Divorce/Separation Agreement Worksheet

HUSBANDS INFORMATION

Full Name:  ____________________________________ 

Social Security Number:  _______-_____-_______

Date Of Birth:  _______/_____/_______

Mailing Address:  ___________________________ _______City:___________________

Zip Code:_____________

Physical Address:_________________________________________________________

Phone Number:  (Home)_______-_______-__________ (Other)_______-_______-_______

What Number of Marriage Was This:  ______________

State or County of Birth:  _________________________________________________________________________

Education Level:  __________________________________ Years of College:___________

WIFES INFORMATION

Full Name:  ____________________________________ 

Social Security Number:  _______-_____-_______

Date Of Birth:  _______/_____/_______

Mailing Address:  ___________________________________ City:_______________ 

Zip Code:_______________

Physical Address:___________________________________________________________

Phone Number:  (Home)_______-_______-__________ (Other)_______-_______-_______

What Number of Marriage Was This:  ______________

State or County of Birth:  ________________________________________________________________________

Education Level:  ____________________________________  Years of College:_________________

MARITAL INFORMATION

Date of Marriage:  __________/__________/_________

Date of Separation:  _________/_________/__________

Number of Children Born of This Marriage:  __________________

Name and Birth Dates of Children:

1.______________________________________________________

DOB:_________/________/________

2. ______________________________________________________

DOB:_________/________/________

3.______________________________________________________

DOB:_________/________/_________

4.______________________________________________________

DOB:_________/________/_________

5.______________________________________________________

DOB:_________/________/_________

Number of Children Under 18 Whose Physical Custody was Awarded to:

Husband: ______________   Wife: _______________

Joint Custody: ______________  Other: _____________  No Children: _____________

Legal Grounds of Divorce:_______________________________________________________________

County and State (or Country) you were Married in:  (County)___________________ (State)___________________
(Country)___________________

Last County and State you lived together as Husband and Wife:

(County)__________________ (State)____________

List Name and Date of Birth of ALL Children Under the Age of 18 (Eighteen)

1.____________________________________________________________

2.____________________________________________________________

3.____________________________________________________________

4.____________________________________________________________

5.____________________________________________________________

6.____________________________________________________________

List ALL Vehicles Make and Model, Even if they are NOT Titled in Both Names:

1._____________________________________________________________

2._____________________________________________________________

3._____________________________________________________________

4._____________________________________________________________

List Location and/or Description, Deed Book, Page Number and County of
ANY and ALL Real Estate Owned also List Date when it was Received or Purchased:

1._______________________________________________________________

2._______________________________________________________________

3._______________________________________________________________

List ALL other Property Real or Otherwise:

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

**List any additional Children and/or Properties on the back of this worksheet.
Copyright 2006 T. Shea Cook