A Copy of a Legit Birth Certificate by cdb12834

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									                                                         Attorneys and Counselors at Law
                                                                  www.colemanchambers.com


                                                                  LEGITIMATION WORKSHEET
  A.             CLIENT INFORMATION:
  Full Name: (Mr. or Mrs.) ______________________________________________________________________
  Maiden / Prior Name (if applicable) _____________________________________________________________
  Residence Street Address: ___________________________________________________________________
  City: ___________________ State: ________ Zip: _________ County: ________________________________
  Home Phone No.: ______________ Cell No.: ___________________ Email: ___________________________
                                        (please do not supply any phone numbers or email address that are not “safe” contacts for you)

  Mailing Address: (safe address for receiving mail)__________________________________________________
  City: ___________________ State: ________ Zip: _________ County: _________________________________
  Employer:__________________________________________________________________________________
  Business Address: __________________________________________________________________________
  City: ___________________ State: ________ Zip: _________ County: _________________________________
  Business Phone:__________________ Annual Gross Income: $ ___________ Commission (Yes / No) _______
  How do you get paid: Hourly $_______ Salary $_________ Weekly, Bi-weekly, other:_____________________
  Date of Birth: ______________________ Age: ____ City and State of Birth: ____________________________
  Social Security No.: ______________________ Currently Married?________ Race: ______________________
  Your relationship to the child or children involved in this action: _______________________________________


  B.             OPPOSING PARTY INFORMATION:
  Full Name: (Mr. or Mrs.) ______________________________________________________________________
  Maiden / Prior Name (if applicable) _____________________________________________________________
  Residence Street Address: ____________________________________Lived here since: _________________
  City: ___________________ State: ________ Zip: _________ County: ________________________________
  Home Phone No.: __________________ Cell No.: ___________________ Other:_______________________
  Mailing Address: ____________________________________________________________________________
  City: ___________________ State: ________ Zip: _________ County: _________________________________
  Employer:__________________________________________________________________________________
  Business Address: __________________________________________________________________________

Form #: FL203
Revised: 01/2010
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  City: ___________________ State: ________ Zip: _________ County: ________________________________
  Business Phone:__________________ Annual Gross Income: $ ___________ Commission (Yes / No) _______
  How does this party get paid: Hourly $________ Salary $_________ Weekly, Bi-weekly, other:______________
  Date of Birth: ______________________ Age: ____ City and State of Birth: ____________________________
  Social Security No.: ______________________ Currently married? _______ Race: _______________________
  Name and Address of other Attorney (if known): ___________________________________________________


  C. GENERAL INFORMATION:
  Duration of your relationship (if applicable) from _____________________to ___________________________
  Is either party in the military (specify) ___________________________________________________________
  Which party left the relationship (if applicable)? ___________________________________________________
  Other: ___________________________________________________________________________________
  _________________________________________________________________________________________
  _________________________________________________________________________________________


  D. CHILDREN:
  Children from THIS relationship, born out of wedlock:
  Full Name:                                                M or F           Date of Birth   Age   Currently Resides With:




  Your children from PRIOR relationships:
  Full Name:                                               M or F          Date of Birth     Age    Resides With:




  Opposing party’s children from PRIOR relationships:
  Full Name:                                                  M or F        Date of Birth:   Age    Resides With:




Form #: FL203
Revised: 01/2010
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The following questions pertain to your desires for the minor children of THIS relationship only:


The child lives with the following person who takes care of the child:
    The mother
    The father (putative father)
    Neither. Instead the child lives with ________________________ whose relationship to the child is
____________________________, at the following address: ____________________________________________


Please answer each:
Yes / No
             Paternity has been established by means of a DNA Parentage Test (please supply a copy of the test results)
             The father (herein) signed or was named on the birth certificate (Please supply a copy of the birth certificate)
              Another man was named on the birth certificate (Please supply a copy of the birth certificate)
             The mother is deceased (Please supply a copy of the death certificate)


Birth Certificate:
    The child’s new name shall be: _________________________________________________________________
                                                                    (Please write the child’s full name: first, middle, last)

    The father’s name shall be listed as: _____________________________________________________________
                                                                    (Please indicate full name: first, middle, last)

    No changes are necessary on the birth record concerning either father’s name or the child’s last name.


Child Support:
    There is a child support order concerning the child which requires ___________ to pay ___________ the sum of
$__________ per _____________. (Please supply a copy of the court order)
    There is currently no child support order concerning the child.
    There is no child support order, however I receive the following assistance: ______________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
(Please be prepared to produce as many receipts as possible for any expenses you have paid for the child’s needs)



  Form #: FL203
  Revised: 01/2010
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* If you are seeking custody, visitation and/or support, please answer the following:


E. CUSTODY / VISITATION:
Physical custody to be defined as: (Physical custody is who the child(ren) will live with)
           Mother
           Father
           Joint
           Other:____________________
           Why do you feel the above should be awarded custody?
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________


Legal Custody to be defined as: (Primary Legal custodial who usually makes the major decisions with regards to the
child(ren) including medical, dental, education, religion)
           Mother
           Father
           Joint (Access school records, medical records, et.)
           Other:____________________
           Why do you fee the above should be awarded final decision making power?
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________


Tie-breaking ability. If you selected joint legal custody on the proceeding question, someone will need to have the
tie-breaking ability in the event that, after a good-faith attempt to negotiate, you and your spouse are unable to agree
on a legal issue concerning the child(ren). Therefore, the following party or parties shall have the tie-breaking ability:
           Mother (all issues)

  Form #: FL203
  Revised: 01/2010
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           Father (all issues)
           Medical only to be determined by (circle one) Mother / Father / Pediatrician or Medical Provider…
           Dental only to be determined by (circle one) Mother / Father / Dentist or Orthondontist…
           Education to be determined by (circle one) Mother / Father / School Teacher or Counselor
           Religion to be determined by (circle one) Mother / Father / Other: ___________________
Visitation or custody period for the non-custodial parent can be any arrangement that you and your spouse can agree
to, however, a specific schedule must be included in your Agreement. Please describe the visitation schedule that
you like for the non-custodial parent.
                       Holiday                                                       With Father          With Mother
Spring vacation, from 6:00 p.m. on the day school                                  Even-number years    Odd-number years
      lets out for vacation, until 6:00 p.m. on the day                            Odd-number years     Even-number years
      before the child(ren) return to school. If none
      of the child(ren) is enrolled in school, this
      vacation shall be for up to one week (seven
      consecutive days) during the months of March
      or April; provided that the visiting parent shall
      give written notice of the chosen week to the
      other parent at least 30 days prior to the
      beginning of this visitation.

Easter weekend, 6:00 p.m. Friday to 6:00 Sunday,                                   Even-number years    Odd-number years
      provided that it does not conflict with Spring                               Odd-number years     Even-number years
      vacation above.

   Mother's Day, from 9:00 a.m. to 6:00 p.m.                                       NOT APPLICABLE EVERY YEAR
   Mother’s Day Weekend, 6:00 p.m. Friday to 6:00
p.m. Sunday

Memorial Day weekend, 6:00 p.m. Friday to 6:00                                     Even-number years    Odd-number years
    p.m. Monday                                                                    Odd-number years     Even-number years

   Father's Day, from 9:00 a.m. to 6:00 p.m.      EVERY YEAR                                           NOT APPLICABLE
   Father’s Day Weekend, 6:00 p.m. Friday to 6:00
p.m. Sunday

   Fourth of July, from 10:00 a.m. to midnight                                     Even-number years    Odd-number years
   Fourth of July overnight, from 10:00 a.m. on the                                Odd-number years     Even-number years
holiday until 10:00 a.m. the next morning
Labor Day weekend, 6:00 p.m. Friday to 6:00 p.m.                                   Even-number years    Odd-number years
       Monday                                                                      Odd-number years     Even-number years

Fall Break (If applicable), 6:00 p.m. on the day of                                Even-number years    Odd-number years
      release from school until 6:00 p.m. on the day                               Odd-number years     Even-number years
      before they are to return to school
  Form #: FL203
  Revised: 01/2010
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  Thanksgiving weekend, 6:00 p.m. Wednesday to                                     Even-number years     Odd-number years
     6:00 p.m. Sunday                                                              Odd-number years      Even-number years
-OR-

    First part Thanksgiving day, 10:00 a.m. to 2:00                                Even-number years     Odd-number years
       p.m.                                                                        Odd-number years      Even-number years

                                                                                   Even-number years     Odd-number years
    Latter part Thanksgiving day, 2:00 p.m. to 6:00                                Odd-number years      Even-number years
       p.m.

First part of Christmas vacation, from 6:00 on the                                 Even-number years     Odd-number years
         day school lets out for vacation, until 12:00                             Odd-number years      Even-number years
         noon on December 25th. If none of the
         child(ren) is/are enrolled in school, this
         visitation shall be from 6:00 p.m. on
         December 20th until 12:00 noon on
         December 25lh.

Latter part of Christmas vacation, from 12:00                                      Even-number years     Odd-number years
        noon on December 25lh to 6:00 p.m. on the                                  Odd-number years      Even-number years
        day before the child(ren) return to school. If
        none of the children) is/are enrolled in
        school, this visitation shall be from 12:00
        noon on December 25th until 6:00 p.m. on
        January 1".

Mother’s Birthday, if on school day from 4:00 p.m. NOT APPLICABLE                                      EVERY YEAR
         to 8:00 p.m. If not in school or on
         weekend, from 6:00 p.m. to 9:00 p.m.
Father’s Birthday, if on school day from 4:00 p.m. EVERY YEAR                                          NOT APPLICABLE
         to 8:00 p.m. If not in school or on
         weekend, from 6:00 p.m. to 9:00 p.m.
Summer:

Other:




Religious holidays should be determined by:
                          Christian
                          Jewish
                          Other: ______________



  Form #: FL203
  Revised: 01/2010
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Form #: FL203
Revised: 01/2010
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F. CHILD SUPPORT:
As of January 1, 2007, the new child support guidelines became effective in the State of Georgia. Child support is
based upon the income of both parents. The shared income approach is based upon a utilization of a rate table,
which establishes a base number that in theory is sufficient to meet the child’s or children’s needs.         The following
questions will allow for us to compute child support for your case in accordance with the new child support guidelines.
    A. Mother’s gross monthly income: _________________________
    B. Father’s gross monthly income: __________________________
    C. How many children in this action: ______________________________
    D. Are there expenses for extracurricular activities? If so, please state these monthly expenses for each child
            with specificity:
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________
    E. Are there daycare expenses, if so, please list the monthly amount, and which party pays these expenses (ie.
            tutoring, private school)? __________________________________________________________________
            ______________________________________________________________________________________
    F. Are there extraordinary educational expenses (testing, learning disabilities, special needs child, physical
            disability or significant health issues)? If so, please explain and provide details of these expenses?
            ______________________________________________________________________________________
            ______________________________________________________________________________________
    G. Are there extraordinary medical expenses (testing, learning disabilities, special needs child, physical
            disability or significant health issues)? If so, please explain and provide details of these expenses?
            ______________________________________________________________________________________
            ______________________________________________________________________________________
            ______________________________________________________________________________________
    H. Are there special expenses for child rearing such as band, camps, clubs, athletics, etc.? If so, please explain
            and provide details of these expenses?
            ______________________________________________________________________________________
            ______________________________________________________________________________________
    I.      Which party is to be considered the non-custodial parent, or the parent required to pay child support?

  Form #: FL203
  Revised: 01/2010
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                          Father
                          Mother
                          Neither (shared custody)
            If neither, please explain:__________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
            Child support shall be paid:
                          Weekly on ____________ (day of the week)
                          Bi-Weekly (every other week)
                          Monthly on _____________ (day of month)
                          Bi-Monthly on ________ and on _________ (days of the month)
                          Other: __________________________________________________________________
            Child Support shall be paid by:
                          Check or money order hand-delivered directly to recipient
                          Check or money order mailed to recipient
                          Income Deduction Order *Please note:              If Income Deduction Order is requested additional fees will be assessed.

            Are there any pre-existing child support orders in this case:
                           Example: Do you receive child support from a former spouse or do you pay child support to a former
            spouse? (circle) Yes/No
            Year prior Order entered? __________________
            Amount of Child Support Received or Paid? ______________


G. INCOME TAXES:
Which party shall be permitted to claim the child/children on their personal income tax returns?
             Father
             Mother
             Switch off every other year




  Form #: FL203
  Revised: 01/2010
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H. MEDICAL INSURANCE:


If there is currently health insurance in effect, who carries the coverage for the Child(ren):___________________
In reference to the deductible:
           Father pay's children's deductible
           Mother pay's children's deductible
           Each party will split deductible and other unreimbursed medical expenses for the children equally
           Other:_________________________________________________________________________


I. ATTORNEY’S FEES:
            There are multiple statutes in Georgia that allow one spouse to be awarded fees from the other spouse.
These provisions will be explained to you. Fees are generally awarded to another spouse based on his or her ability
to pay fees. Also, there are fees awarded if one party or the other accelerates or expands the litigation unnecessarily
Are you seeking an award of attorney fees from your spouse, if so, why?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________


Please list any other information below which has not been covered above that needs to be incorporated into your
paperwork or questions you have about the process:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________



  Form #: FL203
  Revised: 01/2010
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