New Client Information | Leigh Daniel Family Law

Today's Date:

Name:

Date of Birth:

Sex:

Street Address:

City:

Are you in the city limits?

County:

State:

Zip Code:

Phone:

Education Level (1-24):

Race:

Cell Phone:

Email Address:

Reason for Today's Visit:

Type of Action (please check each that apply to your action):

Child Support

Visitation

Custody

Paternity

Other, Please List:

What qualities do you feel are most important in an attorney-client relationship:

How did you hear about us? (please select one of the following):

Where were you married:

Date of Marriage:

Separation Date:

Number of Children:

Will wife return to former name (Y/N):

Wife's former name:

Social Security Number:

Number of marriages:

Previous marriage ended by:

Enter the following information on your most recent employer.

Are You Employed:

Position/Title:

Employer:

Address:

City:

State:

Zip Code:

Work Phone:

Monthly Gross Salary:

Other Employment Income:

Self-Employment Income:

Non-Employment Income:

Pre-Existing Alimony:

Pre-Existing Child Support:

Debts Retained:

Property Retained:

Opposing Party Information

Name:

Date of Birth:

Sex:

Street Address:

City:

Are you in the city limits:

County:

State:

Zip Code:

Phone:

Education Level (1-24):

Race:

Cell Phone:

Email Address:

Social Security Number:

Number of marriages:

Previous marriage ended by:

Enter the following information on your spouse's most recent employer.

Are You Employed:

Position/Title:

Employer:

Address:

City:

State:

Zip Code:

Work Phone:

Monthly Gross Salary:

Other Employment Income:

Self-Employment Income:

Non-Employment Income:

Pre-Existing Alimony:

Pre-Existing Child Support:

Debts Retained:

Property Retained:

Children Information

Name:

Address:

Sex (M/F):

Birth Date:

Social Security Number:

Name:

Address:

Sex (M/F):

Birth Date:

Social Security Number:

Name:

Address:

Sex (M/F):

Birth Date:

Social Security Number:

Additional addresses where the children have lived:

List additional persons the children have lived with:

Will daycare be paid by husband or wife:

Amount:

Will health insurance be paid by husband or wife:

Amount:

Child Support shall be calculated by the guidelines of the Code of Alabama. If the parties have agreed on an amount higher that that calculation, then the Court will normally approve such an action. If the amount is less than the amount calculated by the guidelines of the Code of Alabama, then the Judge will require a reason that benefits the child(ren) in lieu of the calculated child support.

Will the child support guidelines be followed:

If no, then please explain:

If no, amount of child support to be paid:

Who will have physical custody:

Type of custody (joint/sole):

Monday	8:30 am - 4:30 pm
Tuesday	8:30 am - 4:30 pm
Wednesday	8:30 am - 4:30 pm
Thursday	8:30 am - 4:30 pm
Friday	8:30 am - 4:30 pm