Massachusetts Divorce Worksheet

Divorce Information and Worksheet

Instructions: This worksheet is designed to be used by persons contemplating a divorce. It may also be used by your attorney. Completing this form before your initial interview with your attorney may save you valuable time and money.

Part 2 - Your Personal Information

Your Name: U.S. Citizen Yes No

Address: Date of Birth:

Social Security Number:

City: State: Zip:

Where do you presently live, if different than address above?

How long have you lived at your present address?

How long did you live at former address, if applicable?

Birth State and County

Have you ever lived in a community property state? Yes No

If yes, what state?

Do you have a known future residence address? Yes No

If yes, list address:

Education level

Describe your physical condition and any health problems you may have.

Describe any emotional problems you may have.

Employment

Where are you employed?

Position

Address

City State Zip

Phone Fax

How long employed at present employer?

Previous employer: Position:

Address

City State Zip

Education

Educational Level Degrees

Part 3 - Spouse Personal Information

Spouse Name: U.S. Citizen Yes No

Address: Date of Birth:

Social Security Number:

City: State Zip

Where does spouse presently live, if different than address above?

How long has spouse lived at present address?

How long did spouse live at former address, if applicable?

Birth State and County

Has spouse lived in a community property state? Yes No

If yes, what state?

Does spouse have a known future residence address? Yes No

If yes, list address

Education level of spouse.

Describe spouse’s physical condition and any health problems he/she may have.

Describe any emotional problems spouse may have.

Spouse Employment

Where is spouse employed?

Position

Address

City State Zip

Phone Fax

How long employed at present employer?

Previous employer: Position:

Address

City State Zip

Education

Educational Level Degrees

Part 4 - Marriage

Place of Marriage

Have you ever been separated from your spouse before? Yes No

If yes, please provide dates and details of separation.

Are you now separated from your spouse? Yes No

If yes, provide details of separation.

What was date of separation?

Part 5 - Children

Name Date of Birth

In what city and state were the children born?

Has there ever been any prior litigation regarding the custody of the children? Yes No

If yes, please explain:

Where do the children reside now? Husband Wife

Are there any special issues or circumstances to be considered regarding the children? (Medical problems, etc.) Yes No

If yes, please explain:

Do the parents agree to terms of custody/visitation? Yes No

If Yes, please select:

Sole custody to Wife with reasonable visitation to Husband

Sole custody to Husband with reasonable visitation to Wife

Joint custody to Husband and Wife

Other-

What is address where children presently reside?

Is wife pregnant? Yes No

If yes, what is due date?

Do the children have any special medical needs? Yes No

If yes, please explain:

Children’s Doctor

Address

City State Zip

Do the children require any special educational needs? Yes No

If yes, provide details.

Please provide day care address and how often the children are kept in day care, if applicable.

Part 6 - Prior Marriages

Your Prior Marriages

Name Date of Marriage Date of Divorce County/State of Divorce

Children from prior marriages?

Name Date of Birth

Do you pay support? Yes No If yes, what amount and how paid?

Do you pay alimony? Yes No If yes, what amount and how paid?

Your Spouse Prior Marriages

Name Date of Marriage Date of Divorce County/State of Divorce

Children from prior marriages?

Name Date of Birth

Does spouse pay support? Yes No If yes, what amount and how paid?

Does spouse pay alimony? Yes No If yes, what amount and how paid?

Part 7 - Income

Income of Husband (Monthly / Yearly)

Salary   Monthly Yearly

Dividends   Monthly Yearly

Rental Income   Monthly Yearly

Notes Receivable   Monthly Yearly

Bonuses   Monthly Yearly

Business   Monthly Yearly

Commissions   Monthly Yearly

Other   Monthly Yearly

Income of Wife (Monthly / Yearly)

Salary   Monthly Yearly

Dividends   Monthly Yearly

Rental Income   Monthly Yearly

Notes Receivable   Monthly Yearly

Bonuses   Monthly Yearly

Business   Monthly Yearly

Commissions   Monthly Yearly

Other   Monthly Yearly

Part 8 - Monthly Expenses

Monthly Expenses (Average)

House Payment to Who Pays Total

Rental Payment to Who Pays Total

Car Loan to Who Pays Total

Car Loan to Who Pays Total

Electricity Total

Gas (Home) Total

Phone Total

Water/Garbage/Sewer Total

Groceries/Housewares Total

Cable TV Total

Internet Total

Laundry Total

Meals (other than house) Total

Clothing Total

Donations Total

Pest Control Total

Day Care Total

Gas/Oil/Auto Care Total

Entertainment Total

Property Taxes Total

Property Insurance Total

Health Insurance Total

Disability Insurance Total

Vacation Total

Education Total

Medical/Dental/Prescriptions Total

Student Loans Total

Other: Who Pays Total

Total Monthly Expenses $

Part 9 - Joint Assets

Joint assets description and current fair market value.

Cash (on hand) Current Fair Market Value

Cash (in banks/credit unions)

Stocks/Bonds

Notes (money owed to you in writing)

Money owed to you (not evidenced by a note)

Real estate: (Home)

(Other)

Business Interests

Automobiles

Boats

Other vehicles

Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

Furniture & furnishings in home

Furniture & furnishings elsewhere

Collectibles

Jewelry

Life insurance (cash surrender value)

Sporting and entertainment (T.V., stereo, etc.) equipment

CD's

Other assets

Total Assets of Husband and Wife (Marital Assets) $

Part 10 - Retirement Accounts

Retirement Accounts | Account Number | Current Fair Market Value

Husband Accounts:

Wife Accounts:

Part 11 - Separate Assets of Husband

Cash (on hand) Current Fair Market Value

Cash (in banks/credit unions)

Stocks/Bonds

Notes (money owed to you in writing)

Money owed to you (not evidenced by a note)

Real estate: (Home)

Date Acquired Purchase Price:

(Other)

Business interests

Automobiles

Boats

Other vehicles

Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

Furniture & furnishings in home

Furniture & furnishings elsewhere

Collectibles

Jewelry

Life insurance (cash surrender value)

Sporting and entertainment (T.V., stereo, etc.) equipment

CD's

Other assets

Total Assets of Husband $

Part 12 - Separate Assets of Wife

Cash (on hand) Current Fair Market Value

Cash (in banks/credit unions)

Stocks/Bonds

Notes (money owed to you in writing)

Money owed to you (not evidenced by a note)

Real estate: (Home)

(Other)

Business interests

Automobiles

Boats

Other vehicles

Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

Furniture & furnishings in home

Furniture & furnishings elsewhere

Collectibles

Jewelry

Life insurance (cash surrender value)

Sporting and entertainment (T.V., stereo, etc.) equipment

CD's

Other assets

Total Assets to Wife $

Part 13 - Liabilities of Both Husband and Wife

Mortgage on real estate (Home)

Mortgage on real estate (Other)

Charge/credit card accounts

Auto loan

Auto loan

Bank/credit union loans

Money you owe (not evidenced by a note)

Judgments

Other

Total Debts and Liabilities of Husband and Wife $

Part 14 - Inheritance

Describe property inherited by husband (please provide dates)

Describe property inherited by wife (please provide dates)

Part 15 - Documents that may be needed, especially if the divorce is contested

Federal, State, and Local Tax Returns

Payroll and W2 Forms

Deeds

Business Tax Returns

Mortgages

Leases

Bank Account Records

Stock Certificates

CD's

Auto Titles

Insurance Petitions

Appraisals

Birth Certificates

INS Documents

Social Security Card

Marriage License

Prior Divorce Documents

Any and all documents relating to income, expenses and assets.

Premarital Agreement, if any, as well as any other written agreements between Husband and Wife

Part 16 - Settlement Worksheet

Who will receive title to the marital home? H W

Who will pay monthly payment on marital home? H W

Who will pay the utilities for the marital home? H W

What marital assets will husband receive?

What marital assets will wife receive?

What marital debts will wife pay?

What marital debts will husband pay?

What separate property of husband will wife receive?

What separate property of wife will husband receive?

What separate debts will be paid by husband?

What separate debts will be paid by wife?

Custody of children:

Custody to wife with visitation to husband

Custody to husband with visitation to wife

Custody to wife with visitation to Husband

Joint Physical and Legal Custody

Joint Legal Custody

Visitation times for non-custodial parent:

Parents will share in the decisions regarding the health of the children? Equally

Parents will share in the decisions relating to education of the children?

Parents will share in the decisions relating to the religion of the children? Equally

Will non-custodial parent be notified before decisions regarding health and education? Yes No

Will non-custodial parent be entitled to access to medical, dental and educational records of the children? Yes No

Will Grandparents have specified visitation rights? Yes No

If yes, please provide names and details of visitation desired?

Will the last name of the children remain the same? Yes No If no, please explain:

Child Support: Child support will be paid by H W

Amount of child support

When paid One Month Every two weeks

Health Insurance: Who will pay health insurance for child? H W

Alimony: Will Alimony be paid? Yes No

If yes, who will pay? H W

How often will alimony be paid?

When will alimony stop, if certain period of time?

Other Settlement Provisions:

Part 17 - Typical No Fault Procedures

1. A Complaint, Petition or Joint Complaint is filed in the County of your residence.

2. At the time of filing the complaint a filing fee is paid.

3. If using a Complaint instead of a joint complaint, the defendant will be served or file a waiver and entry of appearance.

4. If a summons is required, the Defendant may file an answer admitting that a divorce should be granted.

5. After the complaint and waiver or answer are filed, determine how to present judgment of divorce to the court.

6. After the waiting period has expired, ask the clerk or court administrator for the proper procedure to present the judgment to the judge.

7. Present the Separation Agreement and Judgment to the Judge.

Part 18 - Witness Testimony

Summary: Some states require actual testimony, even in a no fault divorce. The sample below is only a sample of questions that a witness may be asked in an uncontested divorce.

Please state your name.

Where do you live (address)?

How long have you lived there?

Do you know __________ and __________?

How long have you known them?

Part 19 - Sample Presentation of Divorce Complaint to Judge

Your Honor, My name is and I am the in this case.

Part 20 - Complete if Child Custody will be contested

Child Custody considerations and facts.

Part 21 - Child Support

Child support considerations.

Part 22 - Visitation

Visitation considerations.