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Why Should I Hire Russell Lloyd

What Your Lawyer Needs to Know Form

WHAT YOUR LAWYER NEEDS TO KNOW
Download as PDF file

Referring Party Date of Interview
Client’s Name State of Birth
Address Date of Birth
  Home Phone
Length of Residence Race
SSN Number of Times Married
Employer Prior Divorce
Address Work Phone Number
  Length of Employment
Job Title Education
  Gross Income
Date of Marriage County of Marriage
Separation Date Pregnant?
Maiden Name Health Status

OPPOSING PARTY INFORMATION

Name State of Birth
Address Date of Birth
  Home Phone
Length of Residence Race
SSN Number of Times Married
Employer Prior Divorce
Address Work Phone Number
  Length of Employment
Job Title Education
Pregnant? Gross Income
Maiden Name Health Status

NAMES, AGES and BIRTH DATES of CHILDREN

Name Age Birth Date
Name Age Birth Date
Name Age Birth Date
Name Age Birth Date
Name Age Birth Date

YOU

Are any of the children from a prior marriage?
Yes
No
If so, who are they and are their any obligations?
Does any child(ren) have special educational needs?
Yes
No
Does any child(ren) have special medical needs or chronic conditions?
Yes
No

YOUR SPOUSE

Are any of the children from a prior marriage?
Yes
No
If so, who are they and are their any obligations?
Does any child(ren) have special educational needs?
Yes
No
Does any child(ren) have special medical needs or chronic conditions?
Yes
No

CUSTODY ARRANGEMENTS, PLACE of RESIDENCE for PAST FIVE YEARS:

 
 
 
 

NON-MARITAL PROPERTY:

 
 
 
 

MARITAL PROPERTY

Real Estate:
Location Value Mortgage Payments
       
       
       
       

PERSONAL PROPERTY:

Savings
Certificates of Deposit
Pension Plan
Stock
Credit Union
Bonds
Bank Accounts
Other

VEHICLES

Year Make/Model Value Lien Payments
         
         
         
         

INCOME FROM ALL WORK SOURCES and WORK HISTORY

Husband:
 
 

Wife:
 
 

DEBTS

Creditor Amount
   
   
   
   

LIFE INSURANCE POLICIES

Company Face Value Cash Value
     
     
     
     

GENERAL

Any use of a prior attorney?
Yes
No
Has there been any period of separation?
Yes
No
How long?
Do you have access to marital funds or other money?
Yes
No
Do you have access to family financial records?
Yes
No
Would your spouse hide or dispose of any assets?
Yes
No
Would your spouse remove children without permission?
Yes
No
Has your spouse ever committed a crime?
Yes
No
If so, what was the arrest for?
Has your spouse ever been in jail or prison?
Yes
No
If so, what for?
Any illegal drug use?
Yes
No
Any hospitalization or enrollment in a drug rehab program?
Yes
No
Any abuse of prescription drugs?
Yes
No
Any alcohol abuse?
Yes
No
Any hospitalization or enrollment in a alcoholic rehab program?
Yes
No
Any gambling problems?
Yes
No
Any suicide attempts?
Yes
No
Ever been hospitalized for any emotional or psychiatric problems?
Yes
No
Received any therapy for emotional or psychiatric problems?
Yes
No
Physically abused the other party?
Yes
No
Any extramarital sexual relationship of which the child(ren) are aware?
Yes
No
Any pregnancy outside the marriage?
Yes
No
Any termination of parental rights?
Yes
No
Any pornographic participation issues?
Yes
No
If so, is it accessible to child(ren)?
Yes
No
Any guns, knives or other weapons?
Yes
No
If so, is it accessible to child(ren)?
Yes
No
Any existing Agreements between the parties?
Yes
No
If so, what type – Alimony Prenuptial Martial

TANGIBLE ASSETS

Awards or Judgments
Blueprints Brand names
Broadcast licenses
 Buy-sell agreements Chemical formulations
Computer software
 Computerized databases Cooperative agreements
Copyrights
 Customer lists Development rights
Distribution rights
 Drilling rights Easements
Employment contracts
 FCC rights Film libraries
Franchise agreements
 Joint ventures Laboratory notebooks
Leasehold interests
 Literary works Manuscripts
Marketing & promotional materials
 Mineral rights Musical compositions
Noncompete agreements
Patent applications Permits
Prizes and awards
Product designs Proprietary products and processes
Regulatory approvals
 Retail shelf space Royalty agreements
Security interests
 Shareholder agreements Subscription lists
Technical documentation
 Technology sharing agreements Trade secrets
Trademarks and tradenames
 Use rights – air, land, or water Work in progress
Airplanes
 Antiques/heirlooms Artworks
Burial plots
 Business interest China, silver, crystal
Collections
 Debentures Farm assets
Furs
 Jewelry Musical instruments
Pets
 Precious metals Prepaid obligations
Rental property
 Time share property Vacation property
Stereo
 Television Boat or trailer
Wine or liquor collection
    

EXPENSE INVENTORY

Any alimony payments required by prior decree?
Yes
No
Any car or lease payments?
Yes
No
Any food and household supplies?
Yes
No
Any expenses for the child(ren)?
Yes
No
Any clothing expenses?
Yes
No
Any donations?
Yes
No
Any entertainment expenses?
Yes
No
Any housing expenses?
Yes
No
Any installment payments due?
Yes
No
Any incidentals?
Yes
No
Any insurance?
Yes
No
Any medical?
Yes
No
Any membership dues?
Yes
No
Any transportation costs?
Yes
No
Pet care?
Yes
No
Professional services?
Yes
No
Reserve for replacement items?
Yes
No
Retirement fund?
Yes
No
School expenses for you or child(ren)?
Yes
No
Support payments from prior decree?
Yes
No
Any taxes?
Yes
No
Any utilities?
Yes
No
Any vacations?
Yes
No
Any visitation expenses?
Yes
No

MONTHLY LIVING EXPENSES SCHEDULE

Rent
  
Food/Groceries
  
Mortgage   Doctor  
Property Taxes   Dentist  
House Maintenance   Prescription Drugs  
LG&E   Eyeglasses, Hearing  
Fuel Oil   Auto Liability Insurance  
Telephone   Hospitalization  
Water   Life Insurance  
Garbage Collection   Other Insurance  
Sewage   Professional Dues  
Yard Expenses   Social Clubs  
Vet & Pet Food   Newspapers  
Maid Services   Magazines & Books  
Car Payment   Barber & Beauty Shop  
Gas & Oil   Cosmetics, Personal Hygiene  
License Tag   Clothing  
Automobile Repairs   Uniforms  
Other Transportation   Dry Cleaning  
Church & Charity   Other:  
Entertainment      

TOTAL MONTHLY EXPENSES (both Columns) __________________
(does NOT include debts)

 

 

 

 

(502) 540-5700 • 600 West Main Street • Louisville, Kentucky 40202
This is an advertisement. The Kentucky Bar Association does not recognize specialties in the practice of law.
© J. Russell Lloyd, P.S.C. 2006