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Sample_Questionnaire

VIEWS: 36 PAGES: 5

									                                                    The Mediation Specialists


                                    Focusing on Solutions not problems


         CONSENT DECREE QUESTIONNAIRE
               With Minor Children
We want to make your divorce as easy, inexpensive and worry free
as possible. Your accurate completion of this Questionnaire will go a long
way towards reaching these goals.

Please be sure to read the Helpful Information (“HI”) below which is not
intended as legal advice, but it will provide you with the legal, financial, tax,
and other information needed to make informed decisions.

After you complete this form and send it to me, I will contact you about how
we can inexpensively help if you and your spouse have any
particular questions or concerns and want to confer about them by
telephone or meet in person with one of our mediators.

Tina Trueblood, Mediation Manager
By email: Tina@outofcourtsolutions.com
By fax: 866.929.1985
By mail: Out-of-Court Solutions
8350 E. Raintree Drive, Suite A205,
Scottsdale, AZ 85260


I. CLIENT INFORMATION

This form is completed by: Choose an item.

Husband (name)
  Address:
                                                                       Page 1 of 23
  Tel #
  Email

Wife (name)
  Address:


  Tel #
  Email

This Choose an item. a Covenant Marriage.

II. COMMUNITY PROPERTY:

Real Estate:

Check box that applies:
   We did not acquire during our marriage nor do we presently own any real
estate, OR

      We acquired during our marriage and presently own real estate located
at:




                                                Select...
  Title to this real estate is in the name of

  This real estate:

                                                 Select...         Select...
              Will be kept after our divorce by           with
        signing a Quit Claim Deed transferring his/her community
                            Select...
              interest to               , OR

              Will be co-owned by both of us after our divorce, OR
                                                                      Page 2 of 23
              Will be sold through    a real estate agent, OR    a short sale,
              OR     a foreclosure, OR

              I have questions or need information about this.

       HI: A “Quit Claim” deed is required to transfer title from one spouse to
another and to take care of getting one spouse removed from title as an
owner; however, it does not take care of the joint obligations under a
mortgage (see “Community Debts,” below). Upon your request, we
will prepare a Quit Claim deed.

Furniture,         Furnishings,      Appliances    &    Other     Household
Property:

Check box that applies:
   We did not acquire during our marriage nor do we presently own any
household property, OR

   We have already divided all of our household property, OR

    All of our household property will be divided by mutual agreement, OR

   Husband will keep the following furniture, furnishings, appliances, and
other household property:




And,
   Wife will keep the following furniture, furnishings, appliances, and other
household property:



       I have questions, need information, or we disagree about this.

Bank/Credit Union/Investment Accounts:

Check box that applies:
   We did not acquire during our marriage nor do we presently own any
bank or other accounts, OR
                                                                   Page 3 of 23
   We acquired during our marriage and presently have the following bank
or other accounts:
                                      Last 4 digits  Select who will get
                                  of account #      account after divorce

                                                           Select...

                                                           Select...


       I have questions or need information about this.

Retirement Accounts: Pension/IRA/401K/Profit Sharing
Plan/Stock Plan:

Check box that applies:
    We did not acquire during our marriage nor do we presently own any
retirement accounts, OR

    We acquired during our marriage and presently have the following
retirement accounts:

 Type of account      Name of Financial   Name on account Select who will
                      Institution                      get account after divorce
 Select...                                  Select...           Select...

 Select...                                  Select...           Select...



HI: Except for an individual retirement account (IRA), a Qualified Domestic
Relations Order (“QDRO”) is required to transfer all or part of any retirement
account(s) from one spouse to another. Upon your request, one of our
mediators will provide you with legal information about QDROs and how to
obtain one at the lowest possible cost.

Credit Card Debt:

Visa, MasterCard, AmEx, Discover:
Name of Issuer            Last 4 digits          Type      Select who will be
                           of Card #                        responsible for
                                                            payment of debt

                                                                       Page 4 of 23
                                              Select...            Select...

                                               Select...           Select...



Legal Custody of Minor Children:

Check box that applies:
    Joint, OR
                Select...
    Sole for                 , OR
    I/We have questions, need information, or disagree about this.

      HI: Legal Custody pertains to the making of major life decisions for
children; for example, decisions about medical needs, school, and religion. It
does not pertain to the amount of time child(ren) will spend with each
parent.

Child Support:

    HI: Please copy and paste the following website into your internet
browser to review Arizona’s Guidelines for Child Support in detail and
calculate the amount of child support:
http://www.azcourts.gov/Portals/31/Child%20Support/CSG2004.pdf

                                                           Husband's    Wife's gross
 Factors to be considered:                                 gross income income per
                                                           per month    month
Gross Salary/Income
                                                           $                   $

                                                                         Page 5 of 23
                                    End of Sample

To get all of the other legal, financial, parenting, and additional
information needed to complete your divorce quickly and
inexpensively…

                            Call Out-of-Court Solutions

                                    480-359-5515

								
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