DECREE/ORDER INFORMATION FORM

  • YOU:
  • THE OTHER PARTY:
  • [Ist, 3rd & 5th WEEKENDS, THURSDAYS DURING THE SCHOOL TERM, ALTERNATING HOLIDAYS, AND EXTENDED SUMMER VISITATION]
  • CHILD SUPPORT:
  • Please see Child Support Info. Sheet attached for an explanation of the Employer's Wage Withholding Order.
  • HEALTH INSURANCE:
  • (Uninsured Expenses are shared equally unless agreed otherwise)
  • INFORMATION ON CHILDREN:
  • PLACE OF BIRTH:
  • PLACE OF BIRTH:
  • PROPERTY BOUGHT DURING MARRIAGE
  • (PLEASE SUPPLY LEGAL DESCRIPTION AND STREET ADDRESS BELOW AND TELL US WHO WILL BE AWARDED THE PROPERTY OR IF IT WILL BE PUT UP FOR SALE. YOU MUST SUPPLY US WITH A COPY OF YOUR DEED OF TRUST FOR EACH PROPERTY.)
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  • (TYPE OF COVERAGE, AMOUNT, WHO OR WHAT IS COVERED)
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  • (YEAR, MODEL, MAKE, VIN AND WHO GETS CAR/TRUCK)
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  • (DESCRIPTION, CURRENT BALANCE, IN WHOSE NAME AND IS RETIREMENT/PENSION TO BE SPLIT WITH SPOUSE)
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  • (BANK, TYPE OF ACCOUNT, ACCOUNT #, WHOSE NAME)
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  • SEPARATE PROPERTY:

    (ALL GIFTS, INHERITANCES AND ANYTHING YOU OWNED PRIOR TO THE MARRIAGE)
  • NAME OF ACCOUNT:ACCT NO:WHO WILL BE RESPONSIBLE? YOU/SPOUSE 
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