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INTAKE FORM

DO NOT fill out and submit this form until you have already contacted Form Preparation Services, LLC, and made payment for the services requested. You must fill this form out in its entirety, even if you only put "n/a" to some of the answers. We cannot answer the questions for you. If you are seeking services related to child custody or support, not divorce, please fill out this form anyway and just omit the few questions that are obviously related just to divorce, such as "How long have you been married?"

Your Information:
Title: Mr. Ms. Mrs.
Full Name:
Street Address:
City:
State:
County
Zip Code:
Telephone Number 1:
Telephone Number 2:
Fax:
E-Mail Address:
Social Security No.:
Date of Birth:

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Your Spouse's Information:
Title: Mr. Ms. Mrs.
Full Name:
Street Address or Last Known Address:
City:
State:
County
Zip Code:
Telephone Number 1:
Telephone Number 2:
Fax:
E-Mail Address:

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Common Marriage Information:
Date of Marriage:
State Where Marriage Transpired:
County Where Marriage Transpired:
Date of Separation:
If you are the wife, do you want to assume another name? State it in full:

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Miscellaneous Information:
Are You in the Military?:
Yes No
Is Your Spouse in the Military?:
 Yes No
Will Your Spouse Sign for the Papers, or Is Sheriff's Service Required?:
Do You Know Where to Locate your Spouse?:
Yes No
If You are Seeking Alimony, State the Amount:
 $

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Financial Information: Section I. Your Income
Your Occupation:
Employer's Name:
Employer's Address:
Monthly Gross Income:
$
Monthly Bonuses, Commission, etc.:
 $
Monthly Disability/SSI:
$
Monthly Workers' Compensation:
 $
Monthly Unemployment:
 $
Monthly Pension/Retirement:
 $
Monthly Social Security:
 $
Monthly Alimony:
 $
Monthly Interest and Dividens:
 $
Monthly Rental Income:
 $
Monthly Royalties, Trusts and Estates:
 $
Monthly Reimbursed Expenses:
 $
Monthly Gains from Dealing in Property:
 $
Monthy "Other Income":
 $

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Financial Information: Section II. Your Deductions
Monthly State and Federal Witholdings:
$
What is your Filing Status:
Number of Co-Dependents Claimed:
Monthly FICA and Self-Employment Taxes:
 $
Monthly Medicare:
 $
Monthly Mandatory Union Dues:
 $
Monthly Mandatory Retirement Plans:
 $
Monthly Health & Dental Insurance:
 $
Monthly Court Ordered Child Support:
 $
Monthly Court Ordered Alimony:
 $

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Financial Information: Section III. Your Monthly Expenses (A.)
Monthly Mortgage or Rent:
$
Monthly Property Tax:
 $
Monthly Utilities:
 $
Monthly Telephone:
 $
Monthly Food:
 $
Monthly Meals Outside the Home:
 $
Monthly Maintenance/Repairs:
 $
Monthly Other (List what it is and the amount):
B.
  
Monthly Auto Gas:
 $
Monthly Auto Repairs:
 $
Monthly Auto Insurance:
 $
C.
  
Monthly Child Day Care:
 $
Monthly Child Lunch Money:
 $
Monthly Child Clothing:
 $
Monthly Child Grooming:
 $
Monthly Child Holiday Gifts:
 $
Monthly Child Medical/Dental (if Uninsured):
 $
Monthly Other (List what it is and the amount):
D.
  
Monthly Medical/Dental Insurance:
  $
Monthly Children's Medical/Dental:
  $
Monthly Life Insurance:
  $
Monthly Other (List what it is and the amount):
E.
  
Your Own Monthly Clothing:
   $
Your Own Monthly Medical/Dental (if Uninsured):
  $
Your Own Monthly Grooming:
  $
Your Own Monthly Entertainment:
  $
Your Own Monthly Gifts:
  $
Your Own Monthly Religious Organizations:
  $
Your Own Monthly Miscellaneous:
  $
Your Own Monthly Other:
F.
  
List Payments to Creditors. Name Each Creditor and the Amount Paid Per Month:
  

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IV. Assets & Liabilities: A.
Cash in Hand:
$
Cash in Banks or Credit Unions:
 $
Stocks, Bonds, Notes (Total Equity or Worth):
 $
Real Estate (Total Equity or Worth):
 $
Other (Total Equity or Worth):
 $
Automobiles (Total Equity or Worth):
 $
Other Personal Property (Total Equity or Worth):
 $
Retirement Plans (Total Equity or Worth):
 $
B.
  
Mortage on Real Estate (How Much Do You Owe):
 $
Second Mortgage on Home (How Much Do You Owe):
 $
Other Mortgages (How Much Do You Owe):
 $
Auto Loans (How Much Do You Owe):
 $
Charge Cards: (How Much Do You Owe):
 $
Other (How Much Do You Owe):
 $
C.
  
List your Possible Additional Assets or Liabilities Such as Lawsuits, Taxes, Debts, etc.

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Information Related to Children, If you have any:
List Each Child, the Date of Birth, Age and Social Security Number:
List the County and State of Residence for Each Child:
Name the Person the Children Live With:
State How Long the Child Has Resided at the Address Specified:
If the Child has Resided at the Specified Address, County and State for Less than One Year, State the Address, County and State Where the Child Resided Before that and the Name of the Person he or she Resided With.
If You are Seeking Child Support, State the Amount:
 $
Has There Been Any Previous Court Action Concerning the Children? If so, List the State and County and the Docket or Case Filing Number. State What Happened in the Litigation.
Yes No
Are There Previous Court Orders Concerning the Children? If so, List the State and County and the Docket or Case Filing Number. State What Happened in the Litigation.
 Yes No
Does Anyone Currently Have Court Ordered Custody or Visitation Rights to the Children?
 Yes No

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Property Settlement Agreements are Not Included In Our Base Price for a Divorce. If you Have Made Payment Arrangements for This Item, or Otherwise Want This Information on File, Please Complete the Following.
Husband transfers to Wife the following property and or assets:
Wife transfers to Husband the following property or assets:
Husband shall be responsible for paying the following debts:
Wife shall be responsible for paying the following debts:

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Child Custody and Visitation Plans and Agreements are Not Included In Our Base Price for a Divorce. If you Have Made Payment Arrangements for This Item, or Otherwise Want This Information on File, Please Complete the Following.
Who will have Primary Custody;
What Days will the Child Be with Whom and at What Times Will the Sessions Begin and End:
Who will Have Custody or Visitation of What Holidays:
What is the Arrangement for Holiday, Spring and Summer Recess:
State the Remainder of Your Agreement:
DISCLOSURE STATEMENT
 
Important Notice: While Form Preparation Services, LLC provides cheap assistance with the preparation of Florida divorce and other types of forms, and we guarantee the integrity of the forms we use, we do not provide legal advice or counseling. Experienced professionals, not attorneys, staff this company. Form Preparation Services, LLC is not representing itself to be a Florida paralegal service or to be staffed by paralegals in accord with the governing regulations. Only an individual working directly under the supervision of a licensed attorney may use the title “paralegal” in advertising in the State of Florida. This website posts copies of the Florida Statutes, portions of the Florida Rules of Court and various articles on legal topics. Those materials are displayed to the public as a courtesy for academic purposes only.

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