AFI Intake Questionnaire

1. PERSONAL INFORMATION

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Full Name

Date of Birth

2. KEY DATES

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Help: Important family law case dates are used to calculate asset division periods, support duration, and other critical determinations. All fields are optional.

Date of Marriage

Date of Separation

Date Parties Stopped Living Together

Date of Move from Marital Home

Date of Service (formal service of papers)

Date Divorce/Dissolution Filed

Date Trial/Hearing (if scheduled)

Current Date

3. EMPLOYMENT TYPE

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Are you employed by an employer?

Yes No

Employment Details

Current Employer Name

Job Title

Start Date

Does your employer provide any non-cash benefits?

Yes No

Employer-Provided Benefits

Which benefits are provided?

Automobile (use/allowance) Housing/Lodging Travel Expenses Paid Meals Other

Provide details of benefits (amounts, frequency)

Do you receive bonuses or commissions?

Yes No

Bonus/Commission Details

Type of Additional Compensation

Frequency

Average Amount Per Period

Last 2 Years of Amounts

Are you self-employed?

Yes No

Self-Employment Details

Business Name

Business Type/Industry

Business Start Date

Ownership Percentage

Average Annual Income (last 2 years)

Business Structure

4. HOUSEHOLD

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Home Ownership Status

Own Rent Other

Mortgage Details

Monthly Mortgage Payment

Lender Name

Monthly Property Taxes (if separate from mortgage)

Monthly Home Insurance

Monthly HOA/Condo Fees (if applicable)

Rental Details

Monthly Rent Payment

Lease Start Date

Lease End Date

Monthly Renters Insurance

Other Household Members and Income

5. CHILDREN

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Do you have children common to the parties?

Yes No

Children Information

Names and Ages of Common Children

Health Insurance for Children?

Yes No

Child Health Insurance

💡 Tip: Import insurance statements to auto-populate this section

Type of Insurance

Insurance Provider

Monthly Cost

Your Portion of Cost (if shared)

Child Care Costs?

Yes No

Child Care Details

Type of Care

Provider Name/Facility

Monthly Cost

Schedule

Ages/Names of Children in Care

Child Support for Other Children?

Yes No

Child Support for Other Children

Monthly Amount Paid

Number of Children Supported

Court Order File Number

Extraordinary Child Expenses (sports, tutoring, special needs)?

Yes No

Extraordinary Expenses

List Expenses and Amounts

Frequency/Duration

6. MONTHLY EXPENSES

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Housing Costs?

Yes No

Housing Expenses

Mortgage/Rent Payment

Maintenance & Repairs

Property Taxes

Utilities?

Yes No

Utility Expenses

Electricity

Gas/Heating

Water/Sewer/Trash

Internet/Cable/Phone

Transportation/Vehicle Expenses?

Yes No

Transportation Expenses

Car Payment

Auto Insurance

Maintenance & Repairs

Fuel/Gas

Parking/Tolls

Pet Expenses?

Yes No

Pet Expenses

Pet Food

Veterinary Care/Medication

Pet Insurance

Grooming/Other Pet Expenses

Other Regular Monthly Expenses

Groceries

Clothing

Medications/Medical

Miscellaneous (subscriptions, memberships, etc.)

7. SUPPORTING DOCUMENTS CHECKLIST

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Pay stubs (2 most recent)

Tax returns (last 3 years)

Health insurance statements

Mortgage/lease agreement

Utility bills (3 months)

Child care invoices

Court orders (if applicable)

8. ADDITIONAL NOTES

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Additional Information or Special Circumstances

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