"Prenuptial/Postnuptial Agreement Intake Form - Amarai & Associates, P.c."

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Prenuptial/Postnuptial Agreement Intake
Client’s Name:
Fiancé’s/Spouse’s Name:
Date:
Spouse 1
First Name:
Middle Name:
Last Name:
Maiden Name:
Yes □
No □
Have you ever been known
by any other name?
Other legal names:
Date of Birth:
Social Security Number:
Street Address:
City/Town:
State & Zip Code:
Home Phone:
Cell Phone:
Work Phone:
Email:
How many times have you
been married?
Spouse 1’s Employment
Your Occupation:
Name of Your Employer:
Employer’s Street Address:
Employer City, State, and Zip Code
Employer’s Telephone Number:
1
Prenuptial/Postnuptial Agreement Intake
Client’s Name:
Fiancé’s/Spouse’s Name:
Date:
Spouse 1
First Name:
Middle Name:
Last Name:
Maiden Name:
Yes □
No □
Have you ever been known
by any other name?
Other legal names:
Date of Birth:
Social Security Number:
Street Address:
City/Town:
State & Zip Code:
Home Phone:
Cell Phone:
Work Phone:
Email:
How many times have you
been married?
Spouse 1’s Employment
Your Occupation:
Name of Your Employer:
Employer’s Street Address:
Employer City, State, and Zip Code
Employer’s Telephone Number:
1
Spouse 1’s Children
Do you have children born or adopted
Yes □
No □
prior to this marriage/relationship?
If yes, how many children?
Are there any previous court actions
Yes □
No □
involving these children?
Court Name:
Court location:
Docket Number(s):
Date of last Order/Judgment:
Disposition of last Order/Judgment:
Child 1
First Name:
Middle Name:
Last Name:
Date of Birth:
Social Security Number:
Gender:
City and State of Birth:
With whom does this
Mother □
Father □ Other □
child live?
If
child
lives
with
Street Address:
someone
other
than
City/Town:
Mother or Father, please
State &
list the child’s address:
Zip Code:
2
Child 2
First Name:
Middle Name:
Last Name:
Date of Birth:
Social Security Number:
Gender:
City and State of Birth:
With whom does this
Mother □
Father □ Other □
child live?
If
child
lives
with
Street Address:
someone
other
than
City/Town:
Mother or Father, please
State &
list the child’s address:
Zip Code:
Child 3
First Name:
Middle Name:
Last Name:
Date of Birth:
Social Security Number:
Gender:
City and State of Birth:
With whom does this
Mother □
Father □ Other □
child live?
If
child
lives
with
Street Address:
someone
other
than
City/Town:
Mother or Father, please
State &
list the child’s address:
Zip Code:
3
Child 4
First Name:
Middle Name:
Last Name:
Date of Birth:
Social Security Number:
Gender:
City and State of Birth:
With whom does this
Mother □
Father □ Other □
child live?
If
child
lives
with
Street Address:
someone
other
than
City/Town:
Mother or Father, please
State &
list the child’s address:
Zip Code:
Child 5
First Name:
Middle Name:
Last Name:
Date of Birth:
Social Security Number:
Gender:
City and State of Birth:
With whom does this
Mother □
Father □ Other □
child live?
If
child
lives
with
Street Address:
someone
other
than
City/Town:
Mother or Father, please
State &
list the child’s address:
Zip Code:
4
Spouse 2
First Name:
Middle Name:
Last Name:
Maiden Name:
Yes □
No □
Have you ever been known
by any other name?
Other legal names:
Date of Birth:
Social Security Number:
Street Address:
City/Town:
State & Zip Code:
Home Phone:
Cell Phone:
Work Phone:
Email:
How many times have you
been married?
Spouse 2’s Employment
Your Occupation:
Name of Your Employer:
Employer’s Street Address:
Employer City, State, and Zip Code
Employer’s Telephone Number:
5