Client Intake Form
Your Details
Name
*
Mr
Mrs
Ms
Miss
Mx
Prefix
First Name(s)
Last Name
Date of birth
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Residential address
*
Street Address
Street Address Line 2
City
State
Post Code
Does your address need to be suppressed?
*
Yes
No
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What is your occupation and salary?
*
Are you an Australian citizen?
*
Yes
No
If no, when did you start living in Australia?
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
How did you hear about Spencer Family Law & Mediation?
*
Other Party's Details
Name
*
Mr
Mrs
Ms
Miss
Mx
Prefix
First Name(s)
Last Name
Date of birth
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Residential address
Street Address
Street Address Line 2
City
State
Post Code
Email address
example@example.com
Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
What is their occupation and salary?
*
Are they an Australian citizen?
*
Yes
No
If no, when did they start living in Australia?
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Does the other party have a lawyer? If yes, please provide details below
*
Relationship Details
Did you begin a relationship with the other party?
*
Yes
No / Not Applicable
Date you began your relationship
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Did you, or do you, live with the other party?
*
Yes
No / Not Applicable
Date you began living together
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Did you marry the other party?
*
Yes
No / Not Applicable
Date of marriage
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Town and country of marriage
*
Have you separated from the other party?
*
Yes
No / Not Applicable
Date of separation
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Are you divorced?
*
Yes
No / Not Applicable
Date of divorce
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Are there any domestic violence orders in place, or a history of domestic violence?
*
Legal Issue
Nature of your legal issue (select all that apply):
*
Parenting & Children
Property/Financial Settlement
Divorce
Domestic Violence & Protection
Other
Are there any Court proceedings currently on foot (ongoing)?
*
If you have received a letter from a lawyer, or have any Court documents that you wish to discuss during your Initial Consultation, please upload copies here:
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Court documents we would particularly wish to be uploaded include: Application for Consent Orders, Minutes of Order, Initiating Application, Response to Initiating Application, Affidavit
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Are there are any existing (current) or previous Orders or Agreements between the parties?
*
Yes
No
If yes, please upload copies here:
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Consent Orders, Sealed Orders, Financial Agreements, Child Support Agreements, Protection Order (including Temporary), Apprehended Violence Order
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Children
Are there children of the relationship under the age of 18?
Yes
No
Child 1 - Full Name
*
First Name
Last Name
Child 1 - Date of birth
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Child 2 - Full Name
First Name
Last Name
Child 2 - Date of birth
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Child 3 - Full Name
First Name
Last Name
Child 3 - Date of birth
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
If you have more than three children, please enter their full names and dates of birth here:
Current care arrangements (who the children live with and how much time they spend with the other parent):
*
Property Pool
Outline of the assets, liabilities and superannuation of the parties
Do you or the other party own any assets or liabilities? (e.g. houses, cars, bank accounts, credit cards, superannuation)
*
Yes
No / Not Applicable
Assets
*
Rows
Description
Owner
Value
Real property 1
Real property 2
Real property 3
Business
Motor vehicle 1
Motor vehicle 2
Motor vehicle 3
Cash at bank 1
Cash at bank 2
Cash at bank 3
Cryptocurrency & shares
Furniture & chattels
Jewellery & artwork
Collectables
Other assets or property
Liabilities
*
Rows
Description
Owner
Value
Home loan 1
Home loan 2
Home loan 3
Business loan
Vehicle loan 1
Vehicle loan 2
Vehicle loan 3
Personal loan
Credit card
Taxation debt
Other liabilities or debt
Superannuation
*
Rows
Description
Owner
Value
Superannuation fund 1
Superannuation fund 2
Superannuation fund 3
Superannuation fund 4
Superannuation fund 5
Verification of Identity
We are required to have a copy of your photo ID on our file. Please upload a copy of your driver licence, passport, or other photo card here:
*
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