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A Divorce Financial Worksheet

Provided by TDPI


This information sheet will serve as a valuable asset whether assisting us in the preparation of your case or for your personal record keeping.
There are many instances when you go through the information sheet that you will need to skip over certain sections because it does not apply to you or that you need to get additional information.In order for this packet to be of  benefit to you it is crucial that you be as accurate as possible. There maybe some information, i.e., values that you don't know.



Name:  
Address:  
Telephone Number(Home): e.g. 123-123-1234 
Telephone Number(Work): e.g. 123-123-1234 
Telephone Number(Cellular): e.g. 123-123-1234 
Telephone Number(Pager): e.g. 123-123-1234 
Date of Birth:
Month Date Year
Place of Birth:  
Social Security Number:    
Date of Marriage:
Month Date Year
Place of Marriage:  
Type of Ceremony:
Name of Spouse:
Spouse Date Of Birth:
Month Date Year
Spouse Place of Birth:
Spouse's Social Security Number:
If this is not your first marriage:    
Name of former spouse:
Date of marriage:
Month Date Year
Date of divorce:
Month Date Year
Court granting divorce:
Case No:
Grounds of divorce:
Are you receiving or paying alimony:
Amount $:
If this is not your first marriage:    
Name of former spouse:
Date of marriage:
Month Date Year
Date of divorce:
Month Date Year
Court granting divorce:
Case No:
Grounds of divorce:
Are you receiving or paying alimony:
Amount $:
If this is not your spouses first marriage:   
Name of their former spouse:
Date of marriage:
Month Date Year
Date of divorce:
Month Date Year
Court granting divorce:
Case No:
Grounds of divorce:
Are you receiving or paying alimony:
Amount $:
If this is not your first marriage:   
Name of their former spouse:
Date of marriage:
Month Date Year
Date of divorce:
Month Date Year
Court granting divorce:
Case No:
Grounds of divorce:
Are they paying alimony:
Amount $:
Children:
Month Date Year
1.  Name of Child: Date of Birth:
2.  Name of Child: Date of Birth:
3.  Name of Child: Date of Birth:
4.  Name of Child: Date of Birth:
5.  Name of Child: Date of Birth:
6.  Name of Child: Date of Birth:
If you have a child that is not by this marriage then list below:   
Month  Date  Year
1.  Name of Child: Date of Birth:
Child living with: If paying or receiving support $:
2.  Name of Child: Date of Birth:
Child living with: If paying or receiving support $:
3.  Name of Child: Date of Birth:
Child living with: If paying or receiving support $:
Educational Background:    
Your educational background including name of institution date of degree if any:
1. 
2. 
3. 
Your spouses educational background including name of institution date of degree if any:
1. 
2. 
3. 
Your employment history:    
( 1 )    Name of Employer:
Employer Address:
Years at current employment: years
Position:
Salary $:
If less than 3 years:
( i )    Name of Employer:
Employer Address:
Years at above employment: years
Position:
Salary $:
( 2 )    Name of Employer:
Employer Address:
Years at current employment: years
Position:
Salary $:
Pensions:
Your Pension:
( a )    Type of Retirement:
Year Started:
Amount $:
How is investment Titled:
Name of fund and/or Company:
Account Number:
Telephone number of Broker or Bank: e.g. 123-123-1234 
Address of Broker or Bank:
Telephone number of Broker or Bank carrier: e.g. 123-123-1234 
Address of Broker or Bank:
Vested :
If not vested: Date of vesting:
Month Date Year
( b )    Type of Retirement:
Year Started:
Amount $:
How is investment Titled:
Name of fund and/or Company:
Account Number:
Telephone number of Broker or Bank: e.g. 123-123-1234 
Address of Broker or Bank:
Telephone number of Broker or Bank carrier: e.g. 123-123-1234 
Address of Broker or Bank:
Vested :
If not vested: Date of vesting:
Month Date Year
( c )    Type of Retirement:
Year Started:
Amount $:
How is investment Titled:
Name of fund and/or Company:
Account Number:
Telephone number of Broker or Bank: e.g. 123-123-1234 
Address of Broker or Bank:
Telephone number of Broker or Bank carrier: e.g. 123-123-1234 
Address of Broker or Bank:
Vested :
If not vested: Date of vesting:
Month Date Year
Spouse’s employment history:    
( 3 )    Name of Employer:
Employer Address:
Years at current employment: years
Position:
Salary $:
If less than 3 years:
( i )    Name of Employer:
Employer Address:
Years at above employment: years
Position:
Salary $:
( 4 )    Name of Employer:
Employer Address:
Years at above employment: years
Position:
Salary $:
Spouses Pension:
( a )    Type of Retirement:
Year Started:
Amount $:
How is investment Titled:
Name of fund and/or Company:
Account Number:
Telephone number of Broker or Bank: e.g. 123-123-1234 
Address of Broker or Bank:
Telephone number of Broker or Bank carrier: e.g. 123-123-1234 
Address of Broker or Bank:
Vested :
If not vested: Date of vesting:
Month Date Year
( b )    Type of Retirement:
Year Started:
Amount $:
How is investment Titled:
Name of fund and/or Company:
Account Number:
Telephone number of Broker or Bank: e.g. 123-123-1234 
Address of Broker or Bank:
Telephone number of Broker or Bank carrier: e.g. 123-123-1234 
Address of Broker or Bank:
Vested:
If not vested: Date of vesting:
Month Date Year
( c )    Type of Retirement:
Year Started:
Amount $:
How is investment Titled:
Name of fund and/or Company:
Account Number:
Telephone number of Broker or Bank: e.g. 123-123-1234 
Address of Broker or Bank:
Telephone number of Broker or Bank carrier: e.g. 123-123-1234 
Address of Broker or Bank:
Vested:
If not vested: Date of vesting:
Month Date Year
Real Estate:  
( 1 )    Address of Property:
How is Property Titled:
Source of Funds for down payment
Marital,Pre-marital Inheritance):
Mortgage:
Name of Lender:
Loan Number:
Amount of Loan $:
Balance of Loan:
Address of Lender:
Mortgage:
Name of Lender Second or Home Equity:
Loan Number:
Amount of Loan $:
Balance of Loan:
Address of Lender:
Telephone number of lender:   e.g. 123-123-1234 
( 2 )    Address of Property:
How is Property Titled:
Source of Funds for down payment
Marital,Pre-marital Inheritance):
Mortgage:
Name of Lender:
Loan Number:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
Amount of Loan $:
Balance of Loan:
Mortgage:
Name of Lender Second or Home Equity:
Loan Number:
Amount of Loan $:
Balance of Loan:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
( 3 )    Address of Property:
How is Property Titled:
Source of Funds for down payment
Marital,Pre-marital Inheritance):
Mortgage:
Name of Lender:
Loan Number:
Amount of Loan $:
Balance of Loan:
Address of Lender:
Mortgage:
Name of Lender Second or Home Equity:
Loan Number:
Amount of Loan $:
Balance of Loan:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
( 4 )    Address of Property:
How is Property Titled:
Source of Funds for down payment
Marital,Pre-marital Inheritance):
Mortgage:
Name of Lender:
Loan Number:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
Amount of Loan $:
Balance of Loan:
Mortgage:
Name of Lender Second or Home Equity:
Loan Number:
Amount of Loan $:
Balance of Loan:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
Homeowner Insurance:   
Name of company:
Address of carrier:
Telephone number of carrier: e.g. 123-123-1234 
Policy Number:
Date of expiration:
Month Date Year
Policy limits:
Umbrella Insurance:   
Name of company:
Address of carrier:
Telephone number of carrier: e.g. 123-123-1234 
Policy Number:
Date of expiration:
Month Date Year
Policy limits:
Automobiles:   
( 1 )    Make:
Year:
VIN:
Amount Paid$:
Balance of Loan:
Source of Funds for down payment
(Marital- Pre-marital Inheritance):
Who is driving the vehicle:
Name of Lender:
Loan Number:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
( 2 )    Make:
Year:
VIN:
Amount Paid$:
Balance of Loan:
Source of Funds for down payment
(Marital- Pre-marital Inheritance):
Who is driving the vehicle:
Name of Lender:
Loan Number:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
( 3 )    Make:
Year:
VIN:
Amount Paid$:
Balance of Loan:
Source of Funds for down payment
(Marital- Pre-marital Inheritance):
Who is driving the vehicle:
Name of Lender:
Loan Number:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
Automobile Insurance:   
Name of company:
Address of carrier:
Telephone number of carrier: e.g. 123-123-1234 
Policy Number:
Date of expiration:
Month Date Year
Policy limits:
Boats:   
Make:
Year:
VIN:
Where is boat docked:
Name of Lender:
Loan Number:
Address of Lender:
Telephone number of lender: e.g. 123-123-1234 
Boat Insurance:   
Name of company:
Address of carrier:
Telephone number of carrier: e.g. 123-123-1234 
Policy Number:
Date of expiration:
Month Date Year
Policy limits:
Stocks-Bonds-Cash(Liquid assets):   
Stocks:
( 1 )    Name of stock or fund:
Value$:
Original Investment $:
Date Acquired:
Month Date Year
Source of Funds investment (Marital-Pre-marital Inheritance) $:
How is investment Titled:
Name of Brokerage Company:
Agent Name:
Account Number:
Telephone number of Broker: e.g. 123-123-1234 
Address of Broker:
( 2 )    Name of stock or fund:
Value$:
Original Investment $:
Date Acquired:
Month Date Year
Source of Funds investment (Marital-Pre-marital Inheritance) $:
How is investment Titled:
Name of Brokerage Company:
Agent Name:
Account Number:
Telephone number of Broker: e.g. 123-123-1234 
Address of Broker:
( 3 )    Name of stock or fund:
Value$:
Original Investment $:
Date Acquired:
Month Date Year
Source of Funds investment (Marital-Pre-marital Inheritance) $:
How is investment Titled:
Name of Brokerage Company:
Agent Name:
Account Number:
Telephone number of Broker: e.g. 123-123-1234 
Address of Broker:
( 4 )    Name of stock or fund:
Value$:
Original Investment $:
Date Acquired:
Month Date Year
Source of Funds investment (Marital-Pre-marital Inheritance) $:
How is investment Titled:
Name of Brokerage Company:
Agent Name:
Account Number:
Telephone number of Broker: e.g. 123-123-1234 
Address of Broker:
( 5 )    Bank Name:
Account Number:
Checking or Savings:
Opening Balance $:
Current Balance:
Closing Balance:
Date of Closing:
Month Date Year
Telephone number of Broker: e.g. 123-123-1234 
Address of Bank:
Telephone number of Bank: e.g. 123-123-1234 
( 6 )    Bank Name:
Account Number:
Checking or Savings:
Opening Balance $:
Current Balance:
Closing Balance:
Date of Closing:
Month Date Year
Address of Bank:
Telephone number of Bank: e.g. 123-123-1234 
( 7 )    Bank Name:
Account Number:
Checking or Savings:
Opening Balance $:
Current Balance:
Closing Balance:
Date of Closing:
Month Date Year
Telephone number of Broker: e.g. 123-123-1234 
Address of Bank:
Telephone number of Bank: e.g. 123-123-1234 
( 8 )    Safety Deposit Box:
Bank Name:
Address of Bank:
Telephone number of Bank: e.g. 123-123-1234 
Contents:
Who is in Possession of key:
Who can sign for entry to box:
Safety Deposit Box:   
Bank Name:
Address of Bank:
Telephone number of Bank: e.g. 123-123-1234 
Contents:
Who is in Possession of key:
Who can sign for entry to box:
Personal Property:   
Premarital Property:
Acquired Value: Description How:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Disputed Property As To Marital Or Non-Marital:
Acquired Value: Description How:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Income:   
List all sources of your income including salary, alimony, child support, interest from accounts, etc.:
Source: Amount(gross): Amount(net):
1.
2.
3.
4.
Debts:   
List all Liabilities:
Credit cards:
Card Issuer: Account No: Amount Owed: Periodic Payments: Sole-Joint:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Bank or other Loans:   
Lender Name: Loan No: Amount Owed: Periodic Payments: Sole-Joint:
1.
2.
3.
4.
Utilities:   
Gas: Electric: Water: Miscellaneous charges including child care, medical insurance. etc. :
1.
2.
3.
4.
5.
6.
7.
IRS debt:   
Include year(s) and amount owed:
1.
2.
3.
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