Family Law Intake Form

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ASUM

Name:

Pronouns:

If other pronouns, please specify:

Email:

Phone Number:

I prefer to be contacted by:

Phone

Address:

Date of Birth

Student ID

Activity Fee Paid

Yes

Check all that apply

Undergraduate Student

Graduate Student

ASUM Employee

ASUM Senate Member

Other spouse or parent's name:

Other spouse or parent's address:

Children names, DOBs, and who they reside with primarily:

Child support ordered, paid, agreed, status?

Please describe your issue and an important details:

Divorce only - Date and County of Marriage:

Divorce only - Most recent Marital residence and duration:

Divorce only - Date of separation:

Divorce only - Property/Assets/Debt needing to be divided:

You will be notified as soon as possible how we are able to assist you. If you are given an appointment, this does not mean that you have retained us to represent you as your attorney. If we are able to represent you then we will sign a Retainer Agreement and you will pay an additional retainer fee. You are responsible for any legal requirements, deadlines and hearings. Sign your understanding:

Today's Date

Month

Day

Year

* Indicates a required field

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ASUM

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