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Phone: 905-523-0017

NICOLE MATTHEWS FAMILY LAW

CLIENT INTAKE FORM

Please fill out the form below:

Date *

Type of Retainer *

LAO

Private

How were you referred to our office? *

LAO list

Internet

Yellow Pages

Friend

Law Assist

JusticeNet

Other

Type of Matter *

Divorce

Separation Agreement

Custody

Support

Children’s Aid

FULL LEGAL NAME *

Address *

City *

Your Postal Code *

Occupation (if none put n/a) *

Employer Name

Employer Address

Employer Phone

Email *

Telephone *

Cell

Other

SIN *

Driving License #

Date of birth *

Estimated Annual Income

RELATIONSHIP DATES:

Married on (date)

Started living together on (date)

Separated on (date)

Or choose below

Never lived together

Still living together

Other Party's Details:

Other Party’s Name *

Other Party's Address *

Other Party's City *

Others Party Postal Code

Other Party’s Telephone *

Other Party’s Cell

Other Party’s SIN

Other Party's Driving License #

Other Party’s Date of Birth *

Other Party’s Estimated Annual Income

Other Party's Name at Birth *

Other Party's Name Prior To Marriage

How long have they lived in current city?

Previously Divorced? *

Yes

No

If (Yes) Date & Place of Divorce

How many children? (select from drop down box)

Children

1
2
3
4
5
6
7
8
9
10
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Children's Names

Children's Date of Birth

Children's School

Children Resides With?

We understand your time is valuable. This is why we offer you options to connect at your convenience. Schedule your one hour paid consultation on our calendar, send a quick chat message, fill out our online contact form ... or call us .

905-523-0017

21 King Street West

5th Floor

Hamilton, Ontario

LP8 4W7

Monday - Friday:

9am - 5pm

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