Client Questionnaire for Custody

Click here to download the 'Custody' Form

 

Date of Questionnaire:  
Client Is: Petitioner
Respondent
Both		  
Client's Email Id:  
     
First Name: Middle Name: Last Name:
Other names used:  
Maiden Name:  
(Client's last name before he/she got married, if different from current last name.)
     
Marital Status:  
Social Security #:  
Does client wish to keep her social security # confidential? Yes No  
     
Current Address:    
Street Address:  
City:  
State:  
Zip Code:  
Country:  
Does client wish to keep her current address confidential? Yes No  
Ok to mail to above address? Yes No  
If not, mailing address:
Street Address:  
City:  
State:  
Zip Code:  
Country:  
     
If opposing party is not the father of the child(ron), State name and address of the father(s) of the child(ren):
Is there a law guardian for the child(ren)?  
If so, what is the contact information for law guardian?  
     
Opposing party's information    
Name of opposing party:  
Social Security Number:  
How is client related to the opposing party?  
Current address of opposing party:    
Street Address:  
City:  
State:  
Zip Code:  
Country:  
     
If the client does not know her opposing party's current address, is there any other location where he/she can be found? Yes No  
If yes, where?  
Phone No.:  
Date of Birth:  
Race:  
Other:  
Immigration Status: Citizen eligible alien
Undocumented alien 		 
Highest level of education completed:  
Partial college(how many years? ):  
Partial high school(how many years? ):  
Is English his first language?: Yes No  
If the answer is "no," what is his first language:  
Is the opposing party represented by counsel?: Yes No  
If yes, attorney's name, phone, and address  
Opposing party's employment information:  
Name and Address of his employer (if applicable):  
   
Court Information:  
Is there a current family court case pending?  
If so, is he/she the petitioner?  
If so, has the client had papers served yet?  
If so, when? (please obtain affidavit of service)
If not, how many attempts were made?  
If client is respondent, has the client been served?  
If so, with what was client served with?  
If so, when? Yes No  
If so, how was he/she served? Yes No  
If so, has he/she filed an answer?  
     
Is there an upcoming court date?  
If so, when:  
Which court?  
When was the case filed?  
What is the docket number?  
How many (if any) court appearances have already been made?  
Dates of prior court appearances:  
What happened at prior court appearances?  
Has a temporary order of protection been issued?  
If so, what is expiration date?  
It so, what are the terms?  
note: obtain copies of all orders.    
Is there a criminal court order of protection?  
If so, what court:  
Which county:  
Docket Number #:  
Terms of Order:  
Indicate here all information regarding all client's present and past order of protection cases in NY court[s]and in all states:
     
Please indicate why you would like custody or visitation:
     
Verification Code: