Family Law Client Worksheet

Thank you for choosing Alderwood Legal, PC for your family law case. Please complete this worksheet as completely and accurately as possible. You will have an opportunity to edit your responses as the case progresses. We will use this information you provide here, along with the additional documentation requested, to help you craft individual budgets, to understand the value of the assets and liabilities to be divided in your case, and to reach an agreement based on that information. If you have any questions about how to complete this form, please contact our office for assistance.
ALDERWOOD LEGAL, PC
565 SE 9^TH STREET
BEND, OREGON 97702
503.683.3224
541.550.1333
WWW.ALDERWOODLEGAL.COM

Information about Your Spouse
Full Name:
Mailing Address:
Physical Address (if different from mailing):
Primary Telephone Number:
Format: (000) 000-0000.
Secondary Telephone Number:
Format: (000) 000-0000.
Email address:
example@example.com
Do we have permission to email you about this case?
Does your spouse have access to your email account password or devices that you use to check your email such as cell phones, shared computers, or tablets?
Date of Marriage:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date of Separation:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Place of Marriage (County, State)
Name of current employer(s):
Position(s) held/Job title(s):
Provide addresses and telephone numbers for all employers:
Gross monthly income from all sources:
Information Required for Oregon Health Authority Vital Statistics Form

For Your Spouse
Former Name(s) (Maiden Name, Former Married Name, Etc.):
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Place of Birth:
Social Security Number:
Race (list all that apply):
Highest Grade Completed/Degree Obtained (Required for Vital Statistics Form):
Has your spouse been married or in a registered domestic partnership (RDP) prior to this relationship?
How many times?
Date prior marriage or RDP ended:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Information about Your Children
Information about All Children Born to You and Your Spouse

Rows	Full Name	Date of Birth	Age	Place of Birth	SSN
1
2
3
4

Please describe the current parenting schedule:
Are you happy with this schedule?
If no, how would you like it to be changed and why?
Who provides health insurance for the children?
How much is the monthly insurance premium for the children alone?
How much is the monthly insurance premium for the spouse providing coverage to cover himself or herself without the children?
Name of medical insurance provider:
Name of Dental Insurance provider:
Name of Vision Insurance provider:
Information about Non-Joint Children

Rows	Name of Child	Date of Birth	Age	Names of Parents
1
2
3
4

MARITAL ASSETS
List all assets or interests belonging to one or both spouses, whether owned by one spouse individually or both spouses jointly. Provide copies of recent statements, appraisals, or other documentation of value where possible. Note that inheritances and gifts belonging to one party alone will be listed under the Separate Property Section later in this worksheet.

A. REAL ESTATE. Include all ownership interests in real property including real estate, land sale contracts, options, life tenancies, leases, cemetery lots, etc.

Rows	Type/Address	Names on Deed	Value	Date and Type of Valuation
1
2
3
4

B. HOUSEHOLD ITEMS AND PERSONAL EFFECTS. Your answers to the questions below will help us to understand whether and how much assistance you will need from us to divide your personal property. In some cases, we will ask you to complete a separate worksheet focusing solely on inventorying and valuing your household items and personal effects.
Do you and your spouse have an agreement regarding how your household items and other personal property should be divided?
If yes, do you believe the personal property division is roughly equal?
Do you believe one of you owes the other money in exchange for receiving more of the personal property?
If yes, please describe how much you think is owed and why.
If you do not have an agreement, are there any items in dispute valued at over $500?
If yes, please briefly list the items you believe will be in dispute.
4

C. VEHICLES. If a vehicle has been appraised within the last six months, please use that value below and attach a copy of the appraisal. Otherwise, please go to kbb.com to obtain a Kelly Blue Book report showing the value of the vehicle if sold to a private party and the appropriate condition. Please submit a copy of that report.

Rows	Year/Make/Model	Party on Title	Value	Date and Type of Valuation
1
2
3
4

D. Cash and Bank Accounts. Include information about cash on hand available to either party if over $500.

Rows	Name of Institution/Last 4 Digits of Account Number	Owner	Balance	Date
1
2
3
4
5
6
7
8

E. RETIREMENT BENEFITS.

Rows	Benefit Owner and Type of Benefit	Plan Administrator	Value	Date of Value	Check if benefit is in payout status.
1
2
3
4
5
6

Has either party taken a loan against any of the retirement benefits listed above?
Should be Empty:

INFORMATION ABOUT YOU AND YOUR SPOUSE

Information about you

Information Required for Oregon Health Authority Vital Statistics Form

Information about Your Spouse

Information Required for Oregon Health Authority Vital Statistics Form

Information about Your Children

Information about All Children Born to You and Your Spouse

Information about Non-Joint Children

MARITAL ASSETS