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GEORGIA UNCONTESTED DIVORCE AND MARITAL AGREEMENT INFORMATION

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This form is an information form/questionnaire provided to you by the law firm of ROWEN & KLONOSKI, P.C. in order to obtain information necessary to prepare and file an uncontested divorce. It is not meant to provide legal advice to you. Nor is it intended to form an attorney/client relationship between our law firm and yourself. Rather, this form is provided to help potential clients understand the categories and range of information necessary to properly provide divorce attorney advice. In an uncontested divorce, the plaintiff and defendant must have reached an agreement regarding all issues of child custody, support, visitation, and equitable division of property and debt division. An attorney can only represent one of the parties, even in an uncontested divorce. The marital separation agreement will be incorporated into the final judicial divorce decree. Please note that a filing fee is required by the Superior Court to file for a divorce. If you have minor children, a seminar for divorcing parents is required by the Superior Court before a final decree may be issued. Attendance is required of both parties in the divorce, but you may attend separate seminars. A separate fee will be assessed for the seminar that you will pay directly to the County.

I. HUSBAND - GENERAL INFORMATION

_____________________________________________________

(Legal Name including suffixes (Jr., Sr., III, etc.))
_____________________________________________________

Street (including Apartment #)
___________________________, __________ ___________ ____________

City State Zip County

DOB: ________________ U.S. Citizen: _________ YES ____________ NO

Telephone: ____________________________________ _(work)
_____________________________________ (home)
_____________________________________ (cell)
_____________________________________ (fax)

E-mail: _____________________________________

Specify whether the husband is plaintiff or defendant: ______________________

Number of marriages prior to this marriage : ___________ ____
(None, 1, 2, 3, etc.)

II. WIFE - GENERAL INFORMATION

_____________________________________________________

(Legal Name)
_____________________________________________________

Street (including Apartment #)
___________________________, __________ ___________ ____________

City State Zip County

DOB: ________________ U.S. Citizen: _________ YES ____________ NO

Telephone: ____________________________________ _(work)
_____________________________________ (home)
_____________________________________ (cell)
_____________________________________ (fax)

E-mail: _____________________________________

Specify whether the wife is plaintiff or defendant: ______________________

Number of marriages prior to this marriage : ___________ ____
(None, 1, 2, 3, etc.)

Wife's Maiden Name ____________________________________.

Does the Wife want her maiden name restored after the divorce? _____ YES _____ NO

III. JURISDICTION

Date of this Marriage: _______\_______\_______
Day Month Year

Date of Separation: ______\_______\_______
Day Month Year

Length of time Husband has resided in state (years and months) __________________

Length of time Husband has resided in county (years and months) __________________

Length of time Wife has resided in state (years and months) __________________

Length of time Wife has resided in county (years and months) __________________

IV. CHILDREN - GENERAL INFORMATION

How many children as issue do you have from this marriage? __________

Name: _____________________________ DOB: _______ M ____ F_____

(Legal Name including middle name)
Name: _____________________________ DOB: _______ M ____ F_____

(Legal Name including middle name)
Name: _____________________________ DOB: _______ M ____ F_____

(Legal Name including middle name)
Name: _____________________________ DOB: _______ M ____ F_____

(Legal Name including middle name)
Name: _____________________________ DOB: _______ M ____ F_____

(Legal Name including middle name)

CUSTODY

Have said Children resided with the plaintiff and defendant since birth? ______ YES _____ NO

Have any other proceedings other than this divorce ever been initiated concerning the custody of said children? ______ YES ______ NO

Does the Plaintiff know of any individual other than the parties to this action who have any claim of custody or visitation rights concerning said Children? ______ YES ______ NO

At the present time, the minor children are living with: ________________________________.

Legal custody of the children should be granted to: ___________________________________
(Mother, Father, Joint, etc.)

Physical custody of the children should be granted to:_________________________________
(Mother, Father, etc.)

CHILD SUPPORT

The gross income of the father: $ ___________________ per month.

The gross income of the mother: $ ___________________ per month.

Monthly child support Husband will pay to the Wife? $_________________________

Monthly child support Wife will pay to the Husband? $ ________________________

In this case child support is being determined for _____________________child(ren).
(Number, 1,2,3, etc.)

CHILD SUPPORT GUIDELINES

The applicable percentage of gross income to be considered is

Number of Children Percentage Range of Gross Income
1 17% to 23%
2 23% to 28%
3 25% to 32%
4 29% to 35%
5 or more 31% to 37%

Child support cannot be less than the minimum amount required by the State of Georgia, unless special circumstances exist. Check below any special circumstances that would warrant deviation from the Georgia child support guidelines:

1. Ages of Child(ren).

2. A child(ren)'s extraordinary medical costs or needs in addition to accident and sickness insurance, provided that all such costs or needs shall be considered if no insurance is available.

3. Educational costs.

4. Day-care costs.

5. Shared physical custody arrangements, including extended visitation.

6. A party's other support obligations to another household.

7. Income that should be imputed to a party because of suppression of income.

8. In-kind income for the self-employed, such as reimbursed meals or a company car.

9. Other support a party is providing or will be providing, such as payment of a mortgage.

10. A party's own extraordinary needs, such as medical expenses.

11. Extreme economic circumstances including but not limited to:
a. Unusually high debt structure; or
b. Unusually high income of either party or both parties, which shall be construed as individual gross income of over $75,000.00 per annum.

12. Historical spending in the family for children which varies significantly from the percentage table.

13. Considerations of the economic cost of living factors of the community of each party

14. In-kind contribution of either parent.

15. The income of the custodial parent.

16. The cost of accident or sickness insurance coverage for dependent children included in the order.

17. Extraordinary travel expenses to exercise visitation or shared physical custody.

18. Any other factor, as described below:
____________________________________________________________________________
___________________________________ ________________________________________

HEALTH INSURANCE

_______________________ will retain children as dependents on health insurance available
(Husband/Wife) through his/her employment; OR

_______________________ will continue to maintain medical insurance on the children.
(Husband/Wife)

TAX RETURNS

______________________ will be able to claim the children as dependents and exemptions
(Husband/Wife) on his/her tax returns.

LIFE INSURANCE

Life insurance maintained for benefit of children:

by Wife _______________________________________ $_________________
Company Amount

by Husband _______________________________________ $______________
Company Amount

VISITATION

Non custodial parent should have reasonable visitation, and at a minimum on the following set schedule:

Every other weekend: ___________________________________________________.________
___________________________________________________________

Holidays: ___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

Birthdays: ___________________________________________________________

Weeks in summer: ___________________________________________________________

Other: ___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

ALIMONY

Neither party will pay alimony. ___________ OR

___________________ will pay alimony for specific time period:
(Husband/Wife) $____________ ___________________________________
Amount Time period

V. DIVISION OF MARITAL PROPERTY/MARITAL DEBT

MARITAL RESIDENCE:

Value of home: $______________________________

Balance owed on home: $______________________________

Address:
________________________________________________________________________

Street (including Apartment #)
___________________________, __________ ___________ ____________
City State Zip County

SALE OF RESIDENCE

Marital home will be sold __________ YES __________ NO

______________________will live in marital home until sold.
(Husband/Wife)

Net proceeds of sale of marital residence will be paid as follows:

In equal shares to Husband and Wife: ____________ YES ____________ NO

If net proceeds are not divided equally, please specify division of property: ____________________________________________________________
_____________________________________________________________

Mortgage and Expenses.

_______________ __ Both parties will pay ½ of mortgage and expenses until property is sold; OR

_________________ will pay mortgage and expenses until property is sold.
(Husband/Wife)

Repairs

_______________ Both parties will pay ½ of repairs until property is sold;
OR

__________________ will pay repairs until property is sold.
(Husband/Wife)

RESIDENCE (IF NOT SOLD)

____________________ will live in the marital home.
(Husband/Wife)

List agreed upon terms for husband/wife to keep the marital home, including re-financing, etc:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

REAL AND PERSONAL PROPERTY (other than marital home)

List all real and personal property that each party will receive including household goods, furniture, clothing, dishes, china, silver, crystal, jewelry, collectibles, books, art work, electronics, tools, guns and other items of value):

Husband: (Continue on separate sheet if needed)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Wife: (Continue on separate sheet if needed)
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

AUTOMOBILES

Husband:

Make ______________________________ Model___________________ Year ______
Titled in name of _________________________________________________________

Make ______________________________ Model __________________ Year ______
Titled in name of _________________________________________________________

Wife:

Make ______________________________ Model___________________ Year ______
Titled in name of _________________________________________________________

Make ______________________________ Model ___________________ Year _____
Titled in name of _________________________________________________________

DEBTS

Please list all joint debts, balance owed and who will assume debt:

Debt Balance Responsible Party
___________________________________ $ __________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________

Please list any other debts and the responsible party to repay the debt. Include credit cards not listed above.

Debt Balance Responsible Party

Husband:
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________

Debt Balance Responsible Party

Wife:
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________

RETIREMENT ACCOUNTS

Will husband and wife keep his/her own retirement benefits? _________ YES __________ NO

If a retirement account is to be divided between the parties, attach a recent statement.

BANK ACCOUNTS

List all checking, savings and brokerage accounts and specify how they will be divided:

Account/Number Amount Distribution
_______________________________ $___________ ________________________
_______________________________ $___________ ________________________
_______________________________ $___________ ________________________
_______________________________ $___________ ________________________
_______________________________ $___________ ________________________
_______________________________ $___________ ________________________

PARENTING SEMINAR

Contact the Superior Court in your county for registration materials and dates.

Clayton County 770-477-4575

Cobb County 770-528-1813 (questions)
770-528-1809 (register by telephone)

DeKalb County 404-371-4953

Fulton County 404-730-4618

Gwinnett County 770-822-8583 (questions)

Ninth District 770-535-3909
(Hall, Cherokee, Forsyth)

This form is the property of Rowen & Klonoski, P.C., and is copyright protected 2004.

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