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National $149* Divorce & Bankruptcy Center
*Online*
Divorce, Legal Separation, or Separation Agreement Worksheet - Order Form

You Make the Decisions - We Do the Paperwork!
Now In Our 14th Year
Your responses and directions, and only your responses, (taken from this form),will be used to generate the 'signature ready' documents*, required to file and process an agreed or default divorce in your state, and returned to you ready for filing at your local courthouse, along with the procedural information & guidelines necessary to process the paperwork without a lawyer - including all of the following documents as required by your filing state: *(any omissions in your form submission, will result in blank spaces to be completed by the customer prior to filing.  Blank financial forms are also included.)

Your Signature Ready Paperwork, (ready to be filed at your local courthouse), will be return mailed to you by E-Mail attachment (for most immediate access) and/or US Postal within 48 hours of receipt of your completed form and payment of the $149 processing fee. [Most within *24 hours) Overnight Fed Ex delivery of hard copies is also available for credit card billing directly by FedEx for delivery services.

*Order 'instantly' on line Order your documents 3 ways with this one form:
1. Online instant ordering with credit card payment;
2. Faxing the form with your choice of payment options; or
3. Point, Click & Print the form for 'snail' mailing or faxing to our office.
Documents are return e-mailed to you as attachments within 48 hours [Most within*24 hours] of receipt of order and verification of payment.


Your information will be held in the strictest confidence. We do not 'sell' our customer's names or information to 'mailing lists' or 'marketers', and do not release any information to anyone other than the customer without prior written consent from the customer.

General Information

How did you hear about us? Not Required - But - We'd like to Know

Will this be a Divorce [Dissolution] or a Separation Agreement?
Divorce
Separation Agreement (provides for the division of property, debts, the care, custody and support of any children)
Legal Separation

Will the grounds for divorce be no-fault?
No Fault Fault Based as follows (i.e. adultery, cruelty, etc. Refer to your state's grounds):

*Note: NY Residents: NY nofault divorce grounds require that you have a separation agreement on file at the court house for 1 year prior to filing for divorce. See NY Fault based grounds at: NY State Site

Is this an Agreed Divorce or Separation?
Yes - My spouse and I have agreedto the terms and conditions of our divorce
No - Myspouse will not sign paperwork and will have to be served divorce papers
No  - My spouse is "missing " and will be served by substitute service (publication of notice etc.)

What State are you going to file divorce in?

What County are you going to file divorce in? (NOT country - NOT - USA)

What City are you going to file this proceeding in? (what city is the courthouse in?)

Which spouse lives in the state where you are filing?
Husband Wife Both

How long has the filing spouse lived in the state?

How long has the filing spouse lived in the county?

How long has the non-filing spouse lived in the state?

How long has the non-filing spouse lived in the county?

Information About the Filing Spouse [You]

What is your full legal name?

Are you the Husband or the Wife?
Husband Wife

What is yoursocial security number?

What is the state and number of your driver's license?
(required in most states)

What is your date of birth?

How old are you?

What is your address?
Street Address
City, state, zip
County,(NOT country - NOT - USA)
Your E-mail address
Your Telephone number [include area code]

Are you in the Military?
No Yes

Name of Employer (if any)

Address of Employer

Information About Your Spouse
**Fill in as much information as you have for your spouse***

What is your spouse's full legal name?

Spouse's date of birth?
Spouse's Age

Spouse's social security number?
Spouse's driver's license? (required in most states)

What is your spouse's address? If you live at the same address, just type "same"
Street Address
City
County, (NOT country - NOT - U.S.A.) State, Zip
Telephone number [include area code]

Is your spouse in the Military?
No Yes

Name of Employer (if any)

Address of Employer

Wife's Maiden Former Name(s)
Required in Most States

Wife's Maiden Name?
All Former Names of the Wife? if different than maiden

Does the Wife want her former name restored?
Yes
No
Never Used Spouse's Surname
Restore Wife's Former Name To:

Information About Your MarriageYour Divorce

What date were you married?

What City were you married?

What State were you married?

What County were you married?

Were you married in a religious or civil ceremony ?
Religious Ceremony (by a minister, clergy etc.)
Civil (by a Justice of Peace etc.)

Have you separated from your spouse?
Yes      No

What date did you and your spouse separate and/or stop living together as husband and wife?

Property & Debts Including Retirement

Do you have marital or community property to be divided as part of the divorce process? If No - [skip to next section on children]

No property (no house - no car) (other than:ONLY personal effects already divided)[Skip to children]
We already have a written agreement  for division of all of our property that we will attach to the paperwork before we file. [Skip to children]
Yes - We AGREE to divide our property as follows below:
 Yes - I want the Court to divide our property as follows:(We can't agree)

Do you own a marital home?
No Yes
Street address of the marital home

City/State/Zip

Mortgage holder i.e.(1st National Trust)

Approximate balance owed 2nd Mortgage holder (if any)
Approximate balance owed

Who will keep the marital home?
I will keep the house
My spouse will keep the house
We will sell the house


Do you own other real estate?
No Yes

Who will keep the 2nd property?
I will keep the house
My spouse will keep the house
We will sell the house

Street address

City/State/Zip

Mortgage holder i.e.(1st National Bank)

2nd Mortgage holder  (if any)
Approximate value of house

Approximate balance owed

Auto # 1

Year/Make/Model (i.e. 1997 Porche 911)

Vehicle Identification # (VIN) [if known)

Lien holder (if none - type "NONE")

Who will 'keep' the auto?
I will keep the auto
My spouse will keep the car

Auto # 2

Year/Make/Model (i.e. 1997 BMW)

Vehicle Identification # (VIN) [if known)

Lien holder (if none - type "NONE")

Who will 'keep' the 2nd auto?
I will keep the auto
My spouse will keep the car

Auto # 3

Year/Make/Model (i.e. 1997 BMW)

Vehicle Identification # (VIN) [if known)

Lien holder (if none - type "NONE")

Who will 'keep' the 3rd auto?
I will keep the auto
My spouse will keep the car

Other Property You Will Keep (computer, piano, grandmother's china)

Other Property Your Spouse Will Keep(all lawn & auto tools etc.)

Debts You Will Pay
(VISA __________ Acct.#123456789 __________ Balance $3000.00)

Debts Your Spouse Will Pay
(Dr. Miller __________ Acct.#987654321__________ Balance $500.00)


Does either spouse have employee or military retirement benefits? If No- skip to next section on
children

No
Yes - BUT - each party will keep his/her own retirement benefits
Yes - to be divided as follows below:

Name of the Spouse with retirement benefits to be divided?

Name of employer ?
Months of employment or military service during the marriage?

How is the retirement to be divided?
Military standard formula for 10 year marriage
% Percentage (pro rata)
OR Fixed monthly sum of


Children

Do you and your spouse have children who are minors (i.e., under the age of 18 or 19 if they are still going to high school)?
Yes      No - If NO - Skip to Final Section

What are the names, birth dates and sex of the child(ren)?
Name
Date of Birth Child's Age Male Female
Place of Birth? (City/State)
 Social Security Number (not required in all states)
Which parent will the child primarily reside with?
Mother Father

Which parent will claim the tax exemption for the child ?
Mother Father

Which parent will provide medical health insurance for the child ?
Mother Father

Name
Date of Birth Child's Age
Male Female
Place of Birth? (City/State)
Social Security Number (not required in all states)
Which parent will the child primarily reside with?
Mother Father

Which parent will claim the tax exemption for the child ?
Mother Father

Which parent will provide medical health insurance for the child ?
Mother Father

Name
Date of Birth Child's Age Male Female
Place of Birth? (City/State)
Social Security Number (not required in all states)
Which parent will the child primarily reside with?
Mother Father

Which parent will claim the tax exemption for the child ?
Mother Father

Which parent will provide medical health insurance for the child ?
Mother Father

Name
Date of Birth Child's Age Male Female
Place of Birth? (City/State)
Social Security Number (not required in all states)
Which parent will the child primarily reside with?
Mother Father

Which parent will claim the tax exemption for the child ?
Mother Father

Which parent will provide medical health insurance for the child ?
Mother Father

Is the following statement true or false?

The following is required information relating to the Uniform Child Custody Jurisdiction Act [UCCJ]: During the last five years each child listed above has lived with no person other than myself or my spouse or both of us. I have not participated in any capacity in any law suit or proceeding in any state concerning custody of any minor child of this marriage. I have no information of any pending custody proceeding or of any person not a party to this proceeding who has physical custody or claims to have custody or visitation rights concerning any minor child of this marriage.

True     False

Child Custody & Visitation

Requesting Court Orders

What type of child custody do you want the court to order?
Procedurally, if you do not ask for something in your initial paperwork (i.e.Petition or Complaint), you may not be able to get it later, when the divorce is granted and the final paperwork signed by a judge or magistrate.
This is especially true if the matter proceeds to default (i.e., your spouse is served divorce papers, but does not file a Response) or if you are responding, to a divorce already filed against you and your spouse does not attend the hearing (if your state requires a final hearing).
Parties are procedurally permitted to "agree", at some point before a final judgment is entered, to less than they initially requested in their paperwork.

Who do you want the court to award legal custody of the children to?
I want to share legal custody of our child(ren) with my spouse.
I want sole legal custody of our child(ren).
My spouse should have sole legal custody of our child(ren).

Who do you want the court to award Primary physical custody of the children to?
I want to be designated as having primary physical custody of our children.
My spouse should be designated as having primary physical custody of our children.

Do you want the non-custodial parent to have visitation rights as detailed in the Standard Visitation Schedule (i.e. every other weekend, alternating holidays etc.)?
Yes - I want the non-custodial parent to have visitation rights.
No - I do not want the non-custodial parent to have visitation rights.

Parenting Plan Optionschoose any or all that apply:

 Neither parent shall conceal a child's whereabouts from the other parent nor remove a child from the state of the child's current residence for more than days without prior written consent of the other parent.

The child(ren)'s primary residence shall remain in the state of and the county of unless prior written consent of the other parent is given or until further order of the court.

The child(ren) will keep the father's surname and not take on the Mother's maiden name or the name of any new spouse, at least until the child is eighteen years of age and old enough to make that decision for themselves.

The following grandparents

shall succeed the non-custodial parent in their rights of visitation and temporary possession of the child(ren) in the event the non-custodial parent, with visitation and temporary possession rights, dies before the child(ren) are eighteen years of age.

Child Support

Do you want the court to order Child Support?
No child support to be paid by either parent
Agreed Child Support as follows:
Husband Wifewill pay child support in the monthly sum of

When the oldest child reaches 18 (19 if still in high school), Child Support will be reduced to the monthly amount of


Do you want the court to order Child Care Expenses in addition to regular child support?
No additional child care expense to be paid.
Agreed Child Care Expenses as follows:
Husband Wife
will pay child care in the monthly sum of
Provided child care expense is actually being paid

Spousal support (i.e., alimony).
No Alimony to be paid by either spouse
Agreed Alimony as follows: Husband Wife
will pay alimony in the monthly sum of
 for a period of months, OR until the lump sum of is paid in full - which ever occurs first.

If you have any additional information that is pertinent to your situation, please feel free to comment here:


Order your forms on-line

Please type where indicated, the address you want your completed forms return mailed via US Postal.
Name
Mailing Address
City
State
Zip Code
E-mail Address #1
E-mail Address #2
Daytime Telephone Number
Evening Telephone Number

Completed forms are available for fastest delivery by return e-mail attachment in their original Word Perfect format or Adobe (.pdf) [portable document format.] MS Word 'claims' to convert word perfect files, however, legal documents often have a complex format that does not convert correctly resulting in formatting errors.   (See Important Note to Non-Word Perfect Users Below):

**Important Note to non-Word Perfect users: Due to the infinite number of possible problems with file conversions, (from the originating word perfect format), i.e. required state form formatting requirements etc., and subsequent file transfer problems beyond our control, WE CANNOT GUARANTEE the formatting accuracy, integrity of files, or the DELIVERY VIA FILE TRANSFER IN ANY FORMAT OTHER THAN THE ORIGINATING WORD PERFECT (for use in Word Perfect), OR ADOBE . (We'll certainly do our best - but we cannot guarantee the integrity of MS Word (.doc) or (.rtf) format conversions). If you should have problems with a file transferjust let us know andwe'll be glad to send out a hard copy ASAP !

Payment Method:
I will pay for my paperwork by:
Credit Card (information below)
Mailing In My Check, Money Order or Cashier's Check

Return mail my signature ready paperwork by:
e-mail attachment to the following e-mail address:

Overnight Express Shipping (Charged to your credit card directly by Fed Ex - no surcharge)
Priority US Postal Shipping [2-3 day delivery] ($5 surcharge)
1st Class U.S. Postal to the above mailing address. [no additional surcharge]



Pay By OnlineCheck orCredit Card :

Check Payment Online: You may make your payment by check using the secure Qchex server.
OR ClickPay by Check!


Credit Card Account Information

For payment by credit card, please complete the information below. This will enable us to begin processing your paperwork immediately.

Checking Account Debit Card (MasterCard & Visa only)
*You may use your MasterCard or Visa checking Account Debit Card by completing the following credit card information. This will allow your checking account to be debited and processing to be done immediately.

Which Credit Card Will You Be Using?
MasterCard
VISA

Credit Card Number/3 digit code on back
Expiration Date

Card Holder's Name (as it appears on the card)

Street Address (As it appears on the card)

City/State (As it appears on the card)
Zip code [As it appears on the card]

Charge my credit card in the amount of:

NON-TEXAS RESIDENTS

$149 [*includes delivery by e-mail or 1st Class US Postal]
$154.00 Priority Mail USP Shipping [2-3 day delivery]($149 + $5 surcharge)
$149.00Overnight FedExpress Shipping (Fed Ex Charges billed by Fed Ex - no surcharge)


TEXAS RESIDENTS: [Includes TX state sales tax of $12.29 included below]

 $161.30 [*includes delivery by e-mail or 1st Class US Postal]
 $166.30Priority Shipping [2-3 day delivery]($161.30 + $5 surcharge)
 $161.30
Overnight FedExpress (Fed Ex Charges billed directly by Fed Ex - no surcharge)


You may also'call in' your credit card account information to (940) 851-0762.

Select the format for file transfer below.

If you wish to mail your payment,please make check or money order payable to:

National Divorce & Bankruptcy Center Center
2831 Roanoke, Wichita Falls, Texas 76308
Phone: (940) 851-0762

E-Mail: divorcehelp@sw.rr.com

We are not attorneys and can not give legal advice. The information we provide shall not be substituted for legal adivce.