BRYANT CLARK LAW
PLLC
ATTORNEY & COUNSELOR AT LAW
MISSISSIPPI
AFFORDABLE
LEGAL SERVICES
Serving the Entire State of Mississippi
What is your ethnicity?
Your Date of Birth?
Are you a resident of Mississippi?
If yes, how long have lived in Mississippi?
Use this form to either (1) start your divorce case, or (2) obtain a precise price quote.
All relevant information on both sides of the form is required.
If you have any questions, require assistance in completing this form, or wish to speak with one of our
matrimonial attorneys prior to submitting your information, please contact us directly at (888)702-6862.
DIVORCE QUESTIONNAIRE
Do you have a 401(K)
or retirement account?
What is the balance of
retirement account?
Is your spouse seeking part of
your retirement?
If yes, how much you all agreed on?
Are you the Husband or Wife?
What is your ethnicity?
Your Date of Birth?
Are you a resident of Mississippi?
If yes, how long have lived in Mississippi?
Do your spouse have a 401(K)
or retirement account?
What is the balance of
retirement account?
Is your spouse seeking part of
your retirement?
If yes, how much you all agreed on?
Date of the Marriage?
Place of Marriage?
Where any Children born to the marriage?
If yes, how many?
Are you and spouse living together?
Date of Seperation?
Do you and spouse own house(s) or land ?
