The Law Office of WLP

Divorce Questionnaire

The Law Office of Whitney L. Thompson, PLLC Please complete this questionnaire. If you spend the time to complete all items, you will give us the background information necessary to begin to understand the complexity of the personal aspects of your case. All information will be held in strict confidence.
Today's Date

MonthDayYear
Client's Name

First NameLast Name
Client: Have you used any other alias names?
If Yes, list of other alias names.
Client's DOB

MonthDayYear
Client's Age
Please enter your current age.
Client's Sex
Client's Place of Birth
City, Texas
Client: Do you have a Driver License Number?
Client's Driver License Number
Do not use any dashes or other symbols
Client: Are you a US Citizen
Client: Do you have a SSN?
Client's SSN
This information will be kept confidential. Do not use any dashes or other symbols
Client's Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What County do you reside in?
How long have you resided in your County?
How long have you lived in Texas?
Do you want to receive mail from our office to a different address?
Client's Preferred Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Client's E-mail Address
Enter an email address you would like to be contacted at about your case.
Client's Phone Number

Area CodePhone Number
Client's Highest Education Level:
Client: Are you employed?
Client: When was your last employer and with who?
Name of last employer & when
Client: How long have you been employed with your current employer?
years or months
Client's Employer's Name
Client's Supervisor's Name
Current Employer Supervisor
Monthly Net Income (after taxes)
Client's Job Title:
Client's Work Number

Area CodePhone Number
Client's Work Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Information About Spouse
Spouse's Full Name

First NameLast Name
Spouse: Has your spouse used any other alias names?
If Yes, list the other alias names used
Spouse's DOB

MonthDayYear
Spouse's Age
Spouse's Place of Birth
City, State
Spouse: Does your spouse have a Driver License Number?
Spouse: Driver License Number
Please do not use dashes.
Spouse: US Citizen?
Spouse: Does your Spouse Have a SSN?
Spouse: SSN
Please do not use dashes.
Spouse's Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse's Phone Number

Area CodePhone Number
Spouse's Highest Education
Is Your Spouse Employed?
Spouse's Job Title
Name of Spouse's Employer:
Spouse's Employer's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse's Employer's Phone Number

Area CodePhone Number
Spouse's Net Monthly Income (after taxes)
Information About Marriage
Date of Marriage

MonthDayYear
Place of Marriage
Date of Separation

MonthDayYear
Are you seeing a marriage counselor or any other counselor?
If Yes, state the counselor's name
Are you requesting a name change?
What is your religious preference?
What is your spouse's religious preference?
If Yes, list the name you are requesting

First NameLast Name

Are any of the following marital difficulties involved in your marriage?

Rows	Myself	Spouse	Neither	Both
Illegal Drug/Alcohol
Sexual Disappointment
Sexual Infidelity
Financial Disputes
Physical Violence
Religion
Incompatibility
Mental Health Issues
Committed a Felony
Been Arrested
Been in Jail or Prison
Prescription Drugs
Arrested for DWI
Arrested for DUI
Gambling (legal or illegal)
Attempted Suicide
Hospitalize for Emotional or Psychiatric Treatment
Child Abuse
Adultery
Homosexual relationships
Engaged in Unusual Sexual Preferences
Pregnancy Outside the Marriage
Venereal Disease

Please describe any of the difficulties you below:
Provide as much detail as possible.
Does your spouse have an attorney now?
If Yes, who?
Have you or your spouse ever filed for divorce?
If Yes when and where?
Have you ever been married before?
If Yes, how many times?
Has your spouse ever been married before?
If Yes, how many?
Children Born During Marriage

Please only include children who are under the age of 18 years of age
Are there any children who are under the age of 18 who were born during the marriage?
(1) Name of Child

First NameLast Name
(1) Sex of the Child
(1) DOB of the Child

MonthDayYear
(1) Place of Birth of the Child:
City, State
(1) Child's SSN
Please do not include any dashes.
(1) Do you need to list another child?
(2) Name of Child

First NameLast Name
(2) Sex of the Child
(2) DOB of the Child

MonthDayYear
(2) Place of Birth of the Child:
City, State
(2) Child's SSN
Please do not include any dashes.
(2) Do you need to list another child?
(3) Name of Child

First NameLast Name
(3) Sex of the Child
(3) DOB of the Child

MonthDayYear
(3) Place of Birth of the Child:
City, State
(3) Child's SSN
Please do not include any dashes.
(3) Do you need to list another child?
(4) Name of Child

First NameLast Name
(4) Sex of the Child
(4) DOB of the Child

MonthDayYear
(4) Place of Birth of the Child:
City, State
(4) Child's SSN
Please do not include any dashes.
Who are the children living with now?
Will there be a dispute over the children?
If there is No dispute over the children, who will the children live with at the end of the divorce?
(if necessary please bring in a separate sheet of paper with additional names and information).
Is the wife current pregnant?
Is the husband the biological father of all of the children born during the marriage?
If the husband is NOT the biological father of all of the children born during the marriage, explain:
Explain who is the biological father of the child(ren)
Do you and/or your children have health insurance?
If Yes, please provide the following information below: 1. Health Insurance Company 2. Policy Number 3. Source of Insurance 4. Cost of Premium and 5. Who pays the Premium each month
Please provide as much information as possible. This information is needed for the court.
Do the children own any property other than (clothing or furniture)?
If Yes, please list all property.
Please provide as much detail as possible.
Children Before or Outside of the Marriage

Please list all children before our outside of the marriage from either you or your spouse.
Did you or your spouse have any children before or outside of the marriage?
(1) Child's Name

First NameLast Name
(1) Child's Gender
(1) Child's DOB

MonthDayYear
(1) Child's Place of Birth
(1) Do you know the child's SSN?
(1) Child's SSN
(1) Who does the child's reside with?
(1) Do you need to list another child?
(2) Child's Name

First NameLast Name
(2) Child's Gender
(2) Child's DOB

MonthDayYear
(2) Child's Place of Birth
(2) Do you know the child's SSN?
(2) Child's SSN
(2) Who does the child's reside with?
(2) Do you need to list another child?
(3) Child's Name

First NameLast Name
(3) Child's Gender
(3) Child's DOB

MonthDayYear
(3) Child's Place of Birth
(3) Do you know the child's SSN?
(3) Child's SSN
(3) Who does the child's reside with?
(3) Do you need to list another child?
(4) Child's Name

First NameLast Name
(4) Child's Gender
(4) Child's DOB

MonthDayYear
(4) Child's Place of Birth
(4) Do you know the child's SSN?
(4) Child's SSN
(4) Who does the child's reside with?
(if necessary please bring in a separate sheet of paper with additional names and information).
Do either of you pay child support for the children before or outside of the marriage?
If Yes, who and how much child support per month is paid?
Emergency Contact

This is a person(s) who you would like for our office to contact about your pending case if you are not able to be reached.
Emergency Contact's Name

First NameLast Name
Emergency Contact's Relationship to You:
Emergency Contact's Phone Number

Area CodePhone Number
Emergency Contact's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Summary of Community Property

Please list anything acquired during the marriage.
Do you and your spouse own any real estate property (marital home, vacation homes, or rental property).
(1) Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
(1) Year Property Purchased?
(1) Fair Market Value of the Property as of today?
(1) Do you owe a mortgage on the property?
(1) If Yes, Name of the Mortgage Company?
(1) Monthly mortgage payments?
(1) Total Mortgage Debt Balance as of today:
(1) Do you need to list another piece of real property?
(2) Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
(2) Year Property Purchased?
(2) Fair Market Value of the Property as of today?
(2) Do you owe a mortgage on the property?
(2) If Yes, Name of the Mortgage Company?
(2) Monthly mortgage payments?
(2) Total Mortgage Debt Balance as of today:
(2) Do you need to list another piece of real property?
(3) Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
(3) Year Property Purchased?
(3) Fair Market Value of the Property as of today?
(3) Do you owe a mortgage on the property?
(3) If Yes, Name of the Mortgage Company?
(3) Monthly mortgage payments?
(3) Total Mortgage Debt Balance as of today:
(if necessary please bring in a separate sheet of paper with additional real property and information).
Motor Vehicles, Boats, Airplanes, Cycles, & Trailers

Please list any property acquired during the marriage.
Do you have any motor vehicles, boats, airplanes, cycles or trailers to list?
(1) Year of Motor Property
(1) Make & Model
(1) Who drives the vehicle
(1) Fair Market Value of the property?
(1) Is there a loan on the property?
(1) If yes, how much is the monthly payment?
(1) How much is balance owed as of today?
(1) Do you need to list another piece of property?
(2) Year of Motor Property
(2) Make & Model
(2) Who drives the vehicle
(2) Fair Market Value of the property?
(2) Is there a loan on the property?
(2) If yes, how much are the monthly payments?
(2) What is the balance owed as of today?
(2) Do you need to list another piece of property?
(3) Year of Motor Property
(3) Make & Model
(3) Who drives the vehicle
(3) Fair Market Value of the property
(3) Is there a loan on this property?
(3) If Yes, how much is the monthly payments?
(3) If Yes, how much is the balance owed as of today?
(3) Do you need to list another piece property?
(4) Year of Motor Property
(4) Make & Model
(4) Who drives the vehicle
(4) Fair Market Value of the Property?
(4) Is there a loan on this property?
(4) If Yes, how much is the monthly payments?
(4) If Yes, how much is the balance owed as of today?
(if necessary please bring in a separate sheet of paper with additional property and information).
Bank Accounts

Please list all separate and joint bank accounts.
Do either you or youse spouse have a bank account?
(1) Name of Bank
(1) Who Can Withdraw From Account?
(1) Type of Account
(1) Available Balance Today?
(1) Do you need to list another account?
(2) Name of Bank
(2) Who Can Withdraw From Account?
(2) Type of Account
(2) Available Balance Today?
(2) Do you need to list another account?
(3) Name of Bank
(3) Who Can Withdraw From Account?
(3) Type of Account
(3) Available Balance as of Today?
(3) Do you need to list another account?
(4) Name of Bank
(4) Who Can Withdraw From Account?
(4) Type of Account
(4) Available Balance as of Today?
(4) Do you need to list another account?
(5) Name of Bank
(5) Type of Account
(5) Who Can Withdraw From Account?
(5) Available Balance as of Today?
(if necessary please bring in a separate sheet of paper with additional accounts and information).
Stock and Mutual Funds

Please list all mutual funds
Do you or your spouse have a stock or mutual fund?
(1) Name of Fund
(1) Estimated Value as of Today
(1) Do you need to list another stock or mutual fund?
(2) Name of Fund
(2) Estimated Value as of Today
(2) Do you need to list another stock or mutual fund?
(3) Name of Fund
(3) Estimated Value as of Today
(3) Do you need to list another stock or mutual fund?
(4) Name of Fund
(4) Estimated Value as of Today
(4) Do you need to list another stock or mutual fund?
(5) Name of Fund
(5) Estimated Value as of Today
(if necessary please bring in a separate sheet of paper with additional funds and information).
Life Insurance

Please list all life insurance policies
Do you or your spouse have life insurance policies?
(1) Name of Company
(1) Insuring life of: (name of person)
(1) Cash Value as of Today?
(1) Do you need to list another policy?
(2) Name of Company
(2) Insuring the life of: (name of person)
(2) Cash Value as of Today?
(2) Do you need to list another policy?
(3) Name of Company
(3) Insuring the life of: (name of person)
(3) Cash Value as of Today?
(if necessary please bring in a separate sheet of paper with additional policies and information).
Retirement, Pensions, & Other Company Benefits

Please list you and your spouse's company benefit information below
Do you and/or your spouse have company benefit accounts?
(1) Type of Account
(1) Whose Name is the Account in?
(1) Estimated Value of the Account as of Today?
(1) Do you have another account to list?
(2) Type of Account
(2) Whose Name is the Account in?
(2) Estimated Value of the Account as of Today?
(2) Do you have another account to list?
(3) Type of Account
(3) Whose Name is the Account in?
(3) Estimated Value of the Account as of Today?
(3) Do you have another account to list?
(4) Type of Account
(4) Whose Name is the Account in?
(4) Estimated Value of the Account as of Today?
(if necessary please bring in a separate sheet of paper with additional accounts and information).
Separate Property

List any of you or your spouse's separate property that was acquired BEFORE the marriage
Do you or your spouse own any separate property?
If YES, list the property description here (i.e cars, homes, etc.)
Did you or your spouse receive a gift or inheritance during your marriage?
If YES, list the gift and inheritance here (i.e the amount and who the inheritance was from)
Debts

Please list all debts other than a home or vehicle.
Do you and your spouse owe additional debts?
(1) Who Debt Owed to:
(1) Monthly Payment
(1) Total Amount Owed as of Today?
(1) Do you need to list another debt?
(2) Who is the Debt Owed to:
(2) Monthly Payment
(2) Total Amount Owed as of Today?
(2) Do you need to list another debt?
(3) Who is the Debt Owed to:
(3) Monthly Payment
(3) Total Amount Owed as of Today?
(3) Do you need to list another debt?
(4) Who is the Debt Owed to:
(4) Monthly Payment
(4) Total Amount Owed as of Today?
(4) Do you need to list another debt?
(5) Who is the Debt Owed to:
(5) Monthly Payment
(5) Total Amount Owed as of Today?
(5) Do you need to list another debt?
(6) Who is the Debt Owed to:
(6) Monthly Payment
(6) Total Amount Owed as of Today?
(6) Do you need to list another debt?
(7) Who is the Debt Owed to:
(7) Monthly Payment
(7) Total Amount Owed as of Today?
(if necessary please bring in a separate sheet of paper with additional debts and information).
Miscellaneous

Please answer the following questions.
Does anyone owe you and/or your spouse money
If YES, please state (1) who owes the money and (2) how much is owed:
Are you or your spouse involved in any lawsuit?
If YES, please explain:
Do you own any livestock or mineral interest?
If YES, please identify below:
Do you or your spouse belong to any club with an equity interest?
If YES, state where below:
Have you filed your taxes for all of the previous years?
If No, (1) how much do you owe or was a refund issued? (2) How much was the balance owed or the refund issued? Please explain below:
How did you file?
Who prepared your tax return?
Do you have a prenuptial agreement? (if yes, please bring a copy with you to your meeting).
Do you and/or you spouse have a Will?
If YES, please please provide detail on who prepared the Will:
What are your goals in this divorce?
Do you have any urgent concerns? (Example interaction with spouse, visitation, and financial issues, and etc.)
If YES, please provide details:
Closing Questions
Did someone refer you to our office?
Name of the Person who Referred You:

First NameLast Name
Have you consulted or retained any other attorneys on this matter before?
If Yes, please state who you consulted with and when:
Should be Empty:

Divorce Questionnaire

Information About Spouse

Information About Marriage

Children Born During Marriage

Children Before or Outside of the Marriage

Emergency Contact

Summary of Community Property

Motor Vehicles, Boats, Airplanes, Cycles, & Trailers

Bank Accounts

Stock and Mutual Funds

Life Insurance

Retirement, Pensions, & Other Company Benefits

Separate Property

Debts

Miscellaneous

Closing Questions