The Law Office of WLP

Divorce Questionnaire

The Law Office of Whitney L. Thompson, PLLC Please complete this questionnaire. If you spend the time to complete all items, you will give us the background information necessary to begin to understand the complexity of the personal aspects of your case. All information will be held in strict confidence.
Today's Date *

Month Day Year Date Picker Icon
Client's Name *

First Name Last Name
Client: Have you used any other alias names? *

Yes No
If Yes, list of other alias names. *
Client's DOB *

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Client's Age *
Please enter your current age.
Client's Sex *

Female Male
Client's Place of Birth *
City, Texas
Client: Do you have a Driver License Number? *

Yes No
Client's Driver License Number *
Do not use any dashes or other symbols
Client: Are you a US Citizen *

Yes No
Client: Do you have a SSN? *

Yes No
Client's SSN *
This information will be kept confidential. Do not use any dashes or other symbols

Client's Current Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

What County do you reside in? *
How long have you resided in your County?
How long have you lived in Texas?
Do you want to receive mail from our office to a different address? *

Yes No

Client's E-mail Address *
Enter an email address you would like to be contacted at about your case.
Client's Phone Number *

Area Code Phone Number
Client's Highest Education Level: *
Client: Are you employed? *

Yes No
Client: When was your last employer and with who? *
Name of last employer & when
Client: How long have you been employed with your current employer? *
years or months
Client's Employer's Name *
Client's Supervisor's Name *
Current Employer Supervisor
Monthly Net Income (after taxes) *
Client's Job Title: *
Client's Work Number *

Area Code Phone Number

Information About Spouse
Spouse's Full Name *

First Name Last Name
Spouse: Has your spouse used any other alias names? *

Yes No
If Yes, list the other alias names used *
Spouse's DOB *

Month Day Year Date Picker Icon
Spouse's Age *
Spouse's Place of Birth *
City, State
Spouse: Does your spouse have a Driver License Number? *

Yes No
Spouse: Driver License Number *
Please do not use dashes.
Spouse: US Citizen? *

Yes No
Spouse: Does your Spouse Have a SSN? *

Yes No
Spouse: SSN *
Please do not use dashes.

Spouse's Address: *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Spouse's Phone Number *

Area Code Phone Number
Spouse's Highest Education *
Is Your Spouse Employed? *

Yes No
Spouse's Job Title *
Name of Spouse's Employer: *

Spouse's Employer's Phone Number *

Area Code Phone Number
Spouse's Net Monthly Income (after taxes) *
Information About Marriage
Date of Marriage *

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Place of Marriage *
Date of Separation *

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Are you seeing a marriage counselor or any other counselor? *

Yes No
If Yes, state the counselor's name *
Are you requesting a name change? *

Yes No
What is your religious preference? *
What is your spouse's religious preference? *
If Yes, list the name you are requesting *

First Name Last Name

Are any of the following marital difficulties involved in your marriage? *

	Myself	Spouse	Neither	Both
Illegal Drug/Alcohol
Sexual Disappointment
Sexual Infidelity
Financial Disputes
Physical Violence
Religion
Incompatibility
Mental Health Issues
Committed a Felony
Been Arrested
Been in Jail or Prison
Prescription Drugs
Arrested for DWI
Arrested for DUI
Gambling (legal or illegal)
Attempted Suicide
Hospitalize for Emotional or Psychiatric Treatment
Child Abuse
Adultery
Homosexual relationships
Engaged in Unusual Sexual Preferences
Pregnancy Outside the Marriage
Venereal Disease

Please describe any of the difficulties you below: *
Provide as much detail as possible.
Does your spouse have an attorney now? *

Yes No
If Yes, who? *
Have you or your spouse ever filed for divorce? *

Yes No
If Yes when and where? *
Have you ever been married before? *

Yes No
If Yes, how many times? *
Has your spouse ever been married before? *

Yes No
If Yes, how many? *
Children Born During Marriage

Please only include children who are under the age of 18 years of age
Are there any children who are under the age of 18 who were born during the marriage? *

Yes No
(1) Name of Child *

First Name Last Name
(1) Sex of the Child *

Female Male
(1) DOB of the Child *

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(1) Place of Birth of the Child: *
City, State
(1) Child's SSN *
Please do not include any dashes.
(1) Do you need to list another child? *

Yes No
(2) Name of Child *

First Name Last Name
(2) Sex of the Child *

Female Male
(2) DOB of the Child *

Month Day Year Date Picker Icon
(2) Place of Birth of the Child: *
City, State
(2) Child's SSN *
Please do not include any dashes.
(2) Do you need to list another child? *

Yes No
(3) Name of Child *

First Name Last Name
(3) Sex of the Child *

Female Male
(3) DOB of the Child *

Month Day Year Date Picker Icon
(3) Place of Birth of the Child: *
City, State
(3) Child's SSN *
Please do not include any dashes.
(3) Do you need to list another child? *

Yes No
(4) Name of Child *

First Name Last Name
(4) Sex of the Child *

Female Male
(4) DOB of the Child *

Month Day Year Date Picker Icon
(4) Place of Birth of the Child: *
City, State
(4) Child's SSN *
Please do not include any dashes.
Who are the children living with now? *

Myself My spouse Other
Will there be a dispute over the children? *

Yes No
If there is No dispute over the children, who will the children live with at the end of the divorce? *

Myself My spouse
(if necessary please bring in a separate sheet of paper with additional names and information).
Is the wife current pregnant? *

Yes No
Is the husband the biological father of all of the children born during the marriage? *

Yes No
If the husband is NOT the biological father of all of the children born during the marriage, explain: *
Explain who is the biological father of the child(ren)
Do you and/or your children have health insurance? *

Yes No
If Yes, please provide the following information below: 1. Health Insurance Company 2. Policy Number 3. Source of Insurance 4. Cost of Premium and 5. Who pays the Premium each month
Please provide as much information as possible. This information is needed for the court.
Do the children own any property other than (clothing or furniture)? *

Yes No
If Yes, please list all property. *
Please provide as much detail as possible.
Children Before or Outside of the Marriage

Please list all children before our outside of the marriage from either you or your spouse.
Did you or your spouse have any children before or outside of the marriage? *

Yes No
(1) Child's Name *

First Name Last Name
(1) Child's Gender *

Female Male
(1) Child's DOB *

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(1) Child's Place of Birth *
(1) Do you know the child's SSN? *

Yes No
(1) Child's SSN *
(1) Who does the child's reside with? *
(1) Do you need to list another child? *

Yes No
(2) Child's Name *

First Name Last Name
(2) Child's Gender *

Female Male
(2) Child's DOB *

Month Day Year Date Picker Icon
(2) Child's Place of Birth *
(2) Do you know the child's SSN? *

Yes No
(2) Child's SSN *
(2) Who does the child's reside with? *
(2) Do you need to list another child? *

Yes No
(3) Child's Name *

First Name Last Name
(3) Child's Gender *

Female Male
(3) Child's DOB *

Month Day Year Date Picker Icon
(3) Child's Place of Birth *
(3) Do you know the child's SSN? *

Yes No
(3) Child's SSN *
(3) Who does the child's reside with? *
(3) Do you need to list another child? *

Yes No
(4) Child's Name *

First Name Last Name
(4) Child's Gender *

Female Male
(4) Child's DOB *

Month Day Year Date Picker Icon
(4) Child's Place of Birth *
(4) Do you know the child's SSN? *

Yes No
(4) Child's SSN *
(4) Who does the child's reside with? *
(if necessary please bring in a separate sheet of paper with additional names and information).
Do either of you pay child support for the children before or outside of the marriage? *

Yes No
If Yes, who and how much child support per month is paid? *
Emergency Contact

This is a person(s) who you would like for our office to contact about your pending case if you are not able to be reached.
Emergency Contact's Name *

First Name Last Name
Emergency Contact's Relationship to You: *
Emergency Contact's Phone Number *

Area Code Phone Number

Emergency Contact's Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Summary of Community Property

Please list anything acquired during the marriage.
Do you and your spouse own any real estate property (marital home, vacation homes, or rental property). *

Yes No

(1) Year Property Purchased? *
(1) Fair Market Value of the Property as of today? *
(1) Do you owe a mortgage on the property? *

Yes No
(1) If Yes, Name of the Mortgage Company? *
(1) Monthly mortgage payments? *
(1) Total Mortgage Debt Balance as of today: *
(1) Do you need to list another piece of real property? *

Yes No

(2) Year Property Purchased? *
(2) Fair Market Value of the Property as of today? *
(2) Do you owe a mortgage on the property? *

Yes No
(2) If Yes, Name of the Mortgage Company? *
(2) Monthly mortgage payments? *
(2) Total Mortgage Debt Balance as of today: *
(2) Do you need to list another piece of real property? *

Yes No

(3) Year Property Purchased? *
(3) Fair Market Value of the Property as of today? *
(3) Do you owe a mortgage on the property? *

Yes No
(3) If Yes, Name of the Mortgage Company? *
(3) Monthly mortgage payments? *
(3) Total Mortgage Debt Balance as of today: *
(if necessary please bring in a separate sheet of paper with additional real property and information).
Motor Vehicles, Boats, Airplanes, Cycles, & Trailers

Please list any property acquired during the marriage.
Do you have any motor vehicles, boats, airplanes, cycles or trailers to list? *

Yes No
(1) Year of Motor Property *
(1) Make & Model *
(1) Who drives the vehicle *

Yes No
(1) Fair Market Value of the property? *
(1) Is there a loan on the property? *

Yes No
(1) If yes, how much is the monthly payment? *
(1) How much is balance owed as of today? *
(1) Do you need to list another piece of property? *

Yes No
(2) Year of Motor Property *
(2) Make & Model *
(2) Who drives the vehicle *

Yes No
(2) Fair Market Value of the property? *
(2) Is there a loan on the property? *

Yes No
(2) If yes, how much are the monthly payments? *
(2) What is the balance owed as of today? *
(2) Do you need to list another piece of property? *

Yes No
(3) Year of Motor Property *
(3) Make & Model *
(3) Who drives the vehicle *

Yes No
(3) Fair Market Value of the property *
(3) Is there a loan on this property? *

Yes No
(3) If Yes, how much is the monthly payments? *
(3) If Yes, how much is the balance owed as of today? *
(3) Do you need to list another piece property? *

Yes No
(4) Year of Motor Property *
(4) Make & Model *
(4) Who drives the vehicle *

Yes No
(4) Fair Market Value of the Property?
(4) Is there a loan on this property? *

Yes No
(4) If Yes, how much is the monthly payments? *
(4) If Yes, how much is the balance owed as of today? *
(if necessary please bring in a separate sheet of paper with additional property and information).
Bank Accounts

Please list all separate and joint bank accounts.
Do either you or youse spouse have a bank account? *

Yes No
(1) Name of Bank *
(1) Who Can Withdraw From Account? *

Myself Spouse Other
(1) Type of Account *

Checking Savings Other
(1) Available Balance Today?
(1) Do you need to list another account? *

Yes No
(2) Name of Bank *
(2) Who Can Withdraw From Account? *

Myself Spouse Other
(2) Type of Account *

Checking Savings Other
(2) Available Balance Today? *
(2) Do you need to list another account? *

Yes No
(3) Name of Bank *
(3) Who Can Withdraw From Account? *

Myself Spouse Other
(3) Type of Account *

Checking Savings Other
(3) Available Balance as of Today? *
(3) Do you need to list another account? *

Yes No
(4) Name of Bank *
(4) Who Can Withdraw From Account? *

Myself Spouse Other
(4) Type of Account *

Checking Savings Other
(4) Available Balance as of Today? *
(4) Do you need to list another account? *

Yes No
(5) Name of Bank *
(5) Type of Account *

Checking Savings Other
(5) Who Can Withdraw From Account? *

Myself Spouse Other
(5) Available Balance as of Today? *
(if necessary please bring in a separate sheet of paper with additional accounts and information).
Stock and Mutual Funds

Please list all mutual funds
Do you or your spouse have a stock or mutual fund? *

Yes No
(1) Name of Fund *
(1) Estimated Value as of Today *
(1) Do you need to list another stock or mutual fund? *

Yes No
(2) Name of Fund *
(2) Estimated Value as of Today *
(2) Do you need to list another stock or mutual fund? *

Yes No
(3) Name of Fund *
(3) Estimated Value as of Today *
(3) Do you need to list another stock or mutual fund? *

Yes No
(4) Name of Fund *
(4) Estimated Value as of Today *
(4) Do you need to list another stock or mutual fund? *

Yes No
(5) Name of Fund *
(5) Estimated Value as of Today *
(if necessary please bring in a separate sheet of paper with additional funds and information).
Life Insurance

Please list all life insurance policies
Do you or your spouse have life insurance policies? *

Yes No
(1) Name of Company *
(1) Insuring life of: (name of person) *
(1) Cash Value as of Today? *
(1) Do you need to list another policy? *

Yes No
(2) Name of Company *
(2) Insuring the life of: (name of person) *
(2) Cash Value as of Today? *
(2) Do you need to list another policy? *

Yes No
(3) Name of Company *
(3) Insuring the life of: (name of person) *
(3) Cash Value as of Today? *
(if necessary please bring in a separate sheet of paper with additional policies and information).
Retirement, Pensions, & Other Company Benefits

Please list you and your spouse's company benefit information below
Do you and/or your spouse have company benefit accounts? *

Yes No
(1) Type of Account *
(1) Whose Name is the Account in? *

Spouse Mine
(1) Estimated Value of the Account as of Today? *
(1) Do you have another account to list? *

Yes No
(2) Type of Account *
(2) Whose Name is the Account in? *

Spouse Mine
(2) Estimated Value of the Account as of Today? *
(2) Do you have another account to list? *

Yes No
(3) Type of Account *
(3) Whose Name is the Account in? *

Spouse Mine
(3) Estimated Value of the Account as of Today? *
(3) Do you have another account to list? *

Yes No
(4) Type of Account *
(4) Whose Name is the Account in? *

Spouse Mine
(4) Estimated Value of the Account as of Today? *
(if necessary please bring in a separate sheet of paper with additional accounts and information).
Separate Property

List any of you or your spouse's separate property that was acquired BEFORE the marriage
Do you or your spouse own any separate property? *

Yes No
If YES, list the property description here (i.e cars, homes, etc.) *
Did you or your spouse receive a gift or inheritance during your marriage? *

Yes No
If YES, list the gift and inheritance here (i.e the amount and who the inheritance was from) *
Debts

Please list all debts other than a home or vehicle.
Do you and your spouse owe additional debts? *

Yes No
(1) Who Debt Owed to: *
(1) Monthly Payment *
(1) Total Amount Owed as of Today? *
(1) Do you need to list another debt? *

Yes No
(2) Who is the Debt Owed to: *
(2) Monthly Payment *
(2) Total Amount Owed as of Today? *
(2) Do you need to list another debt? *

Yes No
(3) Who is the Debt Owed to: *
(3) Monthly Payment *
(3) Total Amount Owed as of Today? *
(3) Do you need to list another debt? *

Yes No
(4) Who is the Debt Owed to: *
(4) Monthly Payment *
(4) Total Amount Owed as of Today? *
(4) Do you need to list another debt? *

Yes No
(5) Who is the Debt Owed to: *
(5) Monthly Payment *
(5) Total Amount Owed as of Today? *
(5) Do you need to list another debt? *

Yes No
(6) Who is the Debt Owed to: *
(6) Monthly Payment *
(6) Total Amount Owed as of Today? *
(6) Do you need to list another debt? *

Yes No
(7) Who is the Debt Owed to: *
(7) Monthly Payment *
(7) Total Amount Owed as of Today? *
(if necessary please bring in a separate sheet of paper with additional debts and information).
Miscellaneous

Please answer the following questions.
Does anyone owe you and/or your spouse money *

Yes No
If YES, please state (1) who owes the money and (2) how much is owed: *
Are you or your spouse involved in any lawsuit? *

Yes No
If YES, please explain: *
Do you own any livestock or mineral interest? *

Yes No
If YES, please identify below: *
Do you or your spouse belong to any club with an equity interest? *

Yes No
If YES, state where below: *
Have you filed your taxes for all of the previous years? *

Yes No
If No, (1) how much do you owe or was a refund issued? (2) How much was the balance owed or the refund issued? Please explain below: *
How did you file? *

Jointly Married filing Separately
Who prepared your tax return? *
Do you have a prenuptial agreement? (if yes, please bring a copy with you to your meeting). *

Yes No
Do you and/or you spouse have a Will? *

Yes No
If YES, please please provide detail on who prepared the Will: *
What are your goals in this divorce? *
Do you have any urgent concerns? (Example interaction with spouse, visitation, and financial issues, and etc.) *

Yes No
If YES, please provide details: *
Closing Questions
Did someone refer you to our office? *

Yes No
Name of the Person who Referred You: *

First Name Last Name
Have you consulted or retained any other attorneys on this matter before? *

Yes No
If Yes, please state who you consulted with and when: *
Should be Empty:

Divorce Questionnaire

Information About Spouse

Information About Marriage

Children Born During Marriage

Children Before or Outside of the Marriage

Emergency Contact

Summary of Community Property

Motor Vehicles, Boats, Airplanes, Cycles, & Trailers

Bank Accounts

Stock and Mutual Funds

Life Insurance

Retirement, Pensions, & Other Company Benefits

Separate Property

Debts

Miscellaneous

Closing Questions