Client Information Sheet

CLIENT INFORMATION SHEET

SECTION 1 CONTACT AND EMPLOYMENT INFORMATION

1(a) CLIENT INFORMATION
Full Legal Name
Other Names You May Go By
Present Address
Mailing Address (if different from above)
Home Phone Number	Work Phone Number				Cell Phone Number	Fax Number
Email Address
Date of Birth			Place of Birth
Maiden Name			Surname Before Marriage (if different than Maiden Name)
Matrimonial Status at Time of Marriage SINGLE DIVORCED WIDOWED
Has your spouse been resident in Alberta for at least 1 year? YES NO
Would you like us to keep any of your contact information confidential from your spouse? YES NO If so, please explain:
Can we contact you and send information to the above phone numbers/addresses? YES NO If not, please explain why and provide alternate contact details:

1(b) CLIENT EMPLOYMENT INFORMATION
Occupation		Employer				Length of employment
Employer’s Address
Gross Annual Income				Gross Income From Last Income Tax Return (line 150)
Occupation at Time of Marriage

1(c) OTHER INCOME INFORMATION
Please list all other sources of current income (i.e. secondary employment, rent, etc.)
Source				Annual Gross Income
Source				Annual Gross Income
Source				Annual Gross Income

1(d) SPOUSE’S INFORMATION
Full Legal Name
Other Names Your Spouse Goes By
Present Address
Mailing Address (if different from above)
Home Phone Number	Work Phone Number				Cell Phone Number	Fax Number
Email Address
Date of Birth			Place of Birth
Maiden Name			Surname Before Marriage (if Different than Maiden Name)
Matrimonial Status at Time of Marriage SINGLE DIVORCED WIDOWED
Has your spouse been resident in Alberta for at least 1 year? YES NO

1(d) SPOUSE’S EMPLOYMENT INFORMATION
Occupation		Employer					Length of employment
Employer’s Address
Gross Annual Income				Gross Income from Last Income Tax Return (line 150)
Occupation at Time of Marriage

1(c) SPOUSE’S OTHER INCOME INFORMATION
Please list all other sources of current income (i.e. secondary employment, rent, etc.)
Source				Annual Gross Income
Source				Annual Gross Income
Source				Annual Gross Income

SECTION 2 RELATIONSHIP HISTORY

MARITAL/RELATIONISHIP HISTORY

Date of Marriage

Place of Marriage

Date of Cohabitation

Date of Separation**

**The Date of Separation is the date you and your spouse officially decided to separate – this does not necessarily mean separated residences.

Is the Date of Separation within the last 18 months?

YES NO If not, this will have to be discussed with one of our lawyers.

Have you and your spouse executed a Cohabitation or Pre-Marriage contract?

YES NO

Have you commenced divorce proceedings against your spouse in the past?

YES NO

If yes, please provide any and all: Agreements and/or Pleadings and/or Court Orders associated with your proceedings, along with any pertinent/applicable documentation from any Court proceedings or previous legal counsel.

Are there any Court dates pending?

YES NO

If Yes, what is the date? _________________________________________________________

Which Court is the date set? Court of Queen’s Bench Provincial Family Court

Is your spouse represented by a lawyer?

YES NO

If so, what is the name of your spouse’s lawyer? ____________________________________________

Do you have any desire to reconcile with your spouse?

YES NO

Are you aware that Marriage Counselling Guidance Facilities and Mediation Services are available to you?

YES NO

Would you like information regarding mediation and counselling?

YES NO

If efforts have been made to reconcile with your spouse, what efforts were made and when were these efforts made?

If you are filing for divorce we will require the following documents from you:

Your original government-issued Marriage Certificate. If you do not have a copy of this certificate, you may attend at any registry agent in person to obtain a copy. If your marriage took place outside of Canada, you may provide the Certificate of Marriage issued to you by the Church or Civil Office that performed your marriage ceremony.

A current picture of your spouse (this is a requirement for service of documents).

I have attached the following documents:

□ Government Issued Marriage Certificate

□ Marriage Certificate issued by the Church or Civil Office that performed my out-of-country ceremony

□ Current picture of my spouse

SECTION 3 CHILDREN

3(a) CHILDREN

Full Legal Name

Date of Birth

Full Legal Name

Date of Birth

Full Legal Name

Date of Birth

Full Legal Name

Date of Birth

Full Legal Name

Date of Birth

At this time, who has full time care of the children?

□ I have full-time care of the children

□ Both my spouse and myself (shared)

□ My Spouse has full time care of the children

□ Other _______________________________

What sort of shared parenting arrangement or schedule would you like to have with your spouse?

Do any of your children have special needs?

NO YES If yes, please explain:

3(b) CHILDREN – Childcare Expenses

Below, please list all children currently attending daycare /babysitting/childcare facilities, along with the cost to you associated with the childcare. Please indicate whether this cost is yearly, monthly, weekly or per visit and whether or not this amount is subsidized. Please be prepared to provide receipts evidencing the cost should they be requested.

Name of Child Attending Childcare

Frequency

Cost

Per

Subsidized?

YES NO

Name of Child Attending Childcare

Frequency

Cost

Per

Subsidized?

YES NO

Name of Child Attending Childcare

Frequency

Cost

Per

Subsidized?

YES NO

Name of Child Attending Childcare

Frequency

Cost

Per

Subsidized?

YES NO

Name of Child Attending Childcare

Frequency

Cost

Per

Subsidized?

YES NO

3(c) CHILDREN – Medical and/or Dental Expenses

Are you currently paying for medical and/or dental insurance (including Alberta Health Care)?

YES NO

If you answered “yes” to the last question, please provide details below. Please be prepared to provide receipts evidencing the cost should they be requested.

Insurance

□ Medical / Dental Amount: __________________ Per_____________________

□ Other_____________ Amount: __________________ Per_____________________

Do any of your children have medical and dental expenses that exceed your insurance coverage?

YES NO

If you answered “yes” to the last question, please provide the costs that exceed your insurance coverage. Please be prepared to provide receipts evidencing the cost should they be requested.

Name of Child

Cost:

Per:

For:

Name of Child

Cost:

Per:

For:

Name of Child

Cost:

Per:

For:

Name of Child

Cost:

Per:

For:

Name of Child

Cost:

Per:

For:

3(d) CHILDREN –Education Expenses

Do any of your children have extra-ordinary school or educational costs (not including regular school fees)? If so, please provide details below. Please be prepared to provide receipts for these costs if requested.

Name of Child

Expense

Cost

Per

Name of Child

Expense

Cost

Per

Name of Child

Expense

Cost

Per

Name of Child

Expense

Cost

Per

Name of Child

Expense

Cost

Per

Are any of your children currently attending post-secondary schooling?

YES NO

If you answered “yes” to the last question, please provide details below.

Name of Child

Institution

Tuition/Books/Fees

Per

Name of Child

Institution

Tuition/Books/Fees

Per

Name of Child

Institution

Tuition/Books/Fees

Per

Name of Child

Institution

Tuition/Books/Fees

Per

Name of Child

Institution

Tuition/Books/Fees

Per

3(e) CHILDREN – Extra-Curricular Activities

Do any of your children attend, or are involved in, extra-curricular activities such as sports teams or lessons? If so, please provide details below. Please be prepared to provide receipts for these costs if requested.

Name of Child

Activity

Cost

Per

Name of Child

Activity

Cost

Per

Name of Child

Activity

Cost

Per

Name of Child

Activity

Cost

Per

Name of Child

Activity

Cost

Per

SECTION 4 SPOUSAL SUPPORT

4 SPOUSAL SUPPORT
Would you like to make an application for spousal support? YES NO
Were you employed prior to marriage? YES NO	Occupation		Approx. Annual Income
If you have children, did you take time off work after your children were born? YES NO			If yes, how long
If you answered yes to the previous question, please indicate whether this was standard maternity leave or special circumstances. Standard Maternity Leave Special circumstances
If there were special circumstances surrounding your time off work after your children were born, please explain:
Have you been a stay-at-home homemaker for any length of time? YES NO		If yes, how long?
What is your educational background? □ HIGH SCHOOL DIPLOMA Institution and Year Graduated: ____________________________________________________ -or- □ LAST GRADE COMPLETED _________ □ POST SECONDARY Institution and Highest Degree Obtained: ____________________________________________ □ Other Courses/Training

SECTION 5 MATRIMONIAL PROPERTY

We require an accurate list of all of your assets and liabilities. Please make your best efforts to fill in all of the information below. If you require information from 3^rd parties (i.e.: your bank, financial institutions, pension administrator) please make a note that you are in the process of obtaining the information requested. If you do not have information respecting your spouses’ assets and/or liabilities please make note of this. We will be able to request this information from your spouse.

Do you have a Will, Enduring Power of Attorney and Personal Directive?

□ YES

□ NO

If you answered “No” to the above question, our office can provide you with information and services with respect to preparing a Will to best protect your assets and Estate for the future.

5(a) PROPERTY

Please list the details of any and all property(ies) that is/are owned by you and/or your spouse.

1 – Property Address

Held Prior to Marriage?

YES NO

Purchase Date

Name(s) on Title

Purchase Price

Current Amount Owing on Mortgage

Approximate Market Value

2 – Property Address

Held Prior to Marriage?

YES NO

Purchase Date

Name(s) on Title

Purchase Price

Current Amount Owing on Mortgage

Approximate Market Value

3 – Property Address

Held Prior to Marriage?

YES NO

Purchase Date

Name(s) on Title

Purchase Price

Current Amount Owing on Mortgage

Approximate Market Value

4 - Property Address

Held Prior to Marriage?

YES NO

Purchase Date

Name(s) on Title

Purchase Price

Current Amount Owing on Mortgage

Approximate Market Value

5(b) Vehicles

Please list below the details of any vehicle(s) that is/are owned by you and/or your spouse. Please include all vehicles, including motorcycles and recreation vehicles.

1 – Vehicle Year/Make/Model

Purchase Date

Is this vehicle leased?

YES NO

Name on Title

Primary Operator

Purchase Price

Amount Owing on Vehicle Loan

Monthly Loan/Lease Payment

Approximate Resale Value

2 – Vehicle Year/Make/Model

Purchase Date

Is this vehicle leased?

YES NO

Name on Title

Primary Operator

Purchase Price

Amount Owing on Vehicle Loan

Monthly Loan/Lease Payment

Approximate Resale Value

3 – Vehicle Year/Make/Model

Purchase Date

Is this vehicle leased?

YES NO

Name on Title

Primary Operator

Purchase Price

Amount Owing on Vehicle Loan

Monthly Loan/Lease Payment

Approximate Resale Value

4 – Vehicle Year/Make/Model

Purchase Date

Is this vehicle leased?

YES NO

Name on Title

Primary Operator

Purchase Price

Amount Owing on Vehicle Loan

Monthly Loan/Lease Payment

Approximate Resale Value

5 – Vehicle Year/Make/Model

Purchase Date

Is this vehicle leased?

YES NO

Name on Title

Primary Operator

Purchase Price

Amount Owing on Vehicle Loan

Monthly Loan/Lease Payment

Approximate Resale Value

6 – Vehicle Year/Make/Model

Purchase Date

Is this vehicle leased?

YES NO

Name on Title

Primary Operator

Purchase Price

Amount Owing on Vehicle Loan

Monthly Loan/Lease Payment

Approximate Resale Value

5(c) REGISTERED RETIREMENT SAVINGS PLANS

Please list below the details of any RRSP’S held by you and/or your spouse.

1 – Institution

Account Number

Inception Date

Current Value

Value as at Separation (if different than current)

If you or your spouse held this RRSP prior to your date of cohabitation and/or marriage, please provide the value of the RRSP as at the date of cohabitation and/or marriage.

2 – Institution

Account Number

Inception Date

Current Value

Value as at Separation (if different than current)

If you or your spouse held this RRSP prior to your date of cohabitation and/or marriage, please provide the value of the RRSP as at the date of cohabitation and/or marriage.

3 – Institution

Account Number

Inception Date

Current Value

Value as at Separation (if different than current)

If you or your spouse held this RRSP prior to your date of cohabitation and/or marriage, please provide the value of the RRSP as at the date of cohabitation and/or marriage.

4 – Institution

Account Number

Inception Date

Current Value

Value as at Separation (if different than current)

If you or your spouse held this RRSP prior to your date of cohabitation and/or marriage, please provide the value of the RRSP as at the date of cohabitation and/or marriage.

5 – Institution

Account Number

Inception Date

Current Value

Value as at Separation (if different than current)

If you or your spouse held this RRSP prior to your date of cohabitation and/or marriage, please provide the value of the RRSP as at the date of cohabitation and/or marriage.

5(d) NON-REGISTERED INVESTMENTS

Please list below the details of any and all investments:

Chequing and Savings Accounts, Term Deposits, GIC’s, Stocks, Bonds, Mutual Funds, Insurance Policies, etc.

1 – Investment

Account Number

Date Acquired

Current Value

Value as at Separation (if different than current)

If you or your spouse held this Investment prior to your date of cohabitation and/or marriage, please provide the value of the Investment as at the date of cohabitation and/or marriage.

2 – Investment

Account Number

Date Acquired

Current Value

Value as at Separation (if different than current)

If you or your spouse held this Investment prior to your date of cohabitation and/or marriage, please provide the value of the Investment as at the date of cohabitation and/or marriage.

3 – Investment

Account Number

Date Acquired

Current Value

Value as at Separation (if different than current)

If you or your spouse held this Investment prior to your date of cohabitation and/or marriage, please provide the value of the Investment as at the date of cohabitation and/or marriage.

4 – Investment

Account Number

Date Acquired

Current Value

Value as at Separation (if different than current)

If you or your spouse held this Investment prior to your date of cohabitation and/or marriage, please provide the value of the Investment as at the date of cohabitation and/or marriage.

5 – Investment

Account Number

Date Acquired

Current Value

Value as at Separation (if different than current)

If you or your spouse held this Investment prior to your date of cohabitation and/or marriage, please provide the value of the Investment as at the date of cohabitation and/or marriage.

5(e) PENSION PLANS

Do you or your spouse have a pension plan other than Canada Pension Plan (CPP)?

□ YES

□ NO

If you answered “yes” to the last question, please provide details below.

Name of Plan Holder

Employer / Plan Provider

Inception Date

Years of Contribution

Name of Plan Holder

Employer / Plan Provider

Inception Date

Years of Contribution

Name of Plan Holder

Employer / Plan Provider

Inception Date

Years of Contribution

5(f) CORPORATE

Do you or your spouse have any interest, directly or indirectly, in any incorporated business, including partnerships and joint ventures?

□ YES

□ NO

If you answered “yes” to the last question, please provide details below.

Asset

Description

Date Acquired

Value

Asset

Description

Date Acquired

Value

Asset

Description

Date Acquired

Value

5(g) OTHER ASSETS

Please list any and all other assets:

i.e. Household items of extraordinary value, jewellery, livestock, farm equipment, collections, location of safety deposit boxes, etc.

Asset / Description

Name of Asset Holder

Date Acquired

Current Value

Value as at Separation (if different)

Asset / Description

Name of Asset Holder

Date Acquired

Value

Value as at Separation (if different

Asset / Description

Name of Asset Holder

Date Acquired

Value

Value as at Separation (if different

Asset / Description

Name of Asset Holder

Date Acquired

Value

Value as at Separation (if different)

Asset / Description

Name of Asset Holder

Date Acquired

Value

Value as at Separation (if different)

Asset / Description

Name of Asset Holder

Date Acquired

Value

Value as at Separation (if different)

Asset / Description

Name of Asset Holder

Date Acquired

Value

Value as at Separation (if different)

Asset / Description

Name of Asset Holder

Date Acquired

Value

Value as at Separation (if different)

SECTION 6 LIABILITIES

6(a) CREDIT CARDS
Please list below the details of any and all credit card accounts for both yourself and your spouse, including department store credit cards.
1 – Name of Card Holder	Credit Provider					Account Number
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

2 – Name of Card Holder	Credit Provider					Account Number
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

3 – Name of Card Holder	Credit Provider					Account Number
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

4 – Name of Card Holder	Credit Provider					Account Number
Current Balance					Balance as at Separation (if different than current)
Monthly Payment					Date Acquired

5 – Name of Card Holder	Credit Provider					Account Number
Current Balance				Balance as at Separation (if different than current)
Monthly Payment				Date Acquired

6(b) LOANS
Please list below the details of any and all loans with any financial institutions or personal loans held by you or your spouse.
1 – Name of Debtor	Credit Provider					Account Number
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

2 – Name of Debtor	Credit Provider					Account Number
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

3 – Name of Debtor	Credit Provider					Account Number
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

4 – Name of Debtor	Credit Provider					Account Number
Current Balance					Balance as at Separation (if different than current)
Monthly Payment					Date Acquired

5 – Name of Debtor	Credit Provider					Account Number
Current Balance				Balance as at Separation (if different than current)
Monthly Payment				Date Acquired

6 – Name of Debtor	Credit Provider					Account Number
Current Balance					Balance as at Separation (if different than current)
Monthly Payment					Date Acquired

6(c) LINES OF CREDIT
Please list below the details of any and all lines of credit held by you or your spouse.
1 – Name of Debtor	Credit Provider					Account Number
Current Balance		Balance as at separation (if different than current)
Monthly Payment		Date Acquired

2 – Name of Debtor	Credit Provider					Account Number
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

3 – Name of Debtor	Credit Provider					Account Number
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

4 – Name of Debtor	Credit Provider					Account Number
Current Balance					Balance as at Separation (if different than current)
Monthly Payment					Date Acquired

5 – Name of Debtor	Credit Provider					Account Number
Current Balance				Balance as at Separation (if different than current)
Monthly Payment				Date Acquired

6 – Name of Debtor	Credit Provider					Account Number
Current Balance					Balance as at Separation (if different than current)
Monthly Payment					Date Acquired

6(d) MORTGAGES
Please list below the details of any and all Mortgages you or your spouse currently holds.
1 – Property Address	Mortgage Provider					Account Number
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

2 – Property Address	Mortgage Provider					Account Number
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

3 – Property Address	Mortgage Provider					Account Number
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

6(e) OTHER LIABILITIES
Please list below the details of any and all liabilities not listed in one of the categories above.
1 – Debtor Name	Liability					Credit Provider
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

2 – Debtor Name	Liability					Credit Provider
Current Balance		Balance as at Separation (if different than current)
Monthly Payment		Date Acquired

3 – Debtor Name	Liability					Credit Provider
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

4 – Debtor Name	Liability					Credit Provider
Current Balance					Balance as at Separation (if different than current)
Monthly Payment					Date Acquired

5 – Debtor Name	Liability					Credit Provider
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

6 – Debtor Name	Liability					Credit Provider
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

7 – Debtor Name	Liability					Credit Provider
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

8 – Debtor Name	Liability					Credit Provider
Current Balance			Balance as at Separation (if different than current)
Monthly Payment			Date Acquired

SECTION 7 PROPERTY EXEMPTIONS

The following section lists cases whereby certain property may be exempt from the division of Matrimonial Property. Please list any assets held under the appropriate category.

7(a) Property Acquired as a Gift from a Third Party (Not from your Spouse)
1 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

2 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

3 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

4 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

5 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

7(b) Property Acquired through Inheritance
1 – Property Acquired by		Description / Details
Date Acquired			Current Value

2 – Property Acquired by		Description / Details
Date Acquired			Current Value

3 – Property Acquired by		Description / Details
Date Acquired			Current Value

7(c) Property Owned Prior to Marriage (including RRSP’s and Savings)
1 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

2 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

3 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

4 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

5 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

6 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

7 – Property Owner		Description / Details
Date Acquired	Value as at separation			Current Value

7(d) Awards or Settlement for Damages
1 – Award or Settlement Amount		Date of Award or Settlement
Details / Description

2 – Award or Settlement Amount		Date of Award or Settlement
Details / Description

3 – Award or Settlement Amount		Date of Award or Settlement
Details / Description

4 – Property Acquired		Date of Award or Settlement
Details / Description

7(e) Proceeds of an Insurance Policy (not insurance in respect of property unless proceeds are for both you and your spouse)
1 – Property Acquired		Description / Details
Date Acquired			Current Value

2 – Property Acquired		Description / Details
Date Acquired			Current Value

3 – Property Acquired		Description / Details
Date Acquired			Current Value

4 – Property Acquired		Description / Details
Date Acquired			Current Value

7(f) Property that was exempt but item no longer exists. Please explain the exempt property and where the item has gone (i.e., sold, exchanged, spent, etc.)
1 – Property Acquired by		Description / Details
Date Acquired		Date Sold, Traded or Disposed of
Description on of Sale, Trade or Disposition of Asset					Value

2 – Property Acquired by		Description / Details
Date Acquired		Date Sold, Traded or Disposed of
Description on of Sale, Trade or Disposition of Asset					Value

3 – Property Acquired by		Description / Details
Date Acquired		Date Sold, Traded or Disposed of
Description on of Sale, Trade or Disposition of Asset					Value

4 – Property Acquired by		Description / Details
Date Acquired		Date Sold, Traded or Disposed of
Description on of Sale, Trade or Disposition of Asset					Value

5 – Property Acquired by		Description / Details
Date Acquired		Date Sold, Traded or Disposed of
Description on of Sale, Trade or Disposition of Asset					Value

6 – Property Acquired by		Description / Details
Date Acquired		Date Sold, Traded or Disposed of
Description on of Sale, Trade or Disposition of Asset					Value