Matrimonial Information Sheet

Todays Date
Who referred you to us?

PERSONAL INFORMATION

Name *
Current address
Street/Apt. No.
City
Postal Code
Home Phone *
Work Phone
Where would you like mail to be sent ? Same as above
Or
E-mail address *
Can confidential information be sent to this e-mail address YesNo
Your occupation
Name and address of your employer
Your approximate income
From employment
From other sources
Date of Birth
Your Birth Place
When did you begin to reside in Ontario

YOUR SPOUSE

Spouse's name
Spouse's Address
Spouse's Phone No.
Spouse's E-mail
Spouse's Income
From employement
From other sources
Spouse's Date of Birth
Spouse's Birth Place
When did you spouse begin in reside on Ontario?
Does you spouse have a lawyer YesNo
SPOUSE'S LAWYER (IF KNOWN)
Name
Address
Phone No.

DETAILS OF YOUR MARRIAGE

Date of Marriage
Marriage Place
Name of Wife at Marriage
Name of Husband at Marriage
Have you been married before? YesNO
Do you have Original Marriage Certificate? YesNo
If yes
Date of previous divorce
Place of previous divorce
Do you have a copy of the Certificate of Divorce or the Divorce
Judgment
YesNo
What was your previous Spouse

CHILDREN: (Under 18 years or still dependent on you or your spouse)

Name
Age
Date of Birth
Now living with
Name
Age
Date of Birth
Now living with
Name
Age
Date of Birth
Now living with
Name
Age
Date of Birth
Now living with

CURRENT LIVING ARRANGEMENTS

Have you separated YesNo
If so, on what date?
Who is living in the matrimonial home?
Have you had marriage counselling? YesNo
If yes, with whom?
Do you think counselling would be helpful? YesNo

EXISTING AGREEMENT

Have you signed a marriage contract, cohabitation agreement or
other document dealing with rights between you and your spouse?
YesNo
Have you sand your spouse any agreements in place (in writing or
otherwise) regarding your respective rights on separation?
YesNo

LITIGATION

Do you have any court proceedings between you and your spouse YesNo
If yes, please give details
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