Client Information Form

The information we have asked for below will help us to understand your personal situation better, so that we can provide you with the best advice we can, at the most efficient cost. PLEASE NOTE that ALL information you give us will be held in the STRICTEST CONFIDENCE, whether you ultimately decide to retain us as your attorneys or not.

Your Information:
Full Name		Date of Birth
Home Address		SS Number
City		Employer
State		Position
Zip Code		Salary
County		E-mail
Home Phone		Work Phone
Cell Phone
Please list any MySpace, FaceBook or other social networking sites:

If you have an attorney, who?
Why?
How were you referred to us?


Opposing Party Information:
Full Name		Date of Birth
Home Address		SS Number
City		Employer
State		Position
Zip Code		Salary
Home Phone		Work Phone
Cell Phone
If attorney, who?


Children:
Name, Age, DOB:		School, Grade:







Marriage Date		Separation Date
City/State		Divorce Date



Narrative:




Assets:




Comments:


	All information, including E-mail addresses, will be kept in strictest privacy and will not be distributed.


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