of service given for a positive and seamless experience.
Address
Should be Empty:

New Client Intake

The Court Wants To Know EVERY Address You've Lived At Since Birth.

About You

Other Party's Info