Dissolution Form My name is:* And my email address is:* Home Phone: Mobile Phone: State you were born in: Last time you lived outside of Illinois: Resident of Illinois since: Employer: Job Title: Other sources of income: Married previously?:* YesNo County & State of Prior Divorce: Do you have a child support or maintenance (“alimony”) obligation for child(ren) or former spouse outside of your current marriage?:* YesNo If you have a prior support or maintenance obligation, please provide the County the Order was entered in, the case number and the name of the opposing party: Do you have children living with you that are not children of your spouse?:* YesNo Names and ages of Children living with you that are not children of your spouse: Your Spouse's Full Name: Spouse's Street Address: Spouse's City: Spouse's State: Spouse's Zip: Spouse's home phone: Spouses cell phone: Spouse's work phone: Spouse's email: Last time spouse lived outside of Illinois: Spouse resident of Illinois since: Last time spouse lived outside of Illinois: Spouse employer: Spouse job title: Spouse other source of income: Was spouse previously married:* YesNo How did spouse's previous marriage end: How did spouse's previous marriage end: County and state of spouse's prior divorce: Does your Spouse have a child support or maintenance (“alimony”) obligation for child(ren) or former spouse outside of your current marriage?:* YesNo If your Spouse has a prior support or maintenance obligation, please provide the County the Order was entered in, the case number and the name of the opposing party: If your Spouse has a prior support or maintenance obligation, please provide the County the Order was entered in, the case number and the name of the opposing party: Does your Spouse have children living with him/her that are not your children?:* YesNo Names and ages of Children living with your Spouse that are not your children: Date of Marriage: Date: City, County and State of Marriage: Date of separation: Are you still residing in the same house?:* YesNo Wife's maiden name: Children Born or Adopted of the Marriage (Names & Date of Birth): Is Wife Currently Pregnant?:* YesNo If Wife is Currently Pregnant, Is Husband the Father?:* YesNo Request for Decision Making for children:* YesNo Sole decision making:* Sole Decision Making to WifeSole Decision Making to Husband Children's Residential Address with: WifeHusband Request for Maintenance (Alimony):* Both parties waiveWife requestsHusband requests Education of Husband:* High SchoolSome CollegeCollege DegreeGrammar SchoolOther Education of Wife:* High SchoolSome CollegeCollege DegreeGrammar SchoolOther Husband's Race: Wife's Race: Have you or your Spouse ever filed for Bankruptcy?:* YesNo If you or your Spouse have every filed for Bankruptcy, please provide the date it was filed: Location of the Bankruptcy Filing: Do you or your Spouse currently or have you had any romantic/sexual relations with anyone other than each other during the marriage?: Wife YesHusband YesBoth Yes Do you or your Spouse currently or have you had any romantic/sexual relations with anyone other than each other during the marriage?: Automobiles: Make, model, year, mileage, condition, Equipment/Features, Value, Loan Balance, Lender Name, Name Title is Held in: Bank accounts: (Checking, Savings, Stocks/Bonds, CD’s, Money Markets) Name & Address of Bank; Type of Account; Account Number; Name Held in; Balance as of Date of Separation; Current Balance: Real Estate: Common Address; County; Property Index Number; Date of Purchase; Purchase Price; Mortgage Lender; Mortgage Balance Due; Monthly Payment; Current Value: Retirement Plans: Name & Address of Plan; Type of Plan (401(k), Pension, IRA, etc.); Owner; Balance; Do you contribute to this plan?; Loans or Withdrawals Taken (Original Amount, Date & Balance of loan): Life Insurance: Name & Address of Company; Policy Number; Policy Value; Type of Policy (Whole or Term); Beneficiary; Loans Taken (Original Amount, Date & Balance); Provided through employment or private policy: Other Valuable Personal Property (Description, date purchased, purchase price, Value): Debts: Creditor Name & Address; Account Number; Purpose of Debt; Balance; Monthly Payment; Who's Name is the Debt In; Date Incurred: This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
