ALIMONY AND POST SEPARATION SUPPORT RECEIVABLE QUESTIONNAIRE

Your answers to the following questions are completely CONFIDENTIAL and falls under ATTORNEY-CLIENT-PRIVILEGE. This information will not be shared with anyone other than those working on your case. Your response to these questions now will help organize your case and save litigation expenses in trying gather and assemble information after the case is in progress.

Please fill out this questionnaire completely and honestly and return it to our office as soon as possible. It is imperative that you are open and honest with your answers so that we may serve you to the best of our abilities. You should answer all questons relevant to your case. If a question is not relevant, please mark the question "N/A".

Name*

First NameLast Name

Your Email*

example@example.com

Cell Phone Number*

Please enter a valid phone number.

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone Number (if any)

Please enter a valid phone number.

Driver's License No.:             State:     Street Address
Social Security Number:
Birthday:   Date       City of Birth:

Current Employer:
Current Employer's Phone Number:          Area Code   Phone Number
Current Employer's Address:  Street Address   Address Line 2   City   State   Zip
Current Salary: $      Current Position:
Current Employer Hire Date:

Please state your employment history for the last five (5) years, including place of employment, position, ending salary, dates of employment and reason for leaving:

	Employer	Position	Ending Salary	Start Date	End Date	Reason for Leaving
Job 1
Job 2
Job 3
Job 4
Job 5

Please provide your residence address for last five (5) years, include all addresses, dates of residence and reason for leaving.

	Address	Move In Date	Move Out Date	Reason for Leaving
Residence
Residence
Residence
Residence
Residence

Prior Marriage(s):   First Name   Last Name ;     First Name   Last Name

Names and Birth Dates of Children of Prior Marriage:
1)   First Name   Last Name    DOB:   Date
2)   First Name   Last Name    DOB:   Date
3)   First Name   Last Name    DOB:   Date

Date of Marriage to Present Spouse:   Date
Place of Marriage:

Are you currently separated from your spouse?*

*To be considered legally separated from your spouse, you need to be living in different homes, and at least one of you needs to intend that the separation be permanent. In general, you are not legally separated if your relationship has ended but you still live in the same home, or if you live in separate homes without the intent to be permanently separated (for example, for work purposes).

If Yes, what is your date of separation?

Date

Spouse Name:   First Name   Last Name
Mailing Address:      Street Address   Address Line 2   City   State   Zip
Email Address:
Home Telephone No.:   Area Code   Phone Number
Cell Phone:    Area Code   Phone Number
Driver's License No.:             State:
Social Security Number:
Date of Birth:   Date       City of Birth:

Employer:
Employer's Phone Number:          Area Code   Phone Number
Employer's Address:  Street Address   Address Line 2   City   State   Zip
Salary: $      Position:
Length of Time with Present Employer:

Prior Marriage(s):   First Name   Last Name ;     First Name   Last Name

Names and Birth Dates of Children of Prior Marriage:
1)   First Name   Last Name    DOB:   Date
2)   First Name   Last Name    DOB:   Date
3)   First Name   Last Name    DOB:   Date

Did you or your spouse do any of the following?

	You	Your Spouse
Engage in illicit sexual behavior?
Cause a separation through criminal activity?
Abandon the other spouse (by moving out of your home)?
Constructively abandon the other spouse (withdraw of love, affection, companionship, sex)?
Force the other spouse out of the house?
Endanger or treat the other spouse cruelly?
Render the condition of the other spouse intolerable through indignities (mental cruelties)?
Spend income of either party recklessly, waste or conceal assets, or destroy property?
Use alcohol in a manner that rendered the life of the other spouse intolerable?
Use drugs in a manner that rendered the life of the other spouse intolerable?
Fail to provide necessary subsistence according to the means of the family?

Were you substantially dependent upon your spouse for maintenance and support during the marriage?

If yes, provide details.

Generally, describe what expenses you usually paid from your earnings, and what was paid from your spouse's earnings.

Are you in need of maintenance and support from your spous?

If YOU are SEEKING ALIMONY, please complete the following questions.

If you believe your spouse may seek alimony, skip this section and answer the appropriate questions starting with: If you believe YOUR SPOUSE MAY SEEK ALIMONY:

In your opinion, should the length of your marriage affect the amount and duration of your support? If so, why?

If you indicated on the Alimony and Post Separation Support Questionnaire that your spouse engaged in marital misconduct, was the behavior recent? (Marital misconduct included illicit sexual behavior, cruel behavior, reckless spending of marital assets, excessive alcohol use, refusal to purchase necessities, etc.)

Please describe any of your physical and emotional conditions that should affect the amount or duration of support granted.

Please describe your spouse's physical and emotional conditions.

Please describe the earning capacities of both your spouse and yourself. Base your answer on current and past jobs, training, education, etc.

Did you assist your spouse financially, or with necessary tasks (childcare or housekeeping for example), while he/she was in school or job training? Please explain in detail.

If the care of a minor child will affect your ability to support yourself, please explain how this applies to your case.

Will your standard of living, as established during the marriage, be significantly changed if support is not received?

What homemaking activities did you engage in during the marriage?

What level of education did your spouse attain?

What level of education have you attained?

Will you need to train before starting a new job?

How long do you anticipate looking for a new job before being employed?

Please describe the monthly payments made by you and your spouse on debts, including legal obligations of support (i.e. Payments to previous spouses or children).

Was property gained prior to marriage contributed to the marriage?

Please explain your monthly financial needs that are not apparent from the budget affidavit.

Are there any other factors that will affect your economic situation?

If you believe YOUR SPOUSE MAY SEEK ALIMONY, please complete the following questions. The questions reflect factors that affect the amount and duration of alimony according to the NC Statutes.

In your opinion, should the length of your marriage affect the amount and duration of your support to your spouse?

If you indicated on the Alimony and Post Separation Support Questionnaire that either of you engaged in marital misconduct, was the behavior recent? (Marital misconduct included illicit sexual behavior, cruel behavior, reckless spending of marital assets, excessive alcohol use, refusal to purchase necessities, etc.)

Please describe any of your of your spouse's physical and emotional conditions that should affect the amount or duration of support granted.

Please describe your physical and emotional conditions.

Please describe the earning capacities of your spouse and yourself. Base your answer on current and past jobs, training, education, etc.

Did your spouse financially support you, or with necessary tasks (childcare or housekeeping for example), while you were in school or job training? Please explain in detail.

If the care of a minor child will affect your spouse's ability to support themselves, please explain how this applies to your case.

Will your spouse's standard of living, as established during the marriage, be significantly changed if support is not received?

What homemaking activities did your spouse engage in during the marriage?

Was your spouse a homemaker?

What level of education did you attain?

What level of education did your spouse attain?

Will your spouse need to train before starting a new job?

Does your spouse wish to return to school before assuming a new job?

Please describe the monthly payments made by you and your spouse on debts, including legal obligations of support (i.e. Payments to previous spouses or children).

Was property gained prior to marriage contributed to the marriage?

Explain your spouse's monthly financial needs that are not apparent from the budget affidavit.

Are there any other factors that will affect your spouse's economic situation?

ALIMONY AND POST SEPARATION SUPPORT RECEIVABLE QUESTIONNAIRE

BACKGROUND INFORMATION

BACKGROUND INFORMATION

YOU ARE SEEKING ALIMONY

YOUR SPOUSE MAY SEEK ALIMONY