Baton Rouge Attorney Law Firm

Family Law Intake Form

Your Information:

Name (first middle maiden last)
Adddress:
City:
State:
Zip:
Email:
Parish of Residence:
Home Telephone:
Work Telephone:
Cell Telephone:

Spouse's Information:

Name (first middle maiden last)
Adddress:
City:
State:
Zip:
Email:
Parish of Residence:
Home Telephone:
Work Telephone:
Cell Telephone:

Marriage Information:

Date of Marriage:
Place of Marriage:
Did you have a prenuptial agreement?
Did you have a conenant marriage?
When did you separate? (month day year)
Where did you last live together? (city parish state)
Were any children born of the marriage? (y/n)

list all children of the marriage:
(Name, Date of Birth, Age)

Income:

Your income before taxes:
Your spouse's income before taxes:

List all property of the marriage:
(Item, value, amount owed)

List all debts incurred during the marriage:
(Creditor, Amount)

Other:

Do you or your spouse have a retirement plan?	Yes No
Do you or your spouse have a 401K plan?	Yes No
Have you and your spouse filed all tax returns?	Yes No
Are you and your spouse current on payment of taxes?	Yes No
Would you like to schedule a free consultation on financial planning for your divorce?	Yes No
Would you like to schedule a free consultation on the income tax consequences of your divorce?	Yes No

Per Louisiana Rule of Professional Conduct 7.4, our description of our fields of practice does not state or imply certification, specialization or expertise in any particular areas of law, unless a particular lawyer listed holds a certification or other expertise recognized by the applicable State Bar or regulatory authority.This web site is designed for general information only. The information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer/client relationship.

© 2006 Losavio & DeJean - 8414 Bluebonnet Blvd. Suite 110, Baton Rouge, LA 70810
Phone (225) 769-4200 - Fax (225) 769-2864 - Toll Free (800) 769-3522
See our blog at losaviodejean.blog.com