Reason for Consultation (i.e. divorce, separation, marriage contract, general consultation, second opinion):

Referral Source:

Client Information

Full Legal Name:

Date of Birth:

Place of Birth:

Citizenship:

SIN Number:

Surname at Birth:

Surname Before Marriage:

Current Home Address:

Since When?:

Current Mailing Address (if different from home address):

Home Tel.:

Work Tel.:

Cell:

Fax:

Email:

Preferred Method of Communication:

Divorced Before?:

Place and Date:

Job Title:

Current Employer and Address:

Current Annual Income From Employment:

Income From Other Sources:

Current or Previous Family Lawyer:

Spouse Information

Full Legal Name:

Date of Birth:

Place of Birth:

Citizenship:

SIN Number:

Surname at Birth:

Surname Before Marriage:

Current Home Address:

Since When?:

Current Mailing Address (if different from home address):

Home Tel.:

Work Tel.:

Cell:

Fax:

Email:

Preferred Method of Communication:

Divorced Before?:

Place and Date:

Job Title:

Current Employer and Address:

Current Annual Income From Employment:

Income From Other Sources:

Spouse’s Lawyer and Contact Information:

Marital Information

Date of Marriage:

Date of Cohabitation:

Place of Marriage:

Date of Separation:

Have either you, your spouse, or children been in a court case before?

Have you and your spouse made a written agreement dealing with any matter involved in this case?

If client or spouse is stay-at-home parent, please give relevant dates:

Do you have any safety concerns for yourself or your children?

Have the police been called to the matrimonial home and does either spouse have a criminal record?

Matrimonial Home

First:

Address:

Name(s) on Title:

Value:

Mortgage:

Second:

Address:

Name(s) on Title:

Value:

Mortgage:

Excluded Property

Received by client (during or after marriage):

Received by client’s spouse (during or after marriage):

Children

Please list all children including their name(s), date of birth, who they're living with and current grade/school:

Children’s Expenses

Medical/Dental/Orthodontic:

Private School/Tutoring/Educational Expenses:

Post-secondary Educational Expenses:

Daycare/Child Care:

Extracurricular Activities:

Other Expenses:

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