Revised: 10/22/11

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Easy asDivorce Online

-No Children-

 

 Section I - Personal & Contact Information:

Note: All information put in Court documents becomes public record.  If you have information you wish to keep private then please inform us of that when we call for your consultation.

What type of case is this going to be?

*Name   (Example John Public Doe)

Home phone Work phone   Cell phone    

(Example 602-896-9020)

*Email                            

Mailing address:

Street    Apt.

City  State  Zip

Date of birth  (Example 12-01-1963)

Social Sec. No. (Example 123-04-8789)

Who did you speak with from our office prior to completing this questionnaire?

Section 2 - Spouse (Other party's) Contact Information:

*Name    (Example John Public Doe)

Home phone Work phone  Cell phone

(Example 602-896-9020)

Mailing or severable address:

Street  Apt.

City  State   Zip

Date of birth  (Example 12-01-1963)

 Social Sec. No. (Example 123-04-8789)

Section 3 - Marital Information

Is the wife pregnant? If yes, what is due date of baby?  

(Example 12-01-2010)

 Date of Marriage?   (Example 12-01-1963)

City and State of Marriage

 Does wife want to change her name?

If yes, what is the name (Example John Public Doe)                                 

Section 4 - Division of Assets & Debts

Debts

What debts do you wish to assume?

All debts that are in my name  and/or all debts listed below:

 

 

What debts do you wish the other person to assume?

All debts that are in their name  and/or all debts listed below:

 

 

Property

What is community property and sole and separate property?

What property do you want to be awarded?

All property currently in my possession  and/or all property listed below:

 

 

What property do you want the other person to be awarded?

All property currently in their possession   and/or all property listed below:

 

We own a home.  This is what I would like done with your home(s):

 

Section 5- Spousal Maintenance (Alimony)

What is spousal maintenance/ alimony?

     If alimony is to be paid or received, how much is going to be paid?   $   

      If alimony is to be paid or received, for how long?  month(s), or  never ending, or

      I do not know how much to ask for or for how long.

Section 6- Retirement Benefits

Other

 

Section 7 - Process Service

We must provide your spouse a copy of the legal documents AFTER they have been filed with the Court.  What is the single best way to do this?  Select one:

Option 1 My spouse will come into your office and sign them.

Fee: FREE

Option 2 I will take my spouse a copy of the documents.

Fee: FREE

Option 3 Send the documents by certified mail.

Fee: $25

Option 4 My spouse will not sign anything. They must be served by a Process Server.

Fee: $95 Metro Phoenix / $150 Non-Metro Phoenix

Do I need a Process Server? How does Process Service work?

Option 5 I do not know the whereabouts of my spouse.

Fee: $100

How does Publication / Newspaper Divorce work?

If you stated you do NOT know the whereabouts of your spouse,

then when was the last time you seen them? (Example 05-01-1993)

Section 8 -Other information or comments  

Section 9-Payment Options

Discount Divorce will immediately begin work on your case as soon as your initial phone consultation is complete and your payment is received.

Pricing and cost information:

Discount Divorce will call you between the hours of 9AM and 4PM, Monday thru Friday.

What is the best time to reach you at during the hours listed above? until on

Payment & Acknowledgement

All costs will be discussed with you in advance, and we will not proceed or charge your card until you instruct us to do so.

Card number requiredNote: You are not obligating yourself financially by submitting this form.

*Number *Exp. Date *Type of Card

 

Terms of Service

*I acknowledge that I have read the "Terms of Service" and agree and understand them.

*Applicant Name/Signature: All information contained herein is true and correct

*Date (mm/dd/yyyy):