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Make A Payment
Attorney Profiles
Services
FAQs
Contact Us
- Maps and Directions
- Blog
English
- Español
- Português

Family Law Intake

Name

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Personal Information

Your Name(Required)

First Last

Email

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What County is your home in?

How long have you lived there?

Would you like to change you last name?

Yes

No

Desired Last Name

Date of Birth

Month

Day

Year

Place of Birth

Race/Ethnicity

Gender

Male

Female

Other

Education: Highest grade completed (0-18) and list any degrees or dipolmas

Driver's License: State and Number

Social Security Number

Religion (If Any):

Information about Spouse/Partner

Name

First Last

Email

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What County is the home residence located in?

How long have they lived there?

Last Name before Marriage (if applicable)

Date of Birth

Month

Day

Year

Place of Birth

Race/Ethnicity

Gender

Male

Female

Other

Education: Highest grade completed (0-18) and list any degrees or dipolmas

Driver's License: State and Number

Social Security Number

Religion (If Any):

Marriage Information

Date of Marriage (if legally Married)

Month

Day

Year

Location of Marriage(Required)

Town, City

Location of Marriage(Required)

County

Location of Marriage(Required)

State or Foreign Country

Are you currently separated?

Yes

No

Date of separation

Month

Day

Year

Where were you living at the time of the separation?

(last address of cohabitation)

Street Address Address Line 2 City State ZIP Code

Please list all addresses since separation

Address

Dates of Residence

Relationship

What is your reason for the divorce?

What would your spouse/partner say is the reason for the divorce?

Do you have any interest in reconciliation?

Yes

No

Unknown

Does your spouse have any interest in reconciliation?

Yes

No

Unknown

Have you or your spouse seen any personal or marital counselors?

Yes

No

Unknown

Please list all personal or marital counsellors seen by either you or your spouse.

Name

Self/Spouse

Dates of Treatment

Legal Proceedings

Does your spouse/partner have an attorney?

Unknown

Yes

No

Spouse's Attorney's Name

First Last

Spouse's Attorney's Email

Spouse's Attorney's Phone

Have there been any legal or other proceedings between you and the other party?

Unknown

Yes

No

Describe:

Is this your first marriage?

Yes

No

Is this your spouse's first marriage?

Yes

No

List your previous marriages

Full Name of Former Spouse

Date of marriage

How did the marriage end?

Location of marriage

Any Children? List Name, age, gender and who they reside with.

List your spouses previous marriages

Full Name of Former Spouse

Date of marriage

How did the marriage end?

Location of marriage

Children with Current Spouse

Are there children from this marriage?

Yes

No

Children

Full Name

SSN

Birthdate

Gender

Grade (if applicable)

Currently Lives With

Cont.

Child's Initials

Current Address

If less than 6 months, list previous address, how long they lived there, and with whom.

Do you anticipate a dispute over custody?

Yes

No

Unknown

Who gets custody?

What visitation would be appropriate?

Use the Child Support Calculator provided by the State of Utah to calculate your child support requirements based on the income of both parents, childcare expenses, and proposed custody arrangement. Save the completed worksheet provided and upload it here.

https://orscsc.dhs.utah.gov/orscscapp-hs/orscscweb/actions/Csc0002;jsessionid=FJpprvcXTTGrokHVhFKTd8OCr2R4gcYvBE7uJ_6q.ip-10-204-48-119

Max. file size: 0 bytes.

Employment

Who is your present employer?

Client's present employer's address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What is your present gross monthly income or rate of pay

Who is your spouse's present employer

Spouse's present employer's address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What is your spouse's present gross monthly income or rate of pay

Other

Please list anything else you want your attorney to know at this time

Fillmore Spencer LLC is located in Provo, Saint George, and Murray, UT, and Gilbert, Arizona. The firm services clients in Eagle Mountain, Highland, Lindon, Orem, Provo, Pleasant Grove, Saratoga Springs, Springville, Elberta, American Fork, Wallsburg, Alpine, Mapleton, Midway, Lehi, Spanish Fork, Cedar Valley, Draper, Heber City, Payson, Salem, Goshen, Sandy, Santaquin, Riverton, Duchesne County, Juab County, Sanpete County, Summit County, Utah County, Uintah County, Wasatch County and all of Utah.

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Provo

3301 North University Avenue
Provo, Utah 84604
801-426-8200

Murray

525 W 5300 S #200
Murray, UT 84123
801-890-5366

St. George

20 North Main Street, Suite 301
St. George, Utah 84770
435-429-1096

Proud Sponsor of BYU Athletics

Arizona

2915 E Baseline Rd suite 107
Gilbert, AZ 85234-2475
480-903-4333

This website is lawyer advertising for general information only. The information provided is not formal legal advice, nor does it establish a lawyer/client relationship.

© Copyright 2026 Fillmore Spencer LLC. All rights reserved

Provo Law Office

801-426-8200

Murray Law Office

801-890-5366

St. George Law Office

435-429-1096

Arizona Law Office

480-903-4333

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