Lawrence S. Pascoe's General
Matrimonial Information Form

Part I: Personal Information

Client: Client's Spouse:
 
1.  Full Legal Name:
 1.  Full Legal Name:
2.  Street Address:
 2.  Address:
3.  City and Province:
 3.  City and Province:
4.  Postal Code:
 4. Postal Code:
5.  Home Telephone Number:
 5. Home Phone Number:
6.  Work Telephone Number:
 6. Work Phone Number:
7.  Fax Number:
 7. Fax Number:
8. Cellular / Pager:
 8. Cellular / Pager
9.  E-mail address:
 9. E-mail Address:
10.  Resident in (municipality & province):
 10. Resident in (municipality and province):
11.  Since (date):
 11. Since (date):
12. Birthdate:
 12.  Birth Date:
13. Surname at birth:
 13.  Surname at Birth:
14. Surname just before marriage:
 14.  Surname just before marriage:
15. Divorced before?
no
yes

If yes, place and date of previous order

 15. Divorced before?
yes
no

If yes, place and date of previous order

Spouse's Lawyer's Name:

Payor's mother's maiden name (for Family Responsibility Office):

Relationship Dates:

1.  Married (date):

2.  Married (where):

3.  Started Living Together (date):

4. Separated (date):

5.

Never Lived Together
Still Living Together

6.  Reconciliation Date (if any):

Information About Your Children:

List each child's full legal name, age, birth date, resident in (specifying municipality and province), the name of the person they are now living with and the relationship to the child.

Previous cases or agreements:

Have you or the children been in a court case before?

no
yes

If yes, please provide the details:

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

no
yes

Date:

If yes, please provide the details:

Part II. Financial Information

Note: More detailed information will be obtained at a later date.

Assets and Debts (as of date of separation):

1.  House (Market value):

2.  Outstanding mortgage balance:

3.  Pension Value:

4. Spouse's Pension Value:

5.  Investment Assets:

6.  Spouse's Investment Assets:

7.  Joint Investment Assets:

8.  Automobile Value:

9.  Spouse's Automobile Value:

10.  Debts:

11.  Spouse's Debts:

12.  Joint Debts:

Assets and Debts (as of date of marriage):

1.  Value of Assets:

2.  Spouse's Assets:

3.  Debts:

4.  Spouse's Debts:

5.  Joint Debts:

Assets Received During Marriage:

1.  Value of Inheritances or Gifts received or proceeds of Life Insurance Received:

2.  Value of Spouse's Inheritances or Gifts received or proceeds of Life Insurance Received:

Client's Income Information: Spouse's Income Information:
 
1.  Annual Income from Employment:
 1.  Annual Income from Employment:
2.  Income from other Sources:
 2.  Income from other Sources:
3.  Job Description:
 3.  Job Description:
4.  Employer:
 4.  Employer:
5.  Employer's Address:
 5.  Employer's Address:
6.  Social Insurance Number:
 6.  Social Insurance Number:
7.  Employee Number:
 7.  Employee Number:

Issues:

Issue In Dispute?
 
Custody yes no not sure
Access yes no not sure
Child Support yes no not sure
Spousal Support yes no not sure
Equalization of Assets yes no not sure
Other Issues

**Note: Before submitting this form, you may want to save it to a file or print it out.

 

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