|
A Divorce Financial Worksheet
(provided by Belli, Weil & Grozbean, P.C.)
This information sheet will serve as a valuable asset whether assisting us in the preparation of your case or for your personal record keeping.
There are many instances when you go through the information sheet that you will need to skip over certain sections because it does not apply to you or that you need to get additional information. In order for this packet to be of benefit to you it is crucial that you be as accurate as possible. There maybe some information, i.e., values that you don't know.
Name:__________________________________
Address:________________________________
________________________________
Telephone Number: (Home)______________________
Telephone Number: (Work)______________________
Telephone Number: (Cellular)______________________
Telephone Number: (Pager)______________________
Date of Birth:_______________ Place of Birth:___________________________________
Social Security Number:____________________
Date of Marriage: _________________
Place of Marriage: ________________
Type of Ceremony (Religious or Civil): ___________________
Name of Spouse:_____________ (Maiden Name) _________________
Spouse Date Of Birth: __________Place of Birth: ___________________________________
Spouse's Social Security Number:_______________________
If this is not your first marriage:
Name of former spouse: ____________________________
Date of marriage: ________________
Date of divorce: ____________ Court granting divorce:________________ Case No._________
Grounds of divorce: ______________Are you receiving ____ or paying alimony_____?
Amount $ ______________
If this is not your first marriage:
Name of former spouse: _______________________
Date of marriage: ________________
Date of divorce: ____________ Court granting divorce:________________ Case No._________
Grounds of divorce: ________________ Are you receiving ____ or paying alimony_____?
Amount $ ______________
If this is not your spouses first marriage:
Name of their former spouse: ____________________________
Date of marriage: ________________
Date of divorce: ____________ Court granting divorce:________________ Case No._________
Grounds of divorce: ______________Are they paying alimony_____?
Amount $ ______________
If this is not your first marriage:
Name of their former spouse: ________________________
Date of marriage: ________________
Date of divorce: ____________ Court granting divorce:________________ Case No._________
Grounds of divorce: ________________ Are they paying alimony_____?
Amount $ ______________
Children:
1. Name of Child:_______________________ Date of Birth:________________
2. Name of Child:_______________________ Date of Birth:________________
3. Name of Child:_______________________ Date of Birth:________________
4. Name of Child:_______________________ Date of Birth:________________
5. Name of Child:_______________________ Date of Birth:________________
6. Name of Child:_______________________ Date of Birth:________________
If you have a child that is not by this marriage then list below:
1 Name of Child:____________________ Date of Birth:________________
Child living with: __________ If paying or receiving support $__________
2 Name of Child:____________________ Date of Birth:________________
Child living with: __________ If paying or receiving support $__________
3. Name of Child:____________________ Date of Birth:________________
Child living with: __________ If paying or receiving support $__________
Your educational background including name of institution date of degree if any:
1. __________________________
2. __________________________
3. __________________________
Your spouses educational background including name of institution date of degree if any:
1. __________________________
2. __________________________
3. __________________________
Your employment history:
Name of Employer: ___________________________
1. Employer Address: ____________________________
____________________________
Years at current employment: ____years - Position______________ Salary: $_________
If less than 3 years:
1. Name of Employer: ___________________________
Employer Address: ____________________________
____________________________
Years at above employment: ____years - Position______________ Salary: $_________
2. Name of Employer: ___________________________
Employer Address: ____________________________
____________________________
Years at above employment: ____years - Position______________ Salary: $_________
Pensions:
Your Pension:
1. Type of Retirement: _________Year Started: _____Amount:$_________
How is investment Titled: ___________________
Name of fund and/ or Company: ________________________________
Account Number: ______________________
Telephone number of Broker or Bank ( )__________________
Address of Broker or Bank: ______________________
______________________________________
Telephone number of Broker or Bank carrier ( )__________________
Vested : (Yes)________ No ___________
If not vested: Date of vesting:______________
2. Type of Retirement: _________Year Started: _____Amount:$_________
How is investment Titled: ___________________
Name of fund and/ or Company: ________________________________
Account Number: ______________________
Telephone number of Broker or Bank ( )__________________
Address of Broker or Bank: ______________________
______________________________________
Telephone number of Broker or Bank carrier ( )__________________
Vested : (Yes)________ No ___________
If not vested: Date of vesting:______________
3. Type of Retirement: _________Year Started: _____Amount:$_________
How is investment Titled: ___________________
Name of fund and/ or Company: ________________________________
Account Number: ______________________
Telephone number of Broker or Bank ( )__________________
Address of Broker or Bank: ______________________
______________________________________
Telephone number of Broker or Bank carrier ( )__________________
Vested : (Yes)________ No ___________
If not vested: Date of vesting:______________
Spouses employment history:
Name of Employer: ___________________________
3. Employer Address: ____________________________
____________________________
Years at current employment: ____years - Position______________ Salary: $_________
If less than 3 years:
1. Name of Employer: ___________________________
Employer Address: ____________________________
____________________________
Years at above employment: ____years - Position______________ Salary: $_________
4. Name of Employer: ___________________________
Employer Address: ____________________________
____________________________
Years at above employment: ____years - Position______________ Salary: $_________
Spouses pension:
1. Type of Retirement: _________Year Started: _____Amount:$_________
How is investment Titled: ___________________
Name of fund and/ or Company: ________________________________
Account Number: ______________________
Telephone number of Broker or Bank ( )__________________
Address of Broker or Bank: ______________________
______________________________________
Telephone number of Broker or Bank carrier ( )__________________
Vested : (Yes)________ No ___________
If not vested: Date of vesting:______________
2. Type of Retirement: _________Year Started: _____Amount:$_________
How is investment Titled: ___________________
Name of fund and/ or Company: ________________________________
Account Number: ______________________
Telephone number of Broker or Bank ( )__________________
Address of Broker or Bank: ______________________
______________________________________
Telephone number of Broker or Bank carrier ( )__________________
Vested : (Yes)________ No ___________
If not vested: Date of vesting:______________
3. Type of Retirement: _________Year Started: _____Amount:$_________
How is investment Titled: ___________________
Name of fund and/ or Company: ________________________________
Account Number: ______________________
Telephone number of Broker or Bank ( )__________________
Address of Broker or Bank: ______________________
______________________________________
Telephone number of Broker or Bank carrier ( )__________________
Vested : (Yes)________ No ___________
If not vested: Date of vesting:______________
Real Estate:
1. Address of Property: ______________________
______________________________________
How is Property Titled: ___________________
Source of Funds for down payment (Marital- Pre-marital Inheritance) _________
Mortgage: Name of Lender:________________
Loan Number: ______________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Address of Lender: ______________________
______________________________________
Mortgage: Name of Lender Second or Home Equity:________________
Loan Number: ______________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
2. Address of Property: ______________________
______________________________________
How is Property Titled: ___________________
Source of Funds for down payment (Marital- Pre-marital Inheritance) _________
Mortgage: Name of Lender:________________
Loan Number: ______________________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Mortgage: Name of Lender Second or Home Equity:________________
Loan Number: ______________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
3. Address of Property: ______________________
______________________________________
Source of Funds for down payment (Marital- Pre-marital Inheritance) _________
How is Property Titled: ___________________
Mortgage: Name of Lender:________________
Loan Number: ______________________
Telephone number of lender ( )__________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Address of Lender: ______________________
______________________________________
Mortgage: Name of Lender Second or Home Equity:________________
Loan Number: ______________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
4. Address of Property: ______________________
______________________________________
Telephone number of lender ( )__________________
Source of Funds for down payment (Marital- Pre-marital Inheritance) _________
How is Property Titled: ___________________
Mortgage: Name of Lender:________________
Loan Number: ______________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
Mortgage: Name of Lender Second or Home Equity:________________
Loan Number: ______________________
Amount of Loan: $_________________ Balance of Loan: $_______________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
Homeowner Insurance:
Name of company: _____________________
Address of carrier: ______________________
______________________________________
Telephone number of carrier ( )__________________
Policy Number: _____________________________
Date of expiration: __________________________
Policy limits: ________________
Umbrella Insurance:
Name of company: _____________________
Address of carrier: ______________________
______________________________________
Telephone number of carrier ( )__________________
Policy Number: _____________________________
Date of expiration: __________________________
Policy limits: ________________
Automobiles:
1. Make: _________ Year: __________ VIN: ________________________
Amount Paid: $_____________ Balance of Loan: _____________
Source of Funds for down payment (Marital- Pre-marital Inheritance) $________
Who is driving the vehicle: ____________________
Name of Lender:________________
Loan Number: ______________________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
2. Make: _________ Year: __________ VIN: ________________________
Amount Paid: $_____________ Balance of Loan: _____________
Source of Funds for down payment (Marital- Pre-marital Inheritance) $________
Who is driving the vehicle: ____________________
Name of Lender:________________
Loan Number: ______________________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
3. Make: _________ Year: __________ VIN: ________________________
Amount Paid: $_____________ Balance of Loan: _____________
Source of Funds for down payment (Marital- Pre-marital Inheritance) $________
Who is driving the vehicle: ____________________
Name of Lender:________________
Loan Number: ______________________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
Automobile Insurance:
Name of company: _____________________
Address of carrier: ______________________
______________________________________
Telephone number of carrier ( )__________________
Policy Number: _____________________________
Date of expiration: __________________________
Policy limits: ________________
Boats:
Make: _________ Year: __________ VIN: ________________________
Where is boat docked: __________________
Name of Lender:________________
Loan Number: ______________________
Address of Lender: ______________________
______________________________________
Telephone number of lender ( )__________________
Boat Insurance:
Name of company: _____________________
Address of carrier: ______________________
______________________________________
Telephone number of carrier ( )__________________
Policy Number: _____________________________
Date of expiration: __________________________
Policy limits: ________________
Stocks - Bonds- Cash (Liquid assets):
Stocks:
1. Name of stock or fund: ____________________ Value: $_______________
Original Investment: $________________
Date Acquired: _____________
Source of Funds investment (Marital-- Pre-marital Inheritance) $________
How is investment Titled: ___________________
Name of Brokerage Company: ______________ Agent Name: ______________
Account Number: ______________________
Telephone number of Broker ( )__________________
Address of Broker: ______________________
______________________________________
Telephone number of Broker ( )__________________
2. Name of stock or fund: ____________________ Value: $_______________
Original Investment: $________________
Source of Funds for investment (Marital-- Pre-marital Inheritance) $________
Date Acquired: _____________
How is investment Titled: ___________________
Name of Brokerage Company: ______________ Agent Name: ______________
Account Number: ______________________
Telephone number of Broker ( )__________________
Address of Broker: ______________________
______________________________________
3. Name of stock or fund: ____________________ Value: $_______________
Original Investment: $________________
Source of Funds for investment (Marital-- Pre-marital Inheritance) $________
Date Acquired: _____________
How is investment Titled: ___________________
Name of Brokerage Company: ______________ Agent Name: ______________
Account Number: ______________________
Telephone number of Broker ( )__________________
Address of Broker: ______________________
______________________________________
4. Name of stock or fund: ____________________ Value: $_______________
Original Investment: $________________
Source of Funds for investment (Marital-- Pre-marital Inheritance) $________
Date Acquired: _____________
How is investment Titled: ___________________
Name of Brokerage Company: ______________ Agent Name: ______________
Account Number: ______________________
Telephone number of Broker ( )__________________
Address of Broker: ______________________
______________________________________
5. Bank Name: ____________________________
Account Number: ______________________ Checking or Savings ___________
Opening Balance: $________________ Current Balance: $______________
Closing Balance _______________ Date of Closing: _________________
Telephone number of Broker ( )__________________
Address of Bank: ______________________
_____________________________________
Telephone number of Bank ( )__________________
6. Bank Name: ____________________________
Account Number: ______________________ Checking or Savings ___________
Opening Balance: $________________ Current Balance: $______________
Closing Balance _______________ Date of Closing: _________________
Address of Bank: ______________________
_____________________________________
Telephone number of Bank ( )__________________
7. Bank Name: ____________________________
Account Number: ______________________ Checking or Savings ___________
Opening Balance: $________________ Current Balance: $______________
Closing Balance _______________ Date of Closing: _________________
Telephone number of Broker ( )__________________
Address of Bank: ______________________
_____________________________________
Telephone number of Bank ( )__________________
8. Safety Deposit Box:
Bank Name: ____________________________
Address of Bank: ______________________
_____________________________________
Telephone number of Bank ( )__________________
Contents: _____________________________
_____________________________
_____________________________
Who is in Possession of key: ______________________________
Who can sign for entry to box: ____________________________
Safety Deposit Box:
Bank Name: ____________________________
Address of Bank: ______________________
_____________________________________
Telephone number of Bank ( )__________________
Contents: _____________________________
_____________________________
_____________________________
Who is in Possession of key: ______________________________
Who can sign for entry to box: ____________________________
Personal Property:
PREMARITAL PROPERTY:
DESCRIPTION HOW ACQUIRED VALUE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
PREMARITAL PROPERTY:
DESCRIPTION HOW ACQUIRED VALUE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
DISPUTED PROPERTY AS TO MARITAL OR NON-MARITAL:
DESCRIPTION HOW ACQUIRED VALUE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Income:List all sources of your income including salary, alimony, child support, interest from
accounts, etc.,
Source: Amount (gross): Amount (net):
1.
2.
3.
4.
Income:List all sources of your spouses income including salary, alimony, child support, interest
from accounts, etc
1.
2.
3.
4.
DEBTS:
List all Liabilities:
Credit cards:
Card Issuer Account No Amount Owed Periodic Payments Sole-Joint
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Bank or other Loans:
Lender Name Loan No Amount Owed Periodic Payments Sole-Joint
1.
2.
3.
4.
Utilities:
Gas
Electric
Water
Miscellaneous charges including child care, medical insurance.etc.
1.
2.
3.
4.
5.
6.
7.
IRS debt: Include year(s) and amount owed:
1.
2.
3.
Information provided by:
Belli, Weil & Grozbean, P.C. located at
http://www.bwg-law.com
Go to: Maryland Articles and Resources
|
Please Read Our Disclaimer