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