1001 Texas Avenue - Suite 500. Houston, TX 77002
Monday - Friday: 8:00am - 5:00pm
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PHONE:
(713) 223-5811
FAX:
(713) 223-1416
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Divorce Information Form
Please fill out all of the information required to the best of your knowledge. The more information you provide, the more we can help you. Please be very specific in your answers.
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Spouse's Info
General Info
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highest level of education
Did Not Complete High School
High School/GED
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Have you consulted or retained any other attorneys on this matter before coming to this office? If so who and when?
Who should we contact in the event of an emergency?
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Emergency Contact Name
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Last Name
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Address
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Alaska
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Arizona
California
Colorado
Connecticut
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Florida
Georgia
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Texas
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State
Please select
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Country
Please select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Northern Mariana Islands
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Race/Ethnicity?
American Indian or Alaska Native
Asian
Black or African American
White/ Caucasian
Hispanic or Latino
Other
Age
Drivers License #
State
Please select
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Employer
Job Title
Employer Address
Work Number
Fax Number
Yearly Salary/Income
Monthly
Bi-Weekly
Other Sources of Income
Length of Employment
highest level of education
Did Not Complete High School
High School/GED
Some College
Bachelor's Degree
Master's Degree
Advanced Graduate work or Ph.D.
Date of Marriage
City
State
Please select
Select 1
Are you now separated from your spouse?
Yes
No
Date of Separation
Have you seen a marriage counselor?
Yes
No
Have you or your spouse lived in Texas for the last six months?
Yes
No
If not, where have you lived?
What county have you lived in for the last 90 days?
Are both you and your spouse a United State Resident or Citizen?
Yes
No
Have your or your spouse ever filed for divorce?
Yes
No
If so, when and where?
Does your spouse or ex-spouse have an attorney?
Yes
No
If so, who (name and phone)?
Have you ever been married before?
Yes
No
If so, how many times?
Do you want to request a waiver of the sixty (60) day waiting requirement? (This is an extra charge of $50.00)
Yes
No
Are you or your spouse currently pregnant?
Yes
No
Do you or your spouse have any other children (other than children between you and your spouse) for whom a duty of support is owed? If so, please provide the following information:
Name
Gender
Male
Female
Date of Birth
Age
Place of Birth
Social Security Number
Name
Gender
Male
Female
Date of Birth
Age
Place of Birth
Social Security Number
Name
Gender
Male
Female
Date of Birth
Age
Place of Birth
Social Security Number
Where and with whom do these children live?
Do you pay/receive child support?
Yes
No
If so, how much?
Does your spouse pay/receive child support?
Yes
No
If so, how much?
Provide the biological father’s information for any child born during the marriage, but not the child of you current spouse.
Name
Date of Birth
Social Security Number
Address
State, City, County of residence
Phone Number
Drivers License #
State
Please select
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Race/Ethnicity?
American Indian or Alaska Native
Asian
Black or African American
White/ Caucasian
Hispanic or Latino
Other
Is their name on the birth certificate?
Yes
No
Are there child support orders in place?
Yes
No
Did the father sign an Acknowledgement of Paternity?
Yes
No
Are there any other children under 18 years of age born to or adopted of the marriage?
Yes
No
Do you or do you or your wife want to change your/her last name back to your/her maiden name? ($35.00 extra charge)
Yes
No
If so, what is your/her maiden name?
Was any community property other than personal effects acquired during this marriage?
Yes
No
Were there any pension plans, retirement benefits, or profits sharing plans acquired during the marriage?
Yes
No
If so, give the names of each
Will each party be responsible for their own debts incurred since the date of separation?
Yes
No
Are you planning on re-marrying within 30 days after your divorce is finalized?
Yes
No
Would you like a thirty (30) day waiting period remarriage? (this is an extra charge)
Yes
No
Has a Protective Order already been issued?
Yes
No
Have you are your spouse filed for bankruptcy?
Yes
No
If so, when?
What type of bankruptcy was filed
Chapter 7
Chapter 13
Is the bankruptcy currently pending?
Yes
No
Important Issues
Will you or a child suffer harassment, abuse, serious harm, harm to health, or injury if information about your address (or the address of your child), your telephone numbers, the name of your employer, the address where you work, or your driver’s license number and social security number were to be released to the opposing party? (§§ 85.007, 105.006, 152.209(e), TFC)
Yes
No
Has the Office of the Attorney General ever been a party to a suit or an advocate in a suit concerning financial support of one or more of your children?
Yes
No
Has any child in your family been the recipient of TANF (formerly AFDC) or been covered by Medicaid?
Yes
No
ONLY ANSWER THE FOLLOWING IF YOU HAVE CHILDREN WITH YOUR SPOUSE
Childs Full Name
Gender
Male
Female
Date of Birth
Place of Birth
Social Security Number
Living with father or mother?
Mother
Father
Childs Full Name
Gender
Male
Female
Date of Birth
Place of Birth
Social Security Number
Living with father or mother?
Mother
Father
Childs Full Name
Gender
Male
Female
Date of Birth
Place of Birth
Social Security Number
Living with father or mother?
Mother
Father
Childs Full Name
Gender
Male
Female
Date of Birth
Place of Birth
Social Security Number
Living with father or mother?
Mother
Father
Childs Full Name
Gender
Male
Female
Date of Birth
Place of Birth
Social Security Number
Living with father or mother?
Mother
Father
Will there be a dispute over the children?
Yes
No
If not, with whom will custody be?
Mother
Father
Where and with whom are the children living now?
Mother
Father
Spouse’s monthly earnings
Is your spouse willing to pay child support?
Yes
No
If so, how much?
If not, why not?
Are the children covered by health insurance?
*
Yes
No
Is the insurance provided through the employer?
Yes
No
Which parent covers the children?
Mother
Father
Insurance Company
Policy #
Monthly Premium
Have you and your spouse reached on agreement regarding the amount of child support that he/she will pay?
Yes
No
If so, what amount?
Are the children covered by Medicaid or CHIPS?
Yes
No
Please provide information as to how you want to divide property.
Please provide information as to how you want the issues regarding the children resolved. (Custody, child support amount, health insurance, and visitation and access)
Submit
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