Barbara S. McRae 
Certified Mediator, Registered LDA 11-001

DIVORCE

DIVORCE INTAKE

If you need help with these questions, please call me,
Barbara McRae, at 916-771-4333


Your full legal name:
Your address: Street, City, Zip:
Phone number to be used on court forms:
Your email:
Date of Marriage:
Date of Separation:
If you want your maiden name restored state name:
Full legal name of Spouse:
Address of Spouse: Street, City, Zip:
Email of Spouse:
Phone number of Spouse:
 Is Spouse in active military?:  
Have you lived in CA for 6 months, and this county for 3 months?:
Is spouse in active military?:
LIST MINOR CHILDREN
 
 Child #1. full name, age, gender date and city of birth:  
 Child #2. full name, age, gender date and city of birth:  
 Child #3. full name, age, gender date and city of birth:  
 Child #4. full name, age, gender date and city of birth:  
 If you have minor children, list address of each place you have lived for the past 5 years and the move in and move out date for each:  
   

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