• Please now complete the following form as far as possible, the advice we give is dependent upon the information you provide.

• Please approximate if you do not know the precise answer to any question.

• All enquiries are strictly confidential.

YOUR DETAILS

First Name:*

Surname:*

Address:*

Daytime Tel:*

Email:

We may need to contact you to discuss details. Can we contact you by telephone?

MARRIAGE INFORMATION

Please confirm the legal status of your relationship:

Are you separated?

Date of separation

Spouse's full name

Date of marriage

Place of marriage

Do you know your spouse's present address?

If yes, please provide details.

Address of the matrimonial (family) home

Please describe the occupancy of the matrimonial home

Please describe the ownership of the matrimonial home (or whose name it is held in)

If other, supply details:

When was the matrimonial home or family home purchased?

If other, supply details:

Do you have any Children under 16 years?

Please provide names and Dates of Birth for all children

ASSETS AND DEBTS

• Please provide details of assets owned by either you or your spouse/partner, in joint names or individually, at the date of separation.

• If you are not separated please still provide details of assets - but at the current date

• If you do not know a particular value please try to provide a reasonable estimate as the advice we give is dependent upon the information you provide

Please select the types of assets owned by you or your spouse/partner at the date of separation by entering their value:

Matrimonial Home (£)

Other Heritable Property (holiday homes, flats, timeshares, etc (£)

Bank and Building Society Accounts (£)

Insurance and Endowment Policies (£)

Stocks, Shares, Unit Trusts, Peps, ISA's, Tessa's, etc (£)

Pensions (£)

Private cars, furniture, fine art, jewellery, boats, caravans, etc (£)

Business Assets, Partnerships, Profitshare, etc (£)

Private Loans(£)

Any other Capital Items (£)

Did you bring any of your own funds into the marriage?

If yes please provide details

Did you inherit any property during the marriage?

If yes, please provide details:-

Was any property gifted to you as an individual during the marriage by someone other then your spouse?

If yes, please provide details

DEBTS

• Please provide details of DEBTS owned by either you or your spouse/partner, in joint names or individually, at the date of separation.

• If you are not yet separated, please still provide details of DEBTS - but at the current date.

• If you do not know a particular value please try to provide a reasonable estimate as the advice we give is dependent upon the information you provide.

Please select the types of debts owned by you or your spouse/partner at the date of separation by entering the value:

Matrimonial Home (£)

Mortgages over other property (£)

Bank, Loans, Credit/Store Card Debts (£)

Any other Debts (£)

INCOME AND EXPENSES

YOUR INCOME

Please provide details of your household income

• (If your income is not weekly, ie monthly, please estimate the average weekly equivalent) Please state your average net weekly income (after Income Tax and National Insurance)

My average net weekly income is (£)

SPOUSE'S/PARTNER'S INCOME

• (If your income is not weekly, ie monthly, please estimate the average weekly equivalent) Please state your average net weekly income (after Income Tax and National Insurance)

My Spouse/Partners average net weekly income is (£)

EXPENDITURE SECTION

• Please provide an estimate of all regular household expenses (If expenses are not weekly, ie monthly, please estimate the average weekly equivalent - £ per week)

Food and Groceries (£)

Telephone (£)

Electricity, Gas, Central Heating (£)

Council Tax and Water Rates (£)

Rent / Mortgage / Loan Repayments (£)

Childcare Expenses (£)

Travel Expenses - Work (£)

Regular Debt / HP payments (£)

Others (£)

Your Circumstances

Please give a summary of your situation and areas of dispute: -

Queries are responded to from 9am-5pm, Monday - Friday