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How many years were you married?*
Are there any children in the marriage?*
Yes
No
If Yes, How many?*
Has there been infidelity in the marriage?*
Yes
No
Drug or Alcohol abuse?*
Yes
No
Domestic Violence?*
Yes
No
Is Alimony going to be an issue?*
Yes
No
Do you own a home?*
Yes
No
Is there any Debt?*
Yes
No
Are you still living together? *
Yes
No
If Yes, does this create a conflict?*
Yes
No
Please explain any major conflicts that need to be discussed:*
Name:*
Address:*
Phone:*
Mobile
Email:*
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