New Client Intake Form

NEW FAMILY LAW CLIENT INTAKE FORM

The information in this form is intended to give us a brief overview of your current situation prior to your initial consultation so that we may better address your specific concerns. Your responses will be held in the strictest of confidences. Submission of this form does not establish an attorney-client relationship.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

What is your home address, city and state? *

What is your age and date of birth? *

What is your current occupation and yearly salary? *

What is your spouse's name, age and date of birth? *

What is your spouse's current occupation and yearly salary? *

What is the date and place of your marriage? *

Are you and your spouse currently living together? *

Yes No

If you have children from this marriage, please list their names & ages. *

Approximate value of real estate owned. *

Mortgage balance on real estate owned. *

Approximate value of bank & investment accounts. *

Do you or your spouse own your own business(es)? *

Yes - sole owner Yes - part owner No Not sure

Additional information regarding business(es) if any. *

Approximate debts (credit card, car loans, personal loans) *

Is your case currently pending? *

Yes No Not sure

If your case is currently pending, what is the court number and county where pending? *

Any additional information. *

Submit

7035 Veterans Boulevard, Suite A
Burr Ridge IL 60527

p 630.887.7500
f 630.887.8710

The information in this website are for informational purposes only and does not constitute legal advice. You should not take action based upon this information without consulting with an attorney. This site is not initended to create an attorney-client relationship. Because laws are constantly evolving and changing, the content regarding the various laws addressed herein is subject to revision.