Your divorce attorney may use a form like this to keep track of the issues in your case, the information that has already been gathered, and the information that still needs to be gathered to prepare for mediation and settlement, and if necessary, for trial.

CASE OUTLINE

I. REQUIRED INFORMATION

PETITIONER’S NAME: HEIGHT:       WEIGHT:	SSN: DATE OF BIRTH: AGE:
HOME ADDRESS: CITY/ZIP:	TELEPHONE #: BEEPER #:
EMPLOYER:	TELEPHONE:
ADDRESS:	CITY/ZIP:
ATTORNEY: ADDRESS: CITY/ZIP:	TELEPHONE:
MONTHLY NET INCOME ON FINANCIAL AFFIDAVIT $_____________	DRIVER’S LICENSE #: DATE OF ISSUE:

RESPONDENT’S NAME: HEIGHT:       WEIGHT:	SSN: DATE OF BIRTH: AGE:
HOME ADDRESS: CITY/ZIP:	TELEPHONE #: BEEPER #:
EMPLOYER:	TELEPHONE:
ADDRESS:	CITY/ZIP:
ATTORNEY: ADDRESS: CITY/ZIP:	TELEPHONE:
MONTHLY NET INCOME ON FINANCIAL AFFIDAVIT $_____________	DRIVER’S LICENSE #: DATE OF ISSUE:

Marriage:

DATE OF MARRIAGE:	PLACE OF MARRIAGE:
YEARS OF MARRIAGE:	DATE OF FINAL SEPARATION:

Pleadings:

DATE PETITION FOR DISSOLUTION OF MARRIAGE FILED:

DATE ANSWER FILED:

DATE COUNTERPETITION FOR DISSOLUTION OF MARRIAGE FILED:

DATE ANSWER FILED:

Restoration of maiden name:

MAIDEN NAME TO BE RESTORED? YES____     NO____

MAIDEN NAME: (SPELL OUT ENTIRE NAME, INCLUDING MIDDLE NAME)

Children:

CHILD’S NAME	CHILD’S AGE	DATE OF BIRTH	LOCATION OF CHILD
CHILD SUPPORT PURSUANT TO THE GUIDELINES IS $________MON.	IF DEVIATION REQUESTED, REASON IS ______________ ________________	HAS THE PETITIONER ATTENDED PARENTING COURSE? ______	HAS THE RESPONDENT ATTENDED PARENTING COURSE?______

II. SUMMARY OF ISSUES:

THE FOLLOWING ISSUES ARE SETTLED: attach partial settlement agreement. (PUT N/A NEXT TO SPACES IN WHICH THE ISSUE DOES NOT APPLY IN YOUR CASE)	WE NEED A TRIAL ON THE FOLLOWING ISSUES: (PUT N/A NEXT TO SPACES IN WHICH THE ISSUE DOES NOT APPLY IN YOUR CASE)	LIST ISSUES IN THIS ORDER CUSTODY/PARENTAL RESPONSIBILITY, PROPERTY DIVISION, ALIMONY, CHILD SUPPORT, EVERYTHING ELSE)
JOINT CUSTODY/SHARED PARENTAL RESPONSIBILITY
SOLE CUSTODY/ PARENTAL RESPONSIBILITY
VISITATION/ TIMESHARING/ACCESS
CHILD SUPPORT
PROPERTY DIVISION— DATE OF VALUATION
SEPARATE/NON MARITAL ASSETS COMMUNITY/ MARITAL ASSETS
SEPARATE/NON MARITAL LIABILITIES COMMUNITY/ MARITAL LIABILITIES
UNEQUAL DISTRIBUTION
ALIMONY
ATTORNEY’S FEES- ENTITLEMENT
ATTORNEY’S FEES-AMOUNT
CHARGING LIEN
OTHER: _________________
OTHER: _________________

III. CUSTODY/PARENTAL RESPONSIBILITY:

ANSWER ONLY IF CUSTODY/PARENTAL RESPONSIBILITY IS A CONTESTED ISSUE, AND ANSWER ONLY THOSE PARTS THAT REQUIRE COURT RESOLUTION: A. LEGAL JOINT CUSTODY/SHARED PARENTAL RESPONSIBILITY (DECISION-MAKING) COMPLETE NUMBER ONE (1), TWO (2) OR THREE (3):

1._____ EQUAL LEGAL SHARED CUSTODY/PARENTAL RESPONSIBILITY:	___PARTIES AGREE THAT THEY ARE ABLE TO CONFER AND COOPERATE AND MAKE ALL MAJOR DECISIONS JOINTLY.
2._____ ULTIMATE RESPONSIBILITY (COURT FINDINGS REQUIRED):	___THE PARTIES AGREE THAT THEY ARE ABLE TO CONFER AND COOPERATE AND MAKE MOST MAJOR DECISIONS JOINTLY, BUT THERE IS CONFLICT WITH REGARD TO THE FOLLOWING ISSUE(S) REQUIRING THE COURT TO GIVE ONE PARENT FINAL WORD WHEN THERE IS DISAGREEMENT AFTER DISCUSSION: _____EDUCATION—PUBLIC/PRIVATE _____RELIGIOUS TRAINING/EDUCATION _____MEDICAL/DENTAL CARE _____EXTRA-CURRICULAR ACTIVITIES _____SUMMER CAMP _____TUTORING/PRIVATE LESSONS _____SPORTS PARTICIPATION _____OTHER: ___________________ _______________________________
3._____SOLE CUSTODY/PARENTAL RESPONSIBILITY (COURT FINDINGS REQUIRED): IF THE PARTIES CHECKED THIS BOX, ANSWER THE FOLLOWING: A. PETITIONER ________ SAYS THE DETRIMENT TO THE CHILD(REN) IF THE PARTIES SHARE PARENTAL RESPONSIBILITY IS____________________________ ___________________________________ B. RESPONDENT ________SAYS THE DETRIMENT TO THE CHILD(REN) IF THE PARTIES SHARE PARENTAL RESPONSIBILITY IS______________ ___________________________ _____________________________________	___THE PARTIES ARE NOT ABLE TO CONFER OR COMMUNICATE OR EVEN TALK TO ONE ANOTHER AT ALL ON SPECIFIC DECISION- MAKING ISSUES OR ALL ISSUES AND IT WOULD BE DETRIMENTAL TO THE CHILD(REN) FOR THEM TO DO SO, REGARDING THE FOLLOWING: _____ALL ISSUES _____EDUCATION—PUBLIC/PRIVATE _____RELIGIOUS TRAINING/EDUCATION _____MEDICAL/DENTAL CARE _____EXTRA-CURRICULAR ACTIVITIES _____SUMMER CAMP _____TUTORING/PRIVATE LESSONS _____SPORTS PARTICIPATION _____OTHER:____________________

B. PHYSICAL SHARED CUSTODY/PARENTAL RESPONSIBILITY (WHERE IT IS IN THE BEST INTERESTS OF THE CHILD TO LAY HIS OR HER HEAD DOWN MORE OF THE TIME) CHECK ONE AND ANSWER:

_____ WE AGREE THAT _____________ SHALL BE THE PRIMARY RESIDENTIAL PARENT AND THAT ________________ SHALL BE THE SECONDARY RESIDENTIAL PARENT.

______THE ISSUE OF WHO SHALL BE PRIMARY RESIDENTIAL PARENT IS DISPUTED (COURT FINDINGS REQUIRED).

C. FACTORS. IF THE PARTIES HAVE ANY DISPUTES REGARDING LEGAL OR PHYSICAL SHARED CUSTODY/PARENTAL RESPONSIBILITY, CHECK WHICH OF THE FOLLOWING FACTORS APPLY. EVIDENCE/TESTIMONY WILL BE PRESENTED ON THE FOLLOWING FACTORS AT TRIAL (PUT N/A NEXT TO FACTORS NOT IN DISPUTE):

_____THE PARENT WHO IS MORE LIKELY TO ALLOW THE CHILD FREQUENT AND CONTINUING CONTACT WITH THE OTHER PARENT.

_____THE LOVE, AFFECTION, AND EMOTIONAL TIES EXISTING BETWEEN THE PARENTS AND THE CHILD.

_____THE CAPACITY AND DISPOSITION OF THE PARENTS TO PROVIDE THE CHILD WITH FOOD, CLOTHING, MEDICAL CARE OR OTHER REMEDIAL CARE RECOGNIZED AND PERMITTED UNDER THE LAWS OF THIS STATE IN LIEU OF MEDICAL CARE, AND OTHER MATERIAL NEEDS.

_____THE LENGTH OF TIME THE CHILD HAS LIVED IN A STABLE, SATISFACTORY ENVIRONMENT AND THE DESIRABILITY OF MAINTAINING CONTINUITY.

_____THE PERMANENCE, AS A FAMILY UNIT, OF THE EXISTING OR PROPOSED PRIMARY HOME.

_____THE MORAL FITNESS OF THE PARENTS.

_____THE MENTAL AND PHYSICAL HEALTH OF THE PARENTS.

_____THE HOME, SCHOOL, AND COMMUNITY RECORD OF THE CHILD.

_____THE REASONABLE PREFERENCES OF THE CHILD, IF THE COURT DEEMS THE CHILD TO BE OF SUFFICIENT INTELLIGENCE, UNDERSTANDING, AND EXPERIENCE TO EXPRESS A PREFERENCE.

_____THE WILLINGNESS AND ABILITY OF EACH PARENT TO FACILITATE AND ENCOURAGE A CLOSE AND CONTINUING PARENT-CHILD RELATIONSHIP BETWEEN THE CHILD AND THE OTHER PARENT.

_____A PARTY PROVIDED FALSE INFORMATION TO THE COURT IN A DOMESTIC VIOLENCE PROCEEDING.

_____ANY OTHER FACTOR CONSIDERED TO BE RELEVANT:______________.

IV. PROPERTY DIVISION

A. NON-MARITAL/SEPARATE ASSETS AND LIABILITIES (ANSWER ONLY IF APPLIES OR PUT N/A): 1. DATE OF IDENTIFICATION (CHECK ONE):

_____AGREED AS DATE OF FILING

_____AGREED AS DATE OF SEPARATION AGREEMENT DATED__________

_____DISPUTED

2. IF DISTRIBUTION OF NON MARITAL/SEPARATE ASSETS AND LIABILITIES IS AGREED, ATTACH PARTIAL SETTLEMENT AGREEMENT. 3. IF DISPUTED AS TO WHETHER THE ASSET OR LIABILITY IS MARITAL/COMMUNITY OR NON-MARITAL/SEPARATE, COURT FINDINGS REQUIRED AS TO IDENTIFICATION, OWNERSHIP INTEREST, VALUE, VALUATION DATE, AND DESIGNATION OF WHICH SPOUSE SHALL BE ENTITLED TO EACH):

IDENTIFY AND SET FORTH IF ASSET OR LIABILITY	VALUE	OWNERSHIP INTERESTS	DATE OF VALUATION	REASON DISPUTED

B. MARITAL/COMMUNITY ASSETS AND LIABILITIES (ANSWER ONLY IF APPLIES OR PUT N/A): 1. DATE OF IDENTIFICATION (CHECK ONE):

_____AGREED AS DATE OF FILING

_____AGREED AS DATE OF SEPARATION AGREEMENT DATED__________

_____DISPUTED

2. IF DISTRIBUTION OF MARITAL/COMMUNITY ASSETS AND LIABILITIES IS AGREED, ATTACH PARTIAL SETTLEMENT AGREEMENT. 3. SPECIFIC ASSET AND LIABILITY INFORMATION REQUIRED ON DISPUTED ASSETS ONLY (PUT N/A IF DOESN’T APPLY):

a. MARITAL HOME:

(1) FORMAL APPRAISAL ENTERED INTO EVIDENCE BY ___ PETITIONER ___ RESPONDENT

(2) PARTITION REQUESTED BY ___ PETITIONER ___ RESPONDENT

STREET ADDRESS:

LEGAL DESCRIPTION:

PETITIONER SAYS:	VALUE DATE OF FILING	VALUE DATE OF TRIAL
FAIR MARKET VALUE
MORTGAGE
LIENS/TAX EFFECT (IF SALE)
NET EQUITY

RESPONDENT SAYS:	VALUE DATE OF FILING	VALUE DATE OF TRIAL
FAIR MARKET VALUE
MORTGAGE
LIENS/TAX EFFECT (IF SALE)
NET EQUITY

b. OTHER DISPUTED REAL PROPERTY:

(1) FORMAL APPRAISAL ENTERED INTO EVIDENCE BY ___ PETITIONER ___ RESPONDENT

(2) PARTITION REQUESTED BY ___ PETITIONER ___ RESPONDENT

PETITIONER SAYS:	VALUE DATE OF FILING	VALUE DATE OF TRIAL
FAIR MARKET VALUE
MORTGAGE
LIENS/TAX EFFECT (IF SALE)
NET EQUITY

RESPONDENT SAYS:	VALUE DATE OF FILING	VALUE DATE OF TRIAL
FAIR MARKET VALUE
MORTGAGE
LIENS/TAX EFFECT (IF SALE)
NET EQUITY

4. DEBTS / LIABILITIES

a. WE AGREE THAT THE FOLLOWING LIABILITIES SHALL BE PAID AS FOLLOWS:

(1) TO BE PAID BY HUSBAND: ____________________ OF $________ ____________________ OF $________ ____________________ OF $________

(2) TO BE PAID BY WIFE: ____________________ OF $________ ____________________ OF $________ ____________________ OF $________

5. TANGIBLE PERSONAL PROPERTY

a. IF AGREED, ATTACH STIPULATED LIST.

b. IF DISPUTED, ATTACH A LIST THAT SETS FORTH THE FOLLOWING INFORMATION:

(1) DESCRIPTION OF ITEM (2) COST DATE OF PURCHASE (3) PETITIONER’S VALUE DATE OF FILING (4) RESPONDENT’S VALUE DATE OF FILING (5) PETITIONER’S VALUE DATE OF TRIAL (6) RESPONDENT’S VALUE DATE OF TRIAL (7) PETITIONER’S PROPOSED DISTRIBUTION (8) RESPONDENT’S PROPOSED DISTRIBUTION

C. UNEQUAL DISTRIBUTION OF ASSETS. IF EITHER PARTY IS SEEKING AN UNEQUAL DISTRIBUTION OF MARITAL ASSETS, COURT FINDINGS ARE REQUIRED AS TO JUSTIFICATION THEREFOR BASED ON THE FOLLOWING FACTORS. ONLY IF EITHER PARTY IS SEEKING AN UNEQUAL DISTRIBUTION, CHECK THOSE FACTORS FOR WHICH TESTIMONY/EVIDENCE WILL BE PRESENTED AT TRIAL. YOU MAY ATTACH WRITTEN PROPOSED FINDINGS TO THIS PRE-TRIAL STIPULATION: PUT N/A NEXT TO THOSE WHICH DO NOT APPLY:

_____1. CONTRIBUTION TO THE MARRIAGE (HOMEMAKER) _____2. ECONOMIC CIRCUMSTANCES OF THE PARTIES _____3. DURATION OF THE MARRIAGE _____4. INTERRUPTIONS TO CAREERS OR EDUCATION _____5. CONTRIBUTION TO OTHER SPOUSE’S CAREER OR EDUCATION _____6. DESIRABILITY OF RETAINING ANY ASSET INCLUDING AN INTEREST IN A BUSINESS, CORPORATION, OR PROFESSIONAL PRACTICE INTACT AND FREE FROM ANY CLAIM OF INTERFERENCE BY THE OTHER PARTY _____7. CONTRIBUTION OF EACH SPOUSE TO THE ACQUISITION, ENHANCEMENT, AND PRODUCTION OF INCOME OR THE IMPROVEMENT OF, OR THE INCURRING OF LIABILITIES TO BOTH THE MARITAL AND NON-MARITAL ASSETS OF THE PARTIES _____8. DESIRABILITY OF RETAINING THE MARITAL HOME AS A RESIDENCE AS IT IS EQUITABLE TO DO SO, IN THE BEST INTERESTS OF THE CHILD OR FINANCIALLY FEASIBLE FOR THE PARTIES TO DO SO _____9. INTENTIONAL DISSIPATION, WASTE, DEPLETION OR DESTRUCTION OF MARITAL ASSETS AFTER THE FILING OF THE PETITION OR WITHIN TWO YEARS PRIOR TO THE FILING OF THE PETITION _____10. ANY OTHER FACTORS NECESSARY TO DO EQUITY AND JUSTICE _____11. UNEQUAL DISTRIBUTION DESPITE GIFTING, SHORT MARRIAGE _____12. APPRECIATED VALUE OF NON-MARITAL ASSETS, PAYMENTS AND/OR LABOR DURING THE MARRIAGE D. PETITIONER’S PROPOSED DIVISION/DISTRIBUTION: 1. PETITIONER’S PROPOSED DISTRIBUTION CHART:

a. FOR EACH ASSET:

DEBT

AMOUNT

AS OF DATE

$ TO BE PAID BY HUSTAND

$ TO BE PAID BY WIFE

b. FOR EACH DEBT OR LIABILITY:

DEBT

AMOUNT

AS OF DATE

$ TO BE PAID BY HUSTAND

$ TO BE PAID BY WIFE

c. TOTALS TO EACH PARTY

TOTALS TO EACH

HUSBAND

WIFE

2. IF THE TOTALS TO THE HUSBAND AND WIFE ARE NOT EQUAL, GIVE REASONS WHY: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________.

V. ALIMONY. IF ALIMONY IS AN ISSUE, ANSWER THE FOLLOWING (PUT N/A IF DOESN’T APPLY):

A. TEMPORARY ARREARAGES:	____ ATTACH ARREARAGES CALCULATIONS WORKSHEET
B. PERMANENT PERIODIC ALIMONY: ____AGREED NO SUCH ALIMONY ____AGREED NEED/ABILITY FOR $_____ PER MONTH UNTIL _________’S REMARRIAGE OR DEATH OF EITHER PARTY	___HUSBAND SAYS THERE IS NO NEED AND/OR ABILITY TO PAY NEED AND/OR ABILITY TO PAY SUCH ALIMONY ___WIFE SAYS THERE IS NO NEED AND/OR ABILITY TO PAY SUCH ALIMONY ___WIFE SAYS SHE NEEDS $_____ PER MONTH UNTIL THE WIFE’S REMARRIAGE OR DEATH OF EITHER PARTY ___ HUSBAND SAYS HE NEEDS $_____ PER MONTH UNTIL THE HUSBAND’S REMARRIAGE OR DEATH OF EITHER PARTY
C. BRIDGE THE GAP REHABILITATIVE ALIMONY: ____AGREED NO SUCH ALIMONY ____AGREED NEED/ABILITY FOR $_____ PER MONTH UNTIL DATE_________ OR _________’S REMARRIAGE OR DEATH OF EITHER PARTY, WHICHEVER FIRST OCCURS.	___HUSBAND SAYS THERE IS NO NEED AND/OR ABILITY TO PAY SUCH ALIMONY ___WIFE SAYS THERE IS NO NEED AND/OR ABILITY TO PAY SUCH ALIMONY ___WIFE SAYS SHE NEEDS $_____ PER MONTH UNTIL DATE _________ OR THE WIFE’S REMARRIAGE OR DEATH OF EITHER PARTY, WHICHEVER FIRST OCCURS ___HUSBAND SAYS HE NEEDS $_____ PER MONTH UNTIL DATE __________ OR THE HUSBAND’S REMARRIAGE OR DEATH OF EITHER PARTY, WHICHEVER FIRST OCCURS
D. RETRAINING REHABILITATIVE ALIMONY ____AGREED $_______ PER ____ UNTIL ___________________ ______________________ ______________________	___HUSBAND SAYS THERE IS NO NEED AND/OR ABILITY TO PAY SUCH ALIMONY ___WIFE SAYS THERE IS NO NEED AND/OR ABILITY TO PAY SUCH ALIMONY ___WIFE SAYS SHE NEEDS $_____ PER ______ OR UNTIL _____________ FOR THE FOLLOWING: RETRAINING PLAN_________________________ OBJECT OF REHABILITATION ______________________________ COST OF PLAN ________________ PERIOD TO COMPLETE_________ HOW PLAN IS WORKABLE TO MAKE SELF SUPPORTING AND MAINTAIN THE STANDARD OF LIVING COMPARABLE TO THAT ENJOYED DURING THE MARRIAGE ________________ _______________________________ ___HUSBAND SAYS HE NEEDS $_____ PER ______ OR UNTIL _____________ FOR THE FOLLOWING: RETRAINING PLAN_________________________ OBJECT OF REHABILITATION ______________________________ COST OF PLAN ________________ PERIOD TO COMPLETE_________ HOW PLAN IS WORKABLE TO MAKE SELF SUPPORTING_____________ _______________________________
E. LUMP SUM ALIMONY ___AGREED $_____ TO BE PAID AS FOLLOWS ___________________ ________________________	___HUSBAND SAYS THERE IS NO NEED OR ABILITY TO PAY WIFE PERMANENT PERIODIC ALIMONY AND NO UNUSUAL CIRCUMSTANCES OR JUSTIFICATION WHICH WOULD REQUIRE A NON-MODIFIABLE AWARD OF SUPPORT IN THE FORM OF LUMP SUM ALIMONY ___WIFE SAYS THERE IS NO NEED OR ABILITY TO PAY HUSBAND PERMANENT PERIODIC ALIMONY AND NO UNUSUAL CIRCUMSTANCES OR JUSTIFICATION WHICH WOULD REQUIRE A NON-MODIFIABLE AWARD OF SUPPORT IN THE FORM OF LUMP SUM ALIMONY ___WIFE SEEKS LUMP SUM ALIMONY FROM THE HUSBAND AS FOLLOWS:$_____________________ JUSTIFICATION IS________________ SOURCE OF FUNDS TO PAY IS________________________________ ___HUSBAND SEEKS LUMP SUM ALIMONY FROM THE WIFE AS FOLLOWS:$_____________________ JUSTIFICATION IS________________ SOURCE OF FUNDS TO PAY IS_____

CHILD SUPPORT (PUT N/A IF DOES NOT APPLY)

A.GUIDELINES SUMMARY: TO BE ATTACHED B.IF THERE ARE ARREARAGES, ATTACH ARREARAGES CALCULATION WORKSHEETS. C.ADJUSTMENTS: ANSWER ONLY IF SEEKING AN ADJUSTMENT IN THE CHILD SUPPORT GUIDELINES AMOUNT:

____PLUS 5% ____MINUS 5%

COURT TO CONSIDER ALL RELEVANT FACTORS, INCLUDING: ____NEEDS OF CHILD(REN) ____AGE OF CHILD(REN) ____STATION IN LIFE ____STANDARD OF LIVING ____FINANCIAL STATUS AND ABILITY OF EACH PARENT ____OTHER____________________ _______________________________

___PLUS MORE THAN 5% WRITTEN FINDING REQUIRED WHY GUIDELINES AMOUNT UNJUST OR INAPPROPRIATE __________________________________________ ____MINUS MORE THAN 5% WRITTEN FINDING REQUIRED WHY GUIDELINES AMOUNT UNJUST OR INAPPROPRIATE __________________________________________

IDENTIFY FACTORS FOR ADJUSTMENT: ____EXTRAORDINARY MEDICAL ____EXTRAORDINARY PSYCHOLOGICAL ____EXTRAORDINARY EDUCATIONAL ____EXTRAORDINARY DENTAL ____INDEPENDENT INCOME OF CHILD ____SUPPORT FOR A PARENT PAID FOR WHICH THERE IS A NEED ____SEASONAL INCOME/EXPENSES ____AGE OF CHILD/OLDER CHILD ____SPECIAL NEEDS:___________ ____PARENTING ARRANGEMENT: _______________________________ ____MORE THAN 28 CONSECUTIVE DAYS OF CONTACT ____TOTAL AVAILABLE ASSETS ____DEPENDENCY EXEMPTION ____PAY MORE THAN 55% GROSS ____JOINT DEBT OR EXPENSE ____SEEK FROM NON-RECURRING INCOME ID: ___________________ ____ANY OTHER: _______________

E. IF IMPUTED INCOME IS AN ISSUE:

IF WIFE SAYS HUSBAND IS VOLUNTARILY UNEMPLOYED OR UNDEREMPLOYED, WIFE FILL IN REGARDING HUSBAND: EMPLOYMENT POTENTIAL: ________________________________ PROBABLE EARNINGS LEVEL: ________________________________ RECENT WORK HISTORY: ________________________________ OCCUPATIONAL QUALIFICATIONS: ________________________________ PREVAILING EARNINGS LEVEL IN COMMUNITY: ____________________

IF HUSBAND SAYS WIFE IS VOLUNTARILY UNEMPLOYED OR UNDEREMPLOYED, HUSBAND FILL IN REGARDING WIFE: EMPLOYMENT POTENTIAL: ________________________________ PROBABLE EARNINGS LEVEL: ________________________________ RECENT WORK HISTORY: ________________________________ OCCUPATIONAL QUALIFICATIONS: ________________________________ PREVAILING EARNINGS LEVEL IN COMMUNITY: ____________________

F. OTHER CHILD SUPPORT ISSUES:

ISSUE:	LOCATION:	COST:	WHY IN THE BEST INTERESTS OF THE CHILD:
____PRIVATE SCHOOL
____EXISTING CONTRACT FOR PREPAID COLLEGE
____SUMMER CAMP
____SCHOOL FIELD TRIPS/FEES
____SCHOOL UNIFORMS
____TUTORING
____EXTRA- CURRICULAR
____UNINSURED MEDICAL OR DENTAL
____DEPENDENT PAST MAJORITY
____LIFE INSURANCE OR OTHER SECURITY AVAILABILITY________________ CAP__________
____ RETRO-ACTIVE CHILD SUPPORT

VII. ATTORNEY’S FEES, SUIT MONIES AND COSTS:

A. ____ ENTITLEMENT AND AMOUNT SHALL BE HEARD AT A HEARING SUBSEQUENT TO FINAL HEARING B. ____WIFE’S FEES AND COSTS ARE AN ISSUE: (PUT N/A IF DOES NOT APPLY)

ENTITLEMENT: ___TO BE DETERMINED AT TRIAL ___TO BE DETERMINED AT A HEARING SUBSEQUENT TO TRIAL

AMOUNT: ___TO BE DETERMINED AT TRIAL ___TO BE DETERMINED AT A HEARING SUBSEQUENT TO TRIAL

___ENTITLEMENT IS AGREED ___ABILITY TO PAY DISPUTED ___NEED DISPUTED ___ALL CIRCUMSTANCES SHOULD BE CONSIDERED, INCLUDING: ___SCOPE AND HISTORY OF LITIGATION ___DURATION OF THE LITIGATION ___MERITS OF THE RESPECTIVE POSITIONS ___WHETHER THE LITIGATION IS BROUGHT OR MAINTAINED PRIMARILY TO HARASS (OR WHETHER A DEFENSE IS RAISED MAINLY TO FRUSTRATE OR STALL) ___THE EXISTENCE AND COURSE OF PRIOR OR PENDING LITIGATION

___ LODESTAR: ___ WIFE SAYS: ____ HOURS X $_____ REASONABLE HOURLY RATE = $__________FEES AND REASONABLE COSTS = $________ TO BE PAID AS FOLLOWS:_______________________ ___ HUSBAND SAYS: ____ HOURS X $_____ REASONABLE HOURLY RATE = $__________FEES AND REASONABLE COSTS = $_________ TO BE PAID AS FOLLOWS:_______________________

C. ____ HUSBAND’S FEES AND COSTS ARE AN ISSUE: (PUT N/A IF DOES NOT APPLY)

ENTITLEMENT: ___TO BE DETERMINED AT TRIAL ___TO BE DETERMINED AT A HEARING SUBSEQUENT TO TRIAL

AMOUNT: ___TO BE DETERMINED AT TRIAL ___TO BE DETERMINED AT A HEARING SUBSEQUENT TO TRIAL

___ENTITLEMENT IS AGREED ___ABILITY TO PAY DISPUTED ___NEED DISPUTED ___ALL CIRCUMSTANCES SHOULD BE CONSIDERED, INCLUDING: ___SCOPE AND HISTORY OF LITIGATION ___DURATION OF THE LITIGATION ___MERITS OF THE RESPECTIVE POSITIONS ___WHETHER THE LITIGATION IS BROUGHT OR MAINTAINED PRIMARILY TO HARASS (OR WHETHER A DEFENSE IS RAISED MAINLY TO FRUSTRATE OR STALL) ___THE EXISTENCE AND COURSE OF PRIOR OR PENDING LITIGATION

___LODESTAR: ___WIFE SAYS: ____HOURS X $_____ REASONABLE HOURLY RATE = $__________FEES AND REASONABLE COSTS = $________ TO BE PAID AS FOLLOWS:_______________________ ___HUSBAND SAYS: ____HOURS X $_____ REASONABLE HOURLY RATE = $__________FEES AND REASONABLE COSTS = $_________ TO BE PAID AS FOLLOWS:_______________________