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ONE OF THE NATIONS PREEMINENT FAMILY LAW FIRMS-NATIONAL/INTERNATIONAL PRACTICE. FOR CONSULTATION

Separation & Divorce: Financial Information Questionnaire


Support Orders
$____________________ $____________________
Other
$____________________ $____________________
TOTAL DEDUCTIONS:
$____________________ $____________________
NET MONTHLY INCOME: (gross income minus total deductions)
$____________________ $____________________
Monthly Expenses
Rent or Mortgage
$____________________ $____________________
Utilities:
Telephone
$____________________ $____________________
Gas
$____________________ $____________________
Electricity
$____________________ $____________________
Water & Sewer
$____________________ $____________________
Garbage Collection
$____________________ $____________________
Cable Television
$____________________ $____________________
Cellular Phone
$____________________ $____________________
Internet Service
$____________________ $____________________
Property Taxes
$____________________ $____________________
Insurance:
Medical
$____________________ $____________________
Dental
$____________________ $____________________
Life
$____________________ $____________________
Disability
$____________________ $____________________
Long-term Care
$____________________ $____________________

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