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Dissolution Questionaire |
Our office uses DissoMaster(TM), a sophisticated computer program to assist us to project support and the possible tax advantages of certain kinds of support payments. Please print out this form and provide the following information on a PER MONTH recurring basis for both you and the other party. You may then fax this to us for further consultation. If expenses are annual (such as property tax) divide by 12 for the average monthly amount. Include all expenses you will be paying for any minor children whose support you and the other party must provide. Use your best estimate of monthly income, expense and tax information lakely to be incurred over the next few years.
| Husband | Wife | ||||||||||||||
| How many children of this relationship primarily reside with each parent (primarily = more than 50% of the time): (insert number and give ages of the children. | __________ | __________ | |||||||||||||
| % of the 365 day year that child(ren) will visit the other parent (indicate percentage under the column of the parent they will be visiting with - "every other weekend, one mid-week, half of holidays is 20%)): | __________% | __________% | |||||||||||||
| Current income tax filing status (single, head of household, married filing joint, married filing separate): | __________ | __________ | |||||||||||||
| Number of exemptions claimed on income taxes (single=1, head of household = 1 plus number of children claiming as deductions, etc...): | __________ | __________ | |||||||||||||
| Wage, salary, bonus & commision income including overtime, can give:
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| Self-employment income after allowable business expenses: | $ | $ | |||||||||||||
| Other income not exempt from federal income tax (e.g.: capital gains, dividents, taxable interest, social security, employment or other): | $ | $ | |||||||||||||
| Other non-taxable income (e.g. disability, military BAQ, etc., or other): | $ | $ | |||||||||||||
| Newspouse's gross taxable income: | $ | $ | |||||||||||||
| Court ordered spousal support paind re: another marriage: | $ | $ | |||||||||||||
| Court ordered Child Support paid re: another marriage: indicate number of children ____________ |
$ | $ | |||||||||||||
| Health insurance expense (self, spouse, and dependents): | $ | $ | |||||||||||||
| Property tax (give monthly amount): | $ | $ | |||||||||||||
| Interest portion of your monthly mortgage interest: | $ | $ | |||||||||||||
| Monthly union dues required as a condition of employment: | $ | $ | |||||||||||||
| Retirement and pension contributions, if mandatory: | $ | $ | |||||||||||||
| # of children from another relationship who reside with you: | $ | $ | |||||||||||||
| Monthly child-care expenses: | $ | $ |