Law Office of Stacy Goodbread, P.C.
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CLIENT >>
1. Full Legal Name:
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Age:
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2. Address:
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3. How Long Have You Lived at this Address?
4. What COUNTY Do You Currently Reside in?
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5. Employer:
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Additional Address Where You Can Be Reached:
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EX-SPOUSE >>
1. Ex-Spouse Full Name:
Ex-Spouse Age:
2. Ex-Spouse Address:
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Ex-Spouse Home/Mobile Phone:
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Ex-Spouse Email:
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3. How Long Has Ex-Spouse Lived at this Address?
4. What COUNTY Does Ex-Spouse Currently Reside in?
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5. Ex-Spouse Employer:
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6. Ex-Spouse Driver's License # (inc state):
Ex-Spouse Social Security #:
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7. Is Ex-Spouse Represented by an Attorney?
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If Yes, Please Provide Attorney Info - Name:
Attorney Phone:
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Attorney Address:
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LIVING CHILDREN OF THIS MARRIAGE >>
Child #1
Full Name:
SS #:
Gender:
Please Select
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Female
Place of Birth: (city, state & county)
Date of Birth:
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Currently Resides with:
Child #2
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Place of Birth: (city, state & county)
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Currently Resides with:
Child #3
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Place of Birth:
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Currently Resides with:
Child #4
Full Name:
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Place of Birth:
Date of Birth:
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Where Has the Child(ren) Been Living For the Past 5 Years and with Whom?
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Where
From-To
With Whom
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3.
Explain the Issue:
Has There Ever Been a Custody Fight Regarding the Children?
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No
Has There Ever Been a Protective Order Issued/Applied For the Children?
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Yes
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Have You Ever Visited an Attorney Prior to Today?
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Have You Ever Discussed this Case with Another Attorney?
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If Yes, Name of Attorney:
Attorney Phone:
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Attorney Address:
Street Address
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Has Your Ex-Spouse Ever Discussed ANY Case with the Law Office of Stacy Goodbread?
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How Did You Hear About the Law Office of Stacy Goodbread:
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Client Referral
If Client Referral, Who Provided Referral?
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