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SAM HASLER

ATTORNEY AT LAW

1106 Meridian Plaza, Suite 251

Telephone: 765-641-7906

Web Page: http://samhasler.justia.net/index.html E-mail: samuelhasler@yahoo.com

Anderson, IN 46016

Fax: (765)-374-3811

Web Log: http://haslerlaw2.blogspot.com/

CLIENT DIVORCE CONSULTATION INFORMATION

Thank you for choosing Hasler Law Office to handle your legal matter. In order to assist you better, please take a few moments to answer the following questions. The first section concerns general questions, and the second more specific matters. While lengthy, the idea here is use your time more for answering your questions than in gathering the information contained in this questionnaire. Please understand that any information that you give me will be confidential but that an attorney-client relationship will not exist until and unless I am retained in this matter.

1. Please list your full name:

2. Current address where you are residing, including the Zip Code:

3. Do you have another address to which you would like to have any mail sent from this office?

Yes

No

If yes, please give the complete mailing address as it should appear on the mailing envelope, including the Zip Code:

4. Please list any and all telephone numbers where you can be reached, including cell numbers and area codes:

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5.

If we are unable to reach you using the telephone numbers provided herein, is there anyone else we can

contact to get in touch with you?

Yes

No

If yes, please list their names, full address and telephone numbers, including pager numbers and area codes:

Do you have an E-Mail address? If so what is it.

6. Are you employed? Yes

No

If yes, please state where and the job title and how long you have been there:

Employer’s address and telephone

7. Have you been involved in litigation before? If yes, please state when and what type of lawsuit? What was

the outcome? Were you pleased with the legal system?

8.Your SSN

Your Date Of Birth

9. How did you choose Hasler Law Office for your consultation/representation?

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These questions deal more specifically with the issues of your matter. Not all questions will apply, so do not worry if you do not have an answer.

I. Why do you want a divorce?

II. How long have you lived in Indiana?

III. What county do you live in?

A.

How long have you lived in this County?

Indiana law requires that you live in the state 6 months and in the county 3 months before you

can file for divorce. What county you live in also determines where the case will be filed.

IV.

What is your spouse’s name?

A.

Your spouse’s age?

B.

Your spouse’s Social Security number?

C.

Your spouse's Date Of Birth?

D.

Is Spouse Employed?

E.

Where is Spouse Employed?

F.

Address for Spouse Employer?

G.

Phone Number for Employer?

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V.

When did you marry your spouse?

VI.

Have you separated from your spouse?

Yes

No

A.

If your answer is “Yes”, when did you separate from your spouse?

B.

If your answer is “Yes”, what is your spouse’s address?

C.

Pick the following which best describes your education:

 

High School Diploma

GED

Vocational Training Graduate

Some College

College graduate

Some post college graduate school

 

Post graduate college degree

None of the above

G

 

(1) Do you have any intention of returning to school?

Yes

No

 

B.

Pick the following which best describes your spouse’s education:

A.

 

High School Diploma

GED

Vocational Training Graduate

Some College

College Graduate

Some post college graduate school

 

Post graduate college degree

None of the above

G

(1) Does your spouse intend to return to school?

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Yes

No

II.

Do you and your spouse have any children?

Yes

No

A. If “Yes”, then are any of the children younger than 21?

Yes

No

B. If younger than 21, where do they live?

C. Is the wife now pregnant?

Yes

No

D. Names, Date of Birth, age, current addresses, and social security numbers for the children under 21 years of age.

Child’s name

Date of Birth

Age

Current Addresses

social security

number

1

     

2

     

3

     

A. Is there a dispute as to custody of the children?

B. What is your weekly gross income?

Yes

No

(1) If you are not working, please explain why not?

C. Do you pay child support?

(1) If so, how much a week?

Yes

No

D. Do you have custody of children from a prior marriage?

Yes

No

E. What is your spouse’s weekly gross income?

F. Does your spouse pay child support?

Yes

No

(1) If so, how much a week?

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G. Does your spouse have custody of children?

Yes

No

H. Are there child care expenses so that you can work?

Yes

No

(1)

How much in work related child care expenses?

Yes

No

(2)

Who pays this?

(3) Cost of Health Insurance

(4) Maintance from former Marriage

Indiana law presumes a 50-50 split on all property and debts. Property includes real estate, and personal

property (everything that is not land).

II.

Do you and your spouse own any real estate?

Yes

No

A. Was the real estate acquired during the marriage?

Yes

No

B. Was it purchased by you and your spouse?

Yes

No

C. Was it inherited by you?

Yes

No

D. Was it inherited by your spouse?

Yes

No

E. Was it owned by you before this marriage?

Yes

No

F. Was it owned by your before this marriage?

G. Location-where is it?

H. What is the value?

I. Where did the value come from?

Yes

No

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J. What is the date of the value?

K. Is there any debt on property?

L. How much is owed?

M. What is the monthly payment?

 

N. Any agreement on division of real estate?

 

Yes

No

III.

Do you have a pension, 401K or other retirement plan?

Yes

No

IV.

Does your spouse have a pension, 401K or other retirement?

Yes

No

V.

Did you and your spouse own your own business?

Yes

No

A. If “Yes”, what is the name of the business?

 

B. What kind of business is it?

VI.

Do you and your spouse have any joint debts?

 

Yes

No

A.

If “Yes”, list the debts and the approximate amounts owed:

 

B.

Do you think there can be an agreement on these debts?

Yes

No

I.

What do you want from this divorce?

 

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Date:

Your name

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