ATLANTA DIVORCE LAWYER - ATLANTA DIVORCE ATTORNEY

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

Telephone: ____________________________________ _(work)
_____________________________________ (home)
_____________________________________ (cell)
_____________________________________ (fax)
E-mail: _____________________________________

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: _____________________________________

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

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

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) __________________

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)

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.)

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

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:
____________________________________________________________________________
___________________________________ ________________________________________

_______________________ 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.
.

by Wife _______________________________________ $_________________
Company Amount
by Husband _______________________________________ $______________
Company Amount

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: ___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

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

MARITAL RESIDENCE:

Value of home: $______________________________
Balance owed on home: $______________________________

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

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

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

_______________ __ 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)

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

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

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)
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

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 _________________________________________________________

___________________________________ $ __________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________

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
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________
____________________________________ $__________ ____________

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.

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

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

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

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