Dean Sutton or Nick Thompson	
Stone Creek Parkway, Suite 6, Louisville, KY 40223	
Dean's Phone 502-625-0902    Nick's Phone 625-0905  
Fax 502-425-0940	
	
Complete the following information and return to me (please print):	
			
Personal Information	Petitioner (Person filing Divorce)	Respondent	
Name	 	 	
Street Address	 	 	
Street Address 2	 	 	
City, State, Zip	 	 	
County of Residence	 	 	
Social Security No.	 	 	
Telephone (home)	 	 	
Telephone (work)	 	 	
Telephone (cell)	 	 	
Client's email address	 	 	
Age	 	 	
Date of Birth	 	 	
Place of Birth (City, County, State)	 	 	
Resident of Kentucky since (date)	 	 	
Race (required for Vital Statistics Form VS300)	 	 	

			
EMPLOYMENT	Petitioner 	Respondent	
Employer Name	 	 	
Employer Address	 	 	
Occupation (job title)	 	 	
Type of Business	 	 	
Gross Monthly Income	 	 	
Other Income	 	 	
			
MARRIAGE INFORMATION	Petitioner 	Respondent	
Date of Marriage	 	 	
City, County, State of Marriage	 	 	
Date of Separation	 	 	
# of  Times Married (including this one)	 	 	
Full Maiden Name of Wife	 	 	
Does the wife want her Maiden Name Restored?	 	 	
Any possibility the wife is pregnant?	 	 	
Why is marriage irretrievably broken?	 	 	
Circumstances of Separation?		 	
Do you wish to seek Maintenance?	 	How Much?	
Date of last Marital Relations (intercourse) with spouse.  			
			
If Spouse has an Attorney, please complete contact info 	 	
Name	 	 	
Address	 	City, State, Zip	
Phone	 	Fax	
Email	 	 	
Children of Marriage	Child 1	Child 2	
Name	 	 	
Address	 	 	
City, State, Zip	 	 	
Phone No.	 	 	
Social Security No. & Date of Birth	 	 	
Residence with (Name)	 	 	
List all residences for past 5 years 	 	 	
			
Children of Marriage	Child 3	Child 4	
Name	 	 	
Address	 	 	
City, State, Zip	 	 	
Phone No.	 	 	
Social Security No. & Date of Birth	 	 	
Residence with (Name)	 	 	
List all residences for past 5 years	 	 	
			
CUSTODY	Pick one:	
 	Sole Custody to Husband, Reasonable Visitation to Wife	 	
	Sole Custody to Wife, Reasonable Visitation to Husband	
 	Joint Custody, primary residence with Husband	 	
 	Joint Custody, primary residence with Wife	 	
 	Joint Custody, residence 50/50	 	
 	Other: Describe	 	
			
Give Details of Custody Support and Visitation you desire	 	 	

			
Has any minor child been in a custody dispute?	 	
Any alleged incident of child abuse?	 	
Any alleged incident of negligence  or abuse?	 	

Marriage Settlement Agreement	Petitioner 	Respondent	
Who gets what real estate?	 	 	
 	 	 	
Who gets what vehicles?	 	 	
 	 	 	
Who gets which Debts?	 	 	

 	 	 	

Other?	 	 	

			
You will be required to fill out a long mandatory case disclosure about your financial assets and expenses to complete a divorce in Kentucky. 
 
Be sure to download the Mandatory Case Disclosure form from our website and fill it in.  

Marital assets are assets that were acquired during the marriage.  Non marital assets were acquired prior to marriage or acquired by inheritance or gift.

			
Stop!   Only fill out the remaining questions if the case will be contested.
	
Are there any claims that can be used in deciding the division of custody. 

Are there any claims that can be used in deciding the division of marital property. 

	 
 	
Are there any claims that can be used in deciding alimony. 

	 
 	
Please describe any alleged incidents of abuse or neglect.   

	 
 	
Who is best suited to receive custody and why

		
Are there any special issues of Alcohol, Drugs, Gambling, Disability, Mental illness or other issues that are important

		
What are your most important goals in this divorce.