1300 699 688 Client Registration Form Your Personal DetailsMy Matter Relates To* Children; Intervention Order; Property and Financial Matters; Divorce; Child Maintenance; Other Name* TitleMr.Mrs.Ms.MissDr.Prof.Rev. Prefix First Middle Last GenderFemaleMaleNot-SpecifiedDate of Birth* Day Month Year Current AgePlease enter a number from 0 to 100.OccupationEmail* Phone*Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Who Referred You To Pearsons?*If you found us online, please write "Online."Other Party/Former Partner InformationPartner Name* TitleMr.Mrs.Ms.MissDr.Prof.Rev. Prefix First Last Partner GenderFemaleMaleNot-SpecifiedPartner Date of Birth Day Month Year Current AgePlease enter a number from 0 to 100.Partner OccupationPartner Email Partner PhonePartner Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Relationship DetailsDate You Started Living TogetherDate of MarriageDate of SeparationIs there currently an Intervention Order in place or was there an Intervention Order in place?*ChildrenPlease list details of any children.Number of ChildrenNone12345More than 5Child #1: Name First Middle Last Child #1: Date of Birth Day Month Year Child #1: Current AgePlease enter a number from 0 to 100.Child #1: GenderSexMaleFemaleNot SpecifiedChild #1: Who Does The Child Live With?Child #1: What School Does The Child Attend?Child #1: What Year Level Is The Child In?Child #2: Name First Middle Last Child #2: Date of Birth Day Month Year Child #2: Current AgePlease enter a number from 0 to 100.Child #2: GenderSexMaleFemaleNot SpecifiedChild #2: Who Does The Child Live With?Child #2: What School Does The Child Attend?Child #2: What Year Level Is The Child In?Child #3: Name First Middle Last Child #3: Date of Birth Day Month Year Child #3: Current AgePlease enter a number from 0 to 100.Child #3: SexSexMaleFemaleChild #3: Who Does The Child Live With?Child #4: Name First Middle Last Child #4: Date of Birth Day Month Year Child #4: Current AgePlease enter a number from 0 to 100.Child #4: SexSexMaleFemaleChild #4: Who Does The Child Live With?Child #5: Name First Middle Last Child #5: Date of Birth Day Month Year Child #5: Current AgePlease enter a number from 0 to 100.Child #5: SexSexMaleFemaleChild #5: Who Does The Child Live With?Additional ChildrenIf you have more than 5 children, please list additional children below including Name, DoB, Sex & Who The Child Lives WIth.Property/Financial Matters1. Do you have financial questions or property matters you wish to discuss with the lawyer:* Yes No 2. Your gross or net income per annum3. Your spouse/defacto partner’s gross income per annum4. Do you have any health concerns that affect your ability to work? Yes No Specify health issuesPlease specify any health issues that YOU have, that may affect your ability to work.5. Does your partner have any health concerns that affect their ability to work? Yes No Specify health issuesPlease specify any health issues that YOUR PARNER has, that may affect their ability to work.5. Do you support any dependent adult children or other adults? eg. Do you have children who are studying and working part-time or adults? Yes No Please advise the university name and length of the course the adult child is studying6. Do any of your children have disabilities and do they receive NDIS or other funding? Do you receive a carer’s allowance for them? Yes No If yes, how much?7. If you have children, do you pay child support or do you receive child support payments? Yes No If yes, how much per week?Please list your assets PRIOR to you living together:Your Assets PRIOR To Living Together Family Home Investment Property Motor Vehicle Other Vehicles (Boats, Caravans, Motorbikes, Jetskis, etc) Investment Savings Other Family Home Address$ Estimated Value at CommencementInvestment Property - ListInvestment Property Address$ Estimated Value at Commencement Add RemoveInvestment Property - ListMake, Model & Year$ Estimated Value at Commencement Add RemoveOther Vehicles - ListMake, Model & Year (if known)$ Estimated Value at Commencement Add RemoveInvestment TypeAsset Type (shares, crypto, etc)Estimated Value at Commencement Add RemoveEstimated Savings Value at CommencementInvestment TypeType (Business, Antiques, Collectibles, Memorabilia, etc)Estimated Value at Commencement Add RemoveWhat did your spouse/ defacto own PRIOR to you living together:Spouse/Defacto Assets PRIOR To Living Together Family Home Investment Property Motor Vehicle Other Vehicles (Boats, Caravans, Motorbikes, Jetskis, etc) Investment Savings Other Family Home Address$ Estimated Value at CommencementInvestment Property - ListInvestment Property Address$ Estimated Value at Commencement Add RemoveInvestment Property - ListMake, Model & Year$ Estimated Value at Commencement Add RemoveOther Vehicles - ListMake, Model & Year (if known)$ Estimated Value at Commencement Add RemoveInvestment TypeAsset Type (shares, crypto, etc)Estimated Value at Commencement Add RemoveEstimated Savings Value at CommencementInvestment TypeType (Business, Antiques, Collectibles, Memorabilia, etc)Estimated Value at Commencement Add RemoveDid you have any debts PRIOR to you living together:Your Debts PRIOR To Living Together Family home Investment property Credit card Personal loan Business loan HECS/HELP Other (tax debt) Family Home Address$ Estimated ValueInvestment Property - ListInvestment Property Address$ Estimated Value Add Remove$ Credit Card Estimated Value$ Personal Loan Estimated Value$ Business Loan Estimated Value$ HECS/HELP Estimated ValueDebt TypeDebt TypeEstimated Value Add RemoveDid your spouse/defacto partner have any debts PRIOR to you living together:Spouse/Defacto Debts PRIOR To Living Together Family home Investment property Credit card Personal loan Business loan HECS/HELP Other (tax debt) Family Home Address$ Estimated ValueInvestment Property - ListInvestment Property Address$ Estimated Value Add Remove$ Credit Card Estimated Value$ Personal Loan Estimated Value$ Business Loan Estimated Value$ HECS/HELP Estimated ValueDebt TypeDebt TypeEstimated Value Add RemoveDuring your relationship whilst you lived together until NOW:8. Did you receive any lump sum(s) from outside sources: Yes No Your lump sum(s) received:List the dates and amounts for each lump sum payment below: 9. Did your spousal or defacto receive any lump sum(s) from outside sources: Yes No Spousal or Defacto lump sum(s) received:List the dates and amounts for each lump sum payment below: 10. Did you or your spousal/defacto partner engage in any wastage of assets (eg: gambling, drugs and/or alcohol expenditure, excess spending, holidays? Yes No Detail the wastage of assets:11. Are there any other special financial contributions that either you or your spouse / defacto partner made during the relationship that you think may be relevant (eg: renovations conducted by the family members, rent free living with family members)? Yes No Detail any other special financial contributions:Please list what you and your spouse/defacto own NOW:List all assets whether in your name or in joint names or in company or trust names eg:Assets you and spouse/defacto own NOW Family home Investment property Business or company Motor vehicles Boats, caravans, trailers, motor bikes (including current value if sold) Bank accounts Shares or cryptocurrency Memorabilia (if sold) Superannuation Family Home AddressOwnership$ Estimated Value TodayInvestment Property - ListInvestment Property Address$ Estimated Value Today Add RemoveBusiness - ListBusiness or Company$ Estimated Value Today Add RemoveMotor vehicles - ListWho is the vehicle owned by?ModelYear$ Estimated Sale Value Today Add RemoveOther vehicles - ListBoats, caravans, trailers, motor bikes$ Estimated Value Today Add RemoveBank accounts - ListAccount holder (husband, wife or joint)$ Estimated Total Funds Add RemoveShares or Crypto - ListShares or cryptocurrency$ Estimated Value Today Add Remove$ Your Superannuation Estimated Value Today$ Your Spouse/Defacto's Superannuation Estimated Value TodayPlease list all liabilities you and your spouse/defacto have NOW:List all liabilities whether in your name or in joint names or in company or trust names eg:Liabilities you and your spouse/defacto have NOW: Mortgage Credit cards Debts on motor vehicles Outstanding tax Personal loans Any other debts Mortgage - ListMortgage$ Estimated Amount Today Add RemoveCredit Cards - ListCredit Cards (name of card and amounting owing as of today’s date)$ Estimated Amount Today Add RemoveDebt Motor - ListDebts on Motor Vehicles$ Estimated Amount Today Add RemoveOutstanding Tax - ListOutstanding Tax$ Estimated Amount Today Add RemovePersonal Loans - ListPersonal Loans$ Estimated Amount Today Add RemoveOther Debts - ListOther Debts$ Estimated Amount Today Add RemoveNow that you and your spouse/defacto partner have separated, do you expect to come into any payments in the next year or two (redundancy payout, compensation payment or inheritance) Yes No Future Payments - ListPlease specify the payment type$ Estimated Value Add RemovePlease detail future paymentsCommentsThis field is for validation purposes and should be left unchanged. 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