DAVIS & TALIAFERRO, L.L.C HALCYON PARK DRIVE MONTGOMERY, ALABAMA UNCONTESTED DIVORCE INFORMATION FORM

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1 DAVIS & TALIAFERRO, L.L.C HALCYON PARK DRIVE MONTGOMERY, ALABAMA Telephone: (334) Facsimile: (334) Greg Davis Dan W. Taliaferro Tammi Poff UNCONTESTED DIVORCE INFORMATION FORM Please complete Part A if there were no children born of this marriage. Complete both Part A and Part B if there were children born of this marriage PART A: CLIENT INFORMATION: NAME: LAST FIRST MIDDLE MAIDEN(if applicable) STREET ADDRESS: CITY:, STATE: ZIP: DATE OF BIRTH: / / RACE: SOCIAL SECURITY NUMBER: - - HAVE YOU LIVED IN THE STATE OF ALABAMA FOR AT LEAST THE LAST SIX MONTHS? PLEASE CIRCLE YES NO HOME PHONE:, WORK PHONE: CELL PHONE: PRESENT EMPLOYER: EMPLOYER S ADDRESS: 1

Complete both Part A and Part B if there were children born of this marriage PART A: CLIENT INFORMATION: NAME: LAST FIRST MIDDLE MAIDEN(if applicable) STREET ADDRESS: CITY:, STATE: ZIP:

2 JOB TITLE OR POSITION: EDUCATION: PLEASE CIRCLE THE HIGHEST GRADE COMPLETED: HIGH SCHOOL: COLLEGE: OTHER SCHOOL MARRIAGE INFORMATION: DATE OF MARRIAGE: / / CITY AND STATE WHERE YOU WERE MARRIED: HAVE YOU OR YOUR SPOUSE EVER BEEN MARRIED BEFORE? YES NO IF SO, HOW MANY TIMES? YOU:. YOUR SPOUSE: HOW DID PREVIOUS MARRIAGE END? DIVORCE / ANNULMENT/ DEATH DATE YOU AND YOUR SPOUSE SEPARATED: / / WHAT ARE YOUR GROUNDS FOR WANTING A DIVORCE? ( INCOMPATIBILITY, IMPRISONMENT, PHYSICAL CRUELTY, DESERTION, ADULTERY 2

BEFORE? YES NO IF SO, HOW MANY TIMES? YOU:. YOUR SPOUSE: HOW DID PREVIOUS MARRIAGE END?

3 DIVISION OF MARITAL ASSETS: DO YOU AND YOUR SPOUSE OWN ANY REAL ESTATE TOGETHER? YES NO IF YES, HOW IS THE REAL ESTATE TO BE DIVIDED? WHO IS RESPONSIBLE FOR ANY MORTGAGE PAYMENTS ON THE REAL ESTATE? HAVE YOU AND YOUR SPOUSE ALREADY DIVIDED YOUR PERSONAL PROPERTY? Yes No IF, NOT THEN HOW IS PROPERTY TO BE DIVIDED? (Use additional paper if necessary.) LIST ALL AUTOMOBILES OWNED INCLUDING MAKE, MODEL, YEAR AND WHO IS TO RECEIVE AUTOMOBILE IN THE DIVORCE SETTLEMENT: Year Make Model (Who is to receive auto in divorce?) Year Make Model (Who is to receive auto in divorce?) Year Make Model (Who is to receive auto in divorce?) DO YOU AND YOUR SPOUSE HAVE ANY JOINT BANKING ACCOUNTS? YES NO DO YOU AND YOUR SPOUSE OWN ANY SAVINGS ACCOUNTS, CERTIFICATES OF DEPOSIT, ANNUITIES, STOCKS, BONDS, RETIREMENT PLANS OR OTHER TYPES OF INVESTMENT ACCOUNTS. YES NO 3

) LIST ALL AUTOMOBILES OWNED INCLUDING MAKE, MODEL, YEAR AND WHO IS TO RECEIVE AUTOMOBILE IN THE DIVORCE SETTLEMENT: Year Make Model (Who is to receive auto in divorce?

4 IF YOU ANSWERED YES ABOVE, THEN HOW ARE ACCOUNTS AND FUNDS TO BE DIVIDED? SPOUSE INFORMATION: NAME: LAST FIRST MIDDLE MAIDEN(if applicable) STREET ADDRESS CITY, STATE, ZIP CODE DATE OF BIRTH / / RACE: SOCIAL SECURITY NUMBER: - - HOME PHONE, WORK PHONE CELL PHONE SPOUSE S EMPLOYER EMPLOYER ADDRESS SPOUSE S JOB TITLE: SPOUSE S EDUCATION: PLEASE CIRCLE THE HIGHEST GRADE COMPLETED: HIGH SCHOOL: COLLEGE: OTHER SCHOOL Additional information, anything you believe may be important, if any. 4

SOCIAL SECURITY NUMBER: - - HOME PHONE, WORK PHONE CELL PHONE SPOUSE S EMPLOYER EMPLOYER ADDRESS SPOUSE S JOB TITLE: SPOUSE S

5 PART B: Please complete this section if children were born of the marriage. All information requested in this section is necessary to complete the forms and pleadings required by the Court to file a uncontested divorce. Both parties gross monthly income is required in order to calculate child support guideline court forms. INCOME INFORMATION: WHAT IS YOUR MONTHLY INCOME? HOW MUCH DO YOU MAKE AN HOUR? HOW MANY HOURS A WEEK DO YOU WORK? ARE YOU A SALARIED EMPLOYEE? IF SO, WHAT IS YOUR YEARLY INCOME? WHAT IS YOUR SPOUSE S MONTHLY INCOME? HOW MUCH DOES YOUR SPOUSE MAKE PER HOUR? HOW MANY HOURS A WEEK DOES YOUR SPOUSE WORK? IS YOUR SPOUSE A SALARIED EMPLOYEE? IF SO, WHAT IS YOUR SPOUSE S YEARLY INCOME? CHILD INFORMATION: LIST THE NAMES OF ALL CHILDREN BORN OF THE MARRIAGE ALONG WITH THEIR DATE OF BIRTH AND SOCIAL SECURITY NUMBERS. NAME DATE OF BIRTH Soc. Sec. # NAME DATE OF BIRTH Soc. Sec. # 5

Both parties gross monthly income is required in order to calculate child support guideline court forms. INCOME INFORMATION: WHAT IS YOUR MONTHLY INCOME? HOW MUCH DO YOU MAKE AN HOUR?

6 NAME DATE OF BIRTH Soc. Sec. # NAME DATE OF BIRTH Soc. Sec. # WHO DO THE CHILDREN RESIDE WITH? WHICH PARENT IS TO HAVE PRIMARY PHYSICAL CUSTODY OF THE PARTIES MINOR CHILDREN? WHO IS TO MAINTAIN HEALTH INSURANCE ON THE PARTIES MINOR CHILDREN? ARE THE CHILDREN COVERED BY MEDICARE, MEDICAID, OR OTHER STATE SPONSORED HEALTH INSURANCE? YES NO IF YOU ANSWERED THE PRECEEDING QUESTION YES, PLEASE PROVIDE THE NAME OF THE AGENCY. IF THE PARTIES MINOR CHILDREN ARE COVERED BY HEALTH INSURANCE BY ONE OF THE PARENTS, HOW MUCH IS THE MONTHLY PREMIUM FOR THE HEALTH INSURANCE? Do the parties minor children attend day care? YES NO If yes, how much is the weekly day care amount. $ DO YOU OR YOUR SPOUSE PAY CHILD SUPPORT FOR A CHILD BORN DURING A PREVIOUS UNION? HOW DID YOU FIND OUT ABOUT DAVIS & TALIAFERRO, LLC? 6

YES NO IF YOU ANSWERED THE PRECEEDING QUESTION YES, PLEASE PROVIDE THE NAME OF THE AGENCY.

7 UNCONTESTED DIVORCE FEE CONTRACT This FEE CONTRACT, entered into between CLIENT and DAVIS & TALIAFERRO, LLC on this the day of, WITNESSETH: 1. For the sum of $ plus filing fee as set by the applicable Domestic Relations and/or Circuit Court Clerk, the undersigned CLIENT does hereby employ DAVIS & TALIAFERRO, LLC, as attorney to represent CLIENT for preparation and filing of an UNCONTESTED DIVORCE against his or her spouse in the State of Alabama. These contracted services are specifically limited to the following: A. The preparation and filing of a complaint, affidavit, answer, waiver of counsel, settlement agreement, and if applicable, a uniform child custody jurisdiction act affidavit and child support guideline forms. B. The $ fee, and additional filing fee, entitles CLIENT to meet with an attorney, employed by DAVIS & TALIAFERRO, LLC, for an initial consultation and for the completion of the aforementioned forms and filing of the same. C. The $ fee paid by CLIENT expressly does not cover any court appearances, should any Court require an appearance, for any reason. Fees for appearances in court are billed at a rate of $ per hour. 2. CLIENT understands that this Contract is specifically limited to an uncontested divorce filing and proceeding. All terms of the divorce MUST be agreed to by and between the CLIENT and his or her spouse prior to the drafting of any of the forms listed in paragraph A above. In the event CLIENT cannot agree with his or her spouse as to any term of any of the documents drafted and/or prepared for CLIENT, and additional legal services are rendered necessary, additional fees shall be charged to CLIENT at the rate of $ per hour for all additional legal services performed by DAVIS & TALIAFERRO, LLC. Any appearance in court shall be billed at a rate of $ per hour, and a retainer, in an amount quoted by DAVIS & TALIAFERRO, LLC and paid by CLIENT 30 days in advance of any court hearing, shall be required of the CLIENT before any attorney employed by DAVIS & TALIAFERRO, LLC, will appear in court for CLIENT. Failure to pay any required retainer shall result in the immediate withdrawal of DAVIS & TALIAFERRO, LLC as counsel for CLIENT. 3. THIS CONTRACT DOES NOT INCLUDE LEGAL SERVICES BEYOND WHAT IS EXPRESSLY STATED IN PARAGRAPH 1 HEREIN UNLESS ADDITIONAL ATTORNEYS FEES AND A RETAINER ARE PAID BY CLIENT TO DAVIS & TALIAFERRO, LLC. 7

preparation and filing of an UNCONTESTED DIVORCE against his or her spouse in the State of Alabama. These contracted services are specifically limited to the following: A.

8 4. CLIENT expressly agrees that any and all damages he or she may claim, as a result of any legal advice, legal representation, work, or service performed, or not performed, or for any act of commission or omission by DAVIS & TALIAFERRO, LLC, its agents, employees, or attorneys, in connection with any domestic or divorce action undertaken by DAVIS & TALIAFERRO, LLC for CLIENT, shall be strictly limited to the sum of $199.00, and CLIENT expressly and specifically acknowledges that DAVIS & TALIAFERRO, LLC s agreement to the contract price of $ is good and sufficient consideration for CLIENT S limitation of damages as agreed herein. 5. THIS FEE CONTRACT CONTAINS ALL TERMS, WHETHER WRITTEN OR ORAL, OF THE AGREEMENT REACHED BETWEEN CLIENT AND DAVIS & TALIAFERRO, LLC. ANY ORAL REPRESENTATIONS, WHETHER MADE BY CLIENT OR DAVIS & TALIAFERRO, LLC, IF NOT CONTAINTED HEREIN IN WRITING ARE NOT TERMS OF THIS FEE CONTRACT AND ARE NOT AGREED TO BY CLIENT AND DAVIS & TALIAFERRO, LLC. BY SIGNING THIS CONTRACT, CLIENT ACKNOWLEDGES THAT HE OR SHE IS LITERATE, HAS HAD THE OPPORTUNITY TO READ EVERY WORD OF THIS CONTRACT, HAS HAD THE OPPORTUNITY TO RECEIVE LEGAL ADVICE BEFORE SIGNING THIS CONTRACT, AND UNDERSTANDS AND AGREES TO THIS CONTRACT AND ALL OF ITS TERMS. CLIENT DAVIS & TALIAFERRO, LLC 8

strictly limited to the sum of $199.00, and CLIENT expressly and specifically acknowledges that DAVIS & TALIAFERRO, LLC s agreement to the contract price of $199.

Divorce Information and Worksheet

Divorce Information and Worksheet Instructions: This worksheet is designed to be used by persons contemplating a divorce. It may also be used by your attorney. Completing this form before your initial