On Line Divorce Mediation: Part I – NEW CLIENT INTAKE FORM

 

    ON LINE DIVORCE MEDIATION: PART I – NEW CLIENT INTAKE FORM

    Notice

    Form Access Code (Use Code "Free")


    Please enter the access code "Free" above. When you type in the access code "Free", a form will appear. With your spouse, follow the directions, and complete the form. After you have completed it and have submitted it to us, please schedule your Free initial consultation with a mediator by following the link that appears. If you choose to use your own mediator, simply send us an email and we will send you the Free mediated separated agreement that you started, at no obligation. Thank you.

    Please type in your initials.

    Today's Date:

    State where you would like mediation binding.

    Marriage

    Date of the Parties Marriage:
    City/Town/Village where Parties Marriage
    State of the Parties Marriage
    Type of ceremony

    Children

    Number of Children of the Marriage including adopted children that are under 21:
    NoneOneTwoThreeFourFive
























































    Wife's Information:

    Wife''s Email (required):

    Wife's Name:




    Wife's Address1:

    Wife's Address2:

    Wife's City:

    Wife's State:

    Wife's Zip Code:

    Wife's County:

    Wife's Phone:

    Wifes Date of Birth:

    Wifes Place of Birth:

    Wife's Social Security Number:

    Husband's Information:

    Husband's Email (required)

    Husband's Name



    Husband's Address1

    Husband's Address2

    Husband's City

    Husband's State

    Husband's Zip Code

    Husband's County

    Husband's Phone

    Husbands's Date of Birth:

    Husband's Place of Birth

    Husband's Social Security Number

    NON-INTERFERENCE

    SEPARATE OWNERSHIP

    MARITAL DEBT

    DISCHARGE AND RELEASE

    MUTUAL RELEASE OF INHERITANCE RIGHTS

    THE PARTIES INTEND THAT THEIR AGREEMENT BE BINDING UNDER THE LAWS OFTHE STATE OF NEW YORK

    (A)  APPLICABLE LAW.


     
    (B)  CHILD SUPPORT AND MAINTENANCE. 

    1. income and property of the parties.
    2. duration of the marriage prior to physical separation.
    3. age and health of the parties.
    4. the capacity of the persons to be self-supporting.
    5. standard of living.
    6. tax consequences of any amounts of money or property exchanges, given or received;
    7. number of unemancipated child(ren).
    8. financial resources of the parties;


    9. physical and emotional health of the child(ren).
    10. all of the needs of the child(ren).
    11. non-monetary contributions.
    12. all of the factors reasonable and proper affecting the dissolution of the marriage and the amounts of money paid and/or exchange or given in this action and/or Agreement.

    (C)  MARITAL PROPERTY. 

    1. property acquired by each party prior to the marriage.
    2. property acquired by each party by bequest.
    3. property acquired as a result of compensation for personal injury.
    4. the increase in the value of the separate property (non-marital) except to the extent due to the contributions and efforts of the other spouse; and property acquired after the date of physical Separation of the parties.

     

    The parties additionally acknowledge to each other that all property considered separate property and/or marital property as designated in the within agreement shall be deemed conclusively to be the sole and separate property of the designated spouse or the marital property of the spouse in whose name the property is currently held.

    (D) DISTRIBUTION OF PROPERTY.

    1. income and property at the time of the marriage.
    2. income and property at the time of negotiation of this agreement.
    3. duration of the marriage and the date of physical separation of the parties.
    4. age and health of the parties.
    5. the needs of the custodial parent with regard to the marital residence.
    6. loss of inheritance and pension rights.
    7. award of maintenance, child support and/or family allowance.
    8. acquisition of property by indirect contributions, direct contributions, joint efforts, contributions as a spouse, contributions as a homemaker, and contributions to the career or career potential of the spouse.
    9. the liquid and/or non-liquid character of the marital property.
    10. probably future financial circumstances of the parties.
    11. the difficulty in the evaluation of business assets.
    12. all of the factors reasonable and proper affecting the dissolution of the marriage and the amounts of money paid and/or property exchanges or given in this action and/or Agreement.

    The parties acknowledge that each is fully aware of the financial circumstances of the other and have relied upon the candor and truthfulness of each other. The parties specifically agree that no further financial information is necessary to be exchanged between them.

    DIVORCE

    EXECUTION OF DOCUMENTS

    VOLUNTARY EXECUTION OF AGREEMENT

    MODIFICATION OR WAIVER

    ENTIRE UNDERSTANDING

    POSSIBLE INVALIDITY

    GOVERNING LAWS

    BINDING ON REPRESENTATIVES

    INDEPENDENT COVENANTS

    ENTIRE UNDERSTANDING



    • Is Mediation Right For You?  We encourage you to ask your self these two questions.
      First, can I work with my spouse cooperatively, with the assistance of a mediator, and negotiate an agreement and save the costly expenses of contested divorce litigation? 
      Second
      , has my contested divorce litigation stalled or gone out of control and can I work with my spouse cooperatively with the assistance of a mediator.

       

      If you answered yes to either of these questions it may be time to mediate your divorce and negotiate an agreement directly with your spouse and save the ongoing costly expenses of contested divorce litigation!

    • Notice:  At the Initial Free Consultation You, Your Spouse and the Mediator will discuss the form below that your created with your spouse.  Your mediator, within 24 hours of that initial consultation, will quote you a fee to complete your mediation.  If you decide to retain us as your mediator we will continue adding onto this agreement until it is complete.  If you choose not to retain us, keep the beginning draft and use it as you like.