Our Questionnaire : Divorce Papers : Divorce Forms : Oregon : Washington State : ParaLegalAlternatives.com

PLEASE BE CERTAIN TO COMPLETE ALL THE INFORMATION.

THIS INFORMATION IS ALL VERY IMPORTANT.

Legal Alternatives, 6442 SE 91st Ave. Portland, Or 97266

Please email or call with any questions. We are here to help.

divorce@usa.com

(503) 772-5295

Your complete legal name:______________________________________________________________

GENDER:___________________

PHONE NUMBER:_________________Drivers License number:_________________State:________

E-mail address:__________________________________(For our communication)

Former and or/maiden names, if any: ___________________________________________________

CURRENT STREET ADDRESS: ___________________________________________________________

_________________________City:_______________________________STATE:_________________ZIP

CODE:___________________.

COUNTY (within the state - NOT COUNTRY) of residence: ________________________________

Your age:_______________________________Date of birth:____________________________________

Social Security number - REQUIRED: _______-_____-________.

SPOUSES FULL LEGAL NAME:___________________________________________________________

GENDER:_____________.

Spouse's phone number: ______________________.

Spouses former and/or maiden names, if any_____________________________________________

Drivers license number (if known)_______________________State:___________________________

CURRENT STREET ADDRESS:___________________________________________________________

____________City:______________________STATE:__________________ZIP CODE:______________

Spouse's County - NOT COUNTRY (within the state) of residence:________________________.

Spouse's age:______________________Date of birth:_________________________

Spouse's Social Security number: - REQUIRED: _______-_____-________

Does either party wish to RESTORE a FORMER name?

If so person? Wife/Husband:____________________________

RESTORE name to:____________________________________________

Date of marriage: Month__________________Day___________Year____________

City of Marriage:_____________________State of Marriage:___________________

Are you presently separated (living apart)?:________________________________

If so approx. date of separation:____________________________________________

Is the wife pregnant?: No:___________Yes:__________

If so when is the child due?: ______________________

Is the husband the father of the child?:__________________

How many CURRENTLY MINOR children were born to this marriage?:_____________

NAME, DATE OF BIRTH, SOCIAL SECURITY NUMBER:

Child's name:___________________________ Birthdate:___/___/____ SSN: ____-___-_____

Do you wish to have JOINT or SPLIT or SOLE custody?: Please check - JOINT:_______

SPLIT:____________SOLE:__________.

If SOLE custody which parent shall have physical custody of the children?:

_______________________________

(This must be agreeable to both parents).

If there is joint custody, what percent of time will the child spend with each parent?

Mother:_____________% Father:_____________%

If SPLIT custody, which child(ren) will live with the MOTHER?: ________________________

______________________________________________________________________________________

If SPLIT custody, which child(ren) will live with the FATHER?:_________________________

______________________________________________________________________________________

Who have the children lived with for the last 6 months?:____________________________

PARENTING TIME/VISITATION SHOULD BE:

(Please be specific with times, days of week, holidays and birthdays.)

______________________________________________________________________________________

Which holidays will the children spend with the father?:____________________________

______________________________________________________________________________________

Which holidays will the children spend with the mother?: __________________________

______________________________________________________________________________________

Will there be any summer or vacation visitation for the non-custodial parent?

If so, explain:

______________________________________________________________________________________

Who will provide medical insurance for the children?

Father:___________ Mother: __________ Both:________

Cost of insurance: $__________________________________Insurance company:______________

______________________________.

Who will pay deductibles and uninsured costs?

Father:________________________ Mother:__________________ Both:_________________

Who will maintain life insurance with the child as beneficiary?

Father: ______Mother: ________Both: __________.

WILL THIS BE A CO-PETITION DIVORCE? (BOTH parties willing to sign).

Yes:___________, Co-Petition - No__________.

or will this be a:

SINGLE PETITION DIVORCE? (one party must have the other party served by a process server

or sheriff - typically).

You DO NOT expect the other party to sign divorce papers voluntarily).

Yes:___________, Single Petition - No:__________.

Below, list the property that should be awarded to each spouse. If property has been divided,

you may state so. (IE: All property currently in parties possession.)

The Husband should be awarded the following property:__________________________________

___________________________________________________________________________________________

The Wife should be awarded the following property:________________________________________

___________________________________________________________________________________________

(PLEASE REMEMBER TO LIST ADDRESSES FOR REAL ESTATE TO BE AWARDED, IF ANY)

OUTSTANDING DEBTS TO BE PAID BY EACH SPOUSE:

THE HUSBAND should pay the following bills:

___________________________________________________________________________________________

The Wife should pay the following bills:

___________________________________________________________________________________________

How long have you been a resident of your state?: _____years, ____months

How long have you lived in your current county?: _____years, ____months

IMPORTANT INFORMATION REQUIRED IF CHILDREN ARE INVOLVED:

This page must be completed if there are minor children born or adopted to this marriage.

Husband's employer:______________________________________________________________________

Complete address of employer: ___________________________________________________________

___________________________________________________________________________________________

Gross MONTHLY pay (before taxes): $_________________________

Husbands MONTHLY take home pay (after taxes): $___________

Wife's employer___________________________________________________________________________

Complete address of employer: ___________________________________________________________

___________________________________________________________________________________________

Wife's gross MONTHLY pay (before taxes)

$__________

Wife's MONTHLY take home pay(after taxes)

$________

Does anyone recieve Spousal Support (Alimony) from a previous marriage?

If so who:_________________________________________. How much per month? $_______________

Does either party WISH to receive SPOUSAL MAINTENANCE as a result of this divorce?

Yes__________ No__________

If so, who:_________. How much per month? $______________, and for how long? TOTAL number

of MONTHS:____________________. For a TOTAL dollar amount of:________________________

(You must list a specific number of months adn total dollar amount.)

Does anyone RECEIVE child support from a previous marriage or relationship?

If so, who?:____________________________and how much per month?:______________________

Does anyone PAY child support from a previous marriage or relationship?

If so, who?:____________________________and how much per month?:______________________

Are there any Day Care costs paid Out-Of-Pocket relating to the children of this marriage?

Yes:_________________ NO:___________

If so, how much?: $___________who pays DAY CARE costs?:_______________________

Is there, or will there be, health insurance coverage for the children of this marriage?

Yes:____________ NO:___________ NOT AVAILABLE:_____________________

If so, what is the cost each month paid directly OR deducted from payroll? - IMPORTANT-

$_______________________________

Who pays or will be paying for health insurance? Mother:______________

Father:_____________________

Does either spouse recieve welfare? If so, who/Father_________or/mother____________

How much per month? $___________.

Where did you hear about our service, please?

Internet:__________Printed ad:____________Referral:__________Other:____________________

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I (we) hereby request that Legal Alternatives prepare our uncontested divorce.

I (we) understand that Legal Alternatives employees are not lawyers, they are independant paralegals.

We agree and attest that no legal advice has been given to us.

We have chosen of our own free will to have Legal Alternatives fully prepare these documents for a fee.

We have selected the forms and provided all the information used in our divorce documents.

Signed:_____________________________________________

Date:_______________________________________________

Signed:_____________________________________________

Date:_______________________________________________

After completing this form, Please print-out and please return signed questionnaire and

our fee to:

Legal Alternatives, 6442 SE 91st Ave. Portland, Or 97266

Please include payment or make arrangements by phone!

(503) 772-5295

Legal Alternatives, 6442 SE 91st Ave. Portland, Or 97266

Thank you for using our services!