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Divorce Questionnaire

Applicant Information (fields with * are required)

Minimum New Jersey residence requirement met by:
 You
 Your Spouse

Either you or your spouse, or both, must have resided primarily in New Jersey during the past 12 months, in most cases. If neither of you meets the residence requirement, please contact us before completing this questionnaire.

* Your Name:

(select prefix "Mr." or "Ms." and enter first, middle name or initial, and last)

* Spouse's Name:

(first, middle name or initial, and last)

Your Residence Address

* Street Address:

(cannot be a P.O. Box)

Apartment or Unit:

* City:

Township or Taxing Municipality:

(if different from city above)

* State:

* Zip Code:

Mailing Address:
P.O. Box or other if different from above

 An existing court order lets you keep your address hidden from your spouse.

* Phone Numbers:
Provide at least one telephone number below (including area codes)

Home Phone:

Cell (or Other) Phone:

Work Phone:

E-mail Address:

Document Delivery Method

* Our documents to you by:

 E-mail

 Mail to your residence address

 Mail to someone else's address:

If this address is a business, please add "care of" followed by the business name.
If you have not received mail in your name at this address, please add "care of" followed by the individual's name.

* Marriage Date:

(exact date required)

* Marriage City and State:

(or provide city and country, if outside U.S.)

* Marriage Children:
Check as many as apply below

 None

 Adult / Emancipated Children

 Expected child: 
         Enter probable birth month and year in the box above

 Dependent Children (list each below)

      Date of Birth    
  Child's Full Name   Month Day Year   Lives With
1.    
2.    
3.    
4.    
5.    
6.    
7.    
8.    
9.    
10.    
Include each child's full middle name and Jr., II, III, etc (if any).

* Surname:
 Retain Current
 Keep Marriage Surname
 Revert to Former (fill in below)
 New Surname (fill in below)

Indicate Surname to be Used:

* Previous Court Actions:
 No court order ever sought
 Court order(s) issued; none active
 Court order(s) issued; at least one active

Examples of previous court actions:

  • Support orders (child or spousal)
  • Domestic violence complaints
  • Contested emancipation motions

Fee Waiver Requested:
 Yes, I wish to request a court fee waiver
        (find out if you qualify)

* Separation Status:
 Separated (not living at the same residence)
 Not Separated


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