• Service Agreement    

    Moxie Legal Support provides non-lawyer document preparation services only. We are not attorneys and cannot provide legal advice.

    By submitting this form, you acknowledge that you are representing yourself (pro se) and are requesting assistance with preparing legal documents based solely on the information you provide.

    Moxie Legal Support does not represent you in court and cannot advise you on legal strategy, rights, or obligations.

    All information provided must be accurate and truthful. You are responsible for reviewing all prepared documents before filing.

    By continuing, you confirm that you understand and agree to these terms.

  • Service Selection

  • Who is filing?*

  • Customer Information

  • Customer Date of Birth*
     - -

  • Sensitive information is transmitted electronically and will be used solely for document preparation purposes.

  • Format: (000) 000-0000.
  • Are you requesting to restore your Maiden name?*

  • Spouse Information

  • Spouse Date of Birth *
     - -

  • Sensitive information is transmitted electronically and will be used solely for document preparation purposes.

  • Format: (000) 000-0000.
  • Is your spouse wanting to return to their Maiden name?*

  • Marriage Information

  • Date of Marriage*
     - -
  • Date of Separation*
     - -

  • Minor Children

  • Are there minor children of this marriage?*
  • Is either party pregnant?*
  • Child's Date of Birth
     - -

  • Sensitive information is transmitted electronically and will be used solely for document preparation purposes.

  • Child's Sex
  • Has the child lived at the current address for the last 5 years?
  • Child 2 Date of Birth
     - -
  • Child 2 Sex
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?
  • Child 3 Date of Birth
     - -
  • Child 3 Sex
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?
  • Child 4 Date of Birth
     - -
  • Child 4 Sex
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?
  • Child 5 Date of Birth
     - -
  • Child 5 Sex
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?
  • Child 6 Date of Birth
     - -
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?
  • Child 7 Date of Birth
     - -
  • Child 7 Sex
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?
  • Child 8 Date of Birth
     - -
  • Child 8 Sex
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?
  • Child 9 Date of Birth
     - -
  • Same address as first child?
  • Has the child lived at the current address for the last 5 years?

  • Marital Property Information

  • Is marital property being divided? (Examples: home, vehicles, debts, or other assets)*
  • Is real estate being divided?*
  • Are additional properties being divided?
  • Who keeps this vehicle?
  • Are additional vehicles being divided?

  • By signing below, I certify that the information provided in this intake form is true and accurate to the best of my knowledge. I understand that Moxie Legal Support is not a law firm and cannot provide legal advice or legal representation.

  • Payment Amount*

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    USD
    Debit or Credit Card
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