

Am I at the right Webpage? This Web page is for prospective clients who wish to have Attorney Romero assess their case for possible legal representation. This is not the correct page if you are not thinking of hiring legal counsel. If you are planning on not having a lawyer and being self-represented, click here for pro se instructions. Am I committing myself to hiring Attorney Romero if I fill out this application? No. And be assured that all your information you provide will remain confidential. What will I need to fill out this application? 1. A printer to print out this page. Then fax the filled out page to: 877-353-6320 for a free phone consultation. 2. You will need about 15 minutes of your time and the social security numbers of all adults and children involved and all relevant dates of birth. Check stubs, tax records, marriage licenses, creditor names, balances, and other important property and real estate records will also be needed. Simply scroll down to be interviewed and remember the [TAB] button. How did you hear about this Website? What if any questions do you have for Attorney Romero? What is your main concern or goal or priority? Check what you are considering, uncheck what you don't want Absolute Divorce Legal Separation Annulment Name Change Joint Custody Child Support Maintenance How sure are you that you want the above-referenced action? 100% Sure, 50% Sure, 20% Sure? How soon would you want your papers drafted? What additional work would you want Attorney Romero to do? For example Filing of all paperwork, obtaining a final court date, service, appearance in court. What's your full legal name? What is your 10 digit home phone number? What is your spouse's 10 digit home / office phone number? What is your 10 digit work phone number? What is your 10 digit cell phone number? What is your 10 digit pager phone number? What is your 10 digit fax phone number? Which phone number do you prefer? What is the best time to call you? Is it okay to have an attorney call you at your home number? Yes. No. What is your e-mail address? Is one of the parties on social security, welfare, W-2, AFDC, food stamps, Title19? Yes. No. Has one of the parties lived in the state of Wisconsin for the last 6 months? Yes. No. Have you lived in the county in which you want a divorce for more than 30 days? Yes. No. Have you or your the other party ever filed for a divorce, annulment, legal separation, or paternity ever in THIS relationship aside from this request? Yes. No. If you answered YES to the last question, please describe by typing who it was and also enter the date here State Court Resolution Please specify date of this marriage in 00-00-0000 format: Please specify the city, county, and state where the marriage took place: How long have you been legally married? Has your spouse or have you moved away from the marital residence? Yes. No. If so, when? Or enter the date the move will happen in 00-00-0000 format: Enter the woman's full legal name she uses on a daily basis including full middle name(s): Is the woman in any U.S. military service? Yes. No. What is the woman's full street address? Enter the name of city where the woman resides: Enter the name of her county: Enter the name of her state: Enter her residential zip code: Enter woman's date of birth in MO-DY-YEAR / 00-00-0000 format - remember to enter the dashes [Enter n/a if not known.] Enter woman's age [Enter n/a if not known.]: Enter woman's social security number in 000-00-0000 format - please enter the dashes too [Enter n/a if not known.]: What is woman's race (White, Black, Hispanic, etc.)? Is the woman pregnant? Yes. No. Enter the name of woman's occupation? Enter the name of woman's employer: What is the woman's total pre-tax monthly income? (Multiply weekly gross by 4.3 or divide yearly salary by 12 months): This is the woman's ___ marriage If this is another marriage by the woman, please explain whether her last marriage ended by death, divorce, or an annulment, the place it took place, and the date that it ended was (in 00-00-0000 format): Does the woman believe this marriage is irretrievably broken? Yes. No. Please enter the woman's maiden name: If woman's wishes to change her name back to her maiden name, please enter the full legal name desired: (Keep in mind that it is a FREE name change!) Please specify woman's highest grade completed 8th, 12th, 16th, G.E.D.etc.: Please specify woman's hourly rate of pay: Please enter the man's full legal name he uses on a regular basis including full middle name(s): Is the man in any U.S. military service? Yes. No. Enter the man's full street address: Enter man's city: Man's street address is in which county? Man's street address is in which state? Please enter man's mailing zip code: Enter man's date of birth in MO-DY-YR/00-00-0000 format: How old is the Man? [Enter n/a if not known.] Please enter man's social security number in 000-00-0000 format: What is man's race (White, Black, Hispanic, etc.)? What is the name of man's occupation? What is the name of man's employer? What is the man's total pre-tax monthly income? (Multiply weekly gross by 4.3 or divide yearly salary by 12 months) This is the man's ___ marriage? If this is another marriage by the man, please describe if his last marriage ended by death, divorce, or an annulment, the place it occurred, and the date that it ended was when (in 00-00-0000 format): Does the man believe this marriage is irretrievably broken? Yes. No. Please specify only man's highest grade completed 8th, 12th, 16th, G.E.D., etc. Please specify man's hourly rate of pay This information is for the Financial Disclosure Form and Marital Settlement Agreement. What is your hourly wage? or Annual salary? What do you want to do with any major property (over $500), for example pets, boats, bikes, time-shares, and collections, (not real estate)? What do you want to do with any real estate? What is the whole street, city, state, zip code of any real estate owned by either party jointly or separately? (If you have the legal description handy, place this in here, too.) What do you want to do with any checking or savings accounts, pensions, stocks, 401k's, whole life insurance policies? Who wants to keep which cars? Make sure you describe make, model, year, and worth (check the newspaper to see how much similar cars are selling for), debt owing and who gets the automobile Enter like this Make Model Year Market Price Debt Awarded to H Make Model Year Market Price Debt Awarded to W Who is going to be responsible for which bills? Please enter Name, Account #, Balance, Party Responsible, Share of Responsibility Who is going to be responsible for filing and paying taxes? Enter type of tax, Balances owed, Party Responsible, Share of Responsibility Who is going to be getting the tax refunds? Has any party been involved in ANY personal injuries, worker's compensation lawsuits, or involved in ANY litigation such as bankruptcy? Yes. No. How many children were born to or adopted by this marriage How many of your children are now adults that belong to this marriage Please specify the FULL NAMES of any minor children of the marriage with their SSN's DOB's in 00-00-0000 format and AGES During the marriage, has the woman given birth to a child, and the man is not the biological father? Yes. No. If so, please specify the names of any non-marital children born during the marriage: Check what you type of custody and placement you would want to see: Mother gets sole custody (decision-making) and primary physical residential placement (residence). Father gets sole custody and primary physical residential placement. Father and Mother get joint custody. Primary physical placement with Mother. Father and Mother get joint custody. Primary physical placement with Father. Father and Mother get joint custody. Shared physical placement with both parents. What type of visitation / custody schedule would you like and why? What type of child support, alimony, health insurance, and tax deductions do you want? Check one: Mother pays support. Father pays support. Neither pays support. If there is a child support court case # or KIDS# please type in the full number here - if none, leave blank: Check one if you chose neither pays support: Mother claims child tax deductions and credits. Father claims child tax deductions and credits. What if any comments or special directions would you want Attorney Romero to know? Do you have any special concerns you would like addressed? THANK YOU FOR APPLYING! We welcome your electronic information however please be advised that the act of sending this form to a specific attorney, does not create an attorney-client relationship.