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