Date of marriage:

Date of separation:

Home $:

Vehicle(s) $:

Investment / Vacation Property $:

Stocks / Bonds $:

Cash / Savings / Checking $:

Other:

Credit Card $:

Mortgage $:

Vehicle Loan(s) $:

Personal Loan $:

Medical Bills $:

Rental Unit $:

IRS $:

Other:

Your Age:

Occupation:

The other parent or spouse's occupation is:

The other parent or spouse's gross annual income is:

Number of children:

Age of child/children:

How well do you understand your legal situation or issue? Please select the statement that best applies to your situation:

I understand my legal issue.

I have a couple of questions.

I have a lot of questions.

Gross annual income:

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