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  DIVORCE INTAKE FORM ONE

Please note: you are now initiating the order process. At the completion of this form, you will be asked to provide credit card information. Although you may choose to contact our staff and provide this information by telephone, your order cannot be processed until we have credit card data on file. Thank you for your cooperation with this policy.

Complete this form if you have no property and/or children and you and your spouse are in agreement on these issues and your spouse will sign. If you have any questions, please call
1-800-896-4966

Do not leave any fields blank, use N/A if the question does not apply.

Provide Your Information

Full Name:

Street Address:

City:

County:

State:

Zip:

Work Phone:

Home Phone:

Email: (optional)

Will your spouse sign the divorce documents or does he/she need to be served by the Sheriff?

Provide Your Spouse's Information

We will NOT contact your spouse.

Spouse's Name:

Street Address:

City:

State:

Zip:

Work Phone:

Home Phone:

  

 

Provide The Following Marriage Information

Date of Marriage:

Place of Marriage:

Separation Date:

Is Alimony to be Paid?

If yes, please enter the amount:

$

Alimony to be paid by:

To the best of your knowledge, is your combined income with your spouse above or below $50,000/year.

   Above

   Below

  

Wife's Former Name

Wife requests to have former name restored:

Please indicate former name:

  

Payment Information

Billing Address:

City:

State:

Zip:

Card Type:

Master Card  Visa

Card Number:


We cannot complete your divorce until credit card information is provided.

Expiration Date:


Please review all your answers prior to submitting this form. Then press the Submit Form button only once.