Arlene Glenn Simolike, Esq. and Associates, P.C.

Northeast Philadelphia
9223 Frankford Avenue
Philadelphia, PA 19114-2823
Phone: (215) 335-9986
e-mail
map & directions

Bucks County
1200 Bustleton Pike
Suite 15A
Feasterville, PA 19053
Phone: (215) 355-6179
e-mail
map & directions

New Jersey Office
Phone: (856) 662-2215

“Personalized and caring service to each and every client”

Personalized and caring service to each and every client

Family Law Intake Form

*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

What type of family law matter are you interested in?

Are you currently married or cohabiting?
Yes  No 

Check one:
Married  Cohabiting 

If yes, list his or her name, date of birth, and date of marriage/cohabitation:

Do you have children?
Yes  No 

If yes, list their names and dates of birth:

Name Date of Birth

If you have children, with whom and where do they live now?

Were you previously married?
Yes  No 

If yes, when and how did your previous marriage(s) end?

Is your case contested or do you anticipate you will meet opposition to your anticipated actions?
Yes  No 

Have you been served with papers in a family law matter?
Yes  No 

If yes, what is the name of the opposing party and his or her attorney (if known)?

What is your relationship with the opposing party?

If "Other Relationship," please explain:

Have you appeared in court or agreed on terms related to this matter?
Yes  No 

Do you have copies of any documents (court decrees, dissolution agreements, etc.) related to this matter?
Yes  No 

What types of documents do you have?

Is domestic violence an issue in this matter?
Yes  No 

If yes, please describe, including any court actions and incident dates.

Is property at issue?
Yes  No 

If yes, please describe the property and anything known with regard to legal ownership.

Are you or any person involved in this matter currently pregnant?
Yes  No 

Where did you hear about this website?

 

The contents of this contact form are provided by and are the responsibility of the person posting the email communication. Your email will not create an attorney-client relationship and will not necessarily be treated as privileged or confidential. You acknowledge that any reliance on material in email communications is at your own risk.

© Copyright all rights reserved - disclaimer

The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for individual advice regarding your own situation. Click here for FULL DISCLAIMER

This FirmSite® is designed and hosted by FindLaw®