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Family Law Intake Form

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Your Full Name

Please List All Legal Issues You Need Help With

Is This Regarding a Divorce, Custody, Post Divorce Or Other Family Law Issue?

Your Home Address

Your Birthdate and Age

Your Telephone Numbers

Your E-mail Addresses

Please enter a valid e-mail address.

Your Employment Information

Your Social Security Number and Driver's License Number

You or Your Spouses Maiden Name

Your Spouses Full Name

Your Spouses Home Address

Your Spouses Birthdate and Age

Your Spouses Telephone Numbers

Your Spouses E-mail Addresses

Your Spouses Employment Information

Your Spouses Social Security Number and Driver's License Number

Your Date of Marriage and Where You Were married

How Long Have You and Your Spouse Lived in Illinois

Your Date of Separation

Your Divorce Information (if already divorced)

Children Information

Child Support/Maintenance Information

Educational Background

Referral Information

Real Estate Information

Motor Vehicle Information

Pension/Retirement Information

Financial Assets

Debt Information

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G. Edward Murphy,
Murphy & Dunn, P.C.
2886 West Willow Knolls Drive
Peoria, IL 61614-1102

Local: 309-740-9091
Toll Free: 866-681-5405
Fax: 309-691-3890

Email | Map and Directions

Pekin Office
427 1/2 Court Street
Pekin, Illinois 61554

Local: 309-740-9091
Toll Free: 866-681-5405
Fax: (309) 346-2412

Email | Map and Directions

The family law attorneys of Murphy & Dunn, P.C. serve clients in central Illinois, including the communities of Peoria, Pekin, East Peoria, Eureka, Bloomington, Dunlap, Chillicothe, Normal, Lewistown, Lacon, Galesburg, Havana, Tremont, Pontiac, Wyoming, Princeville and Canton, as well as numerous counties throughout the state of Illinois, including Peoria County, McLean County, Tazewell County, Woodford County, Fulton County, Marshall County, Knox County, Sangamon County, Warren County, McDonough County, Bureau County, St. Clair County and Stark County.