1300 699 688 Client Registration Form NameThis field is for validation purposes and should be left unchanged.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*Age*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 RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall 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 BirthPartner AgePartner 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 RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall 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 previously an Intervention Order in place?Is there a pre-nuptial agreement (Binding Financial Agreement) or other orders in place? Please provide details.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?ASSETS & LIABILITIES (What You & Your Partner Own Now)AssetsList all assets in Australia or overseas (you / partner / joint / company / trust). In Asset Description, add key details (e.g. House – 12 Smith St, Savings – CBA, Toyota Hilux, Bitcoin, Super – Hostplus, Company/Trust). Fill Owner and $ Estimated Value. Include houses/land, savings, shares, vehicles, crypto, caravans/trailers, memorabilia, super, companies/trusts. Click the “+” to add more assets.Asset DescriptionOwner$ Estimated Value Add RemoveLiabilitiesList all liabilities in your name, your partner’s, joint, or via company/trust. In Liability Description, note the type and key details (e.g. Mortgage – 12 Smith St, Credit card – ANZ, Car loan – Toyota Hilux). Fill Owner and $ Estimated Value (amount owing). Include mortgages, personal loans, credit cards, vehicle finance, and other debts (state name on the debt). Click the “+” to add more.Liability DescriptionOwner$ Estimated Value Add RemoveThings to Consider Before Your First AppointmentAssets & Liabilities Prior to Living Together: The solicitor in your first interview will ask you about assets you owned before you lived together which include houses, land, shares, crypto, superannuation, motor vehicles and savings. Have a think about that and the values of those assets that you had before you lived together, so you can give that information to the solicitor. Special Contributions Received During Your Relationship: The solicitor at your first interview will ask you questions about external amounts you have received from friends, family or organisations during your relationship which includes redundancies, compensation, inheritances, gifts or loans of money during the relationship from outside sources. In order to prepare for your conference please think about the date you received such lump sums, the amount and what they were used for. Is there any other information you would like to add? Pearsons Lawyers Pty Ltd – 1300 699 688 View our Privacy Policy
