Submit Divorce Information – The Hanzelik Firm

Please use the form below to submit the information that is required for every divorce case:

Name of Client *

Client's Email Address *

Husband Full Legal Name *

Husband Address *

Husband City, State, Zip *

Husband Date of Birth *

Husband SSN:

Husband State of Birth *

Wife Full Legal Name *

Wife Address *

Wife City, State, Zip *

Wife Date of Birth *

Wife SSN

Wife State of Birth *

Wife Maiden Name *

Does Wife desire to Change Name to Maiden Name *

Date of Marriage *

County and State of Marriage *

Date Couple Last Resided Together *

Please list all children OF THIS MARRIAGE with dates of birth for each child *

Husband Ethnicity *

Number of This Marriage for Husband *

If not Husband's 1st Marriage, how did last marriage end? *

How many years of High School did Husband complete? *

How many years of college has Husband completed? *

Wife's Ethnicity *

Number of This Marriage for Wife *

If not Wife's 1st Marriage, how did last marriage end? *

How many years of High School did Wife complete? (copy) *

How many years of college has Wife completed? *

Phone

72599