Mail this form along with a Money Order or Cashier's Check payment payable to MDB Services
Correct payment should be sent in for the type of divorce you’re getting.
SORRY, NO PRESONAL CHECKS....PERSONAL CHECKS WILL BE RETURNED...PLEASE DO NOT SEND CASH
Info you provide is ONLY used to prepare your Documents Fill in all that applies to your Divorce
Your Information Your Full Name: _________________________________________ Driver's License or ID Number:
(ex. TX DL 12345678 or TX ID 12345678)
_________________________________________ Date of Birth: _________________________________________ Your E-mail: _________________________________________ Street Address: _________________________________________ City: __________________________________ County: __________________________________
State: __________________________________ Zip Code: __________________________________
Your Spouse’s Information Spouse’s Full Name: _________________________________________ Spouse’s Driver’s License or ID Number: _________________________________________ Spouse’s Date of Birth: _________________________________________ Street Address: _________________________________________ City: __________________________________ County: __________________________________
State: __________________________________ Zip Code: __________________________________
Information On Your Marriage Date of Marriage: __________________________________ City and State Married: __________________________________ Date of Separation: Date you and your spouse stopped living as husband and wife even if you are still living together
__________________________________
Is this an Agreed Divorce? O Yes, My Spouse and I have agreed to the terms of our Divorce. O No, My Spouse refuses to sign Divorce papers and will be served. O No, My Spouse is MISSING and will be served by Publication of Notice.
Name Change Do you want to restore wife’s former name? O Yes O No If yes, Former name used? __________________________________
Property and Debt Do you own a Marital Home or Land Property? O Yes O No
Who will keep the home / land? O I will keep the home / land. O My Spouse will keep the home / land. O The Home/Land is My Separate Property O The Home/Land is My Spouse’s Separate Property
Give street address with city, state, and zip
List any Legal Description from deed or closing documents __________________________________________________
Properties you will keep (i.e. Car, Clothing, Furniture...Give good description: example 20" RCA TV, Whirlpool Washer/Dryer etc.)
If there are any automobiles, please give year, model, VIN and lien holder if any.
________________________________________________________________________
Debts you will pay (i.e. Visa, MasterCard with last 4 digits of the account number and balance If there’s a mortgage include name of company, date and original loan amount)
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______________________________________________________________ Debts your Spouse will pay
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Minor Child(ren) Information
If you and your spouse are expecting a child together, do not use this service until after the child is born. If a child was worn during the marriage, but the husband is not the biological father please state so below.
Name and Birth Date of each minor child you have with your spouse.
_______________________________________________________________
Which Parent will the child(ren) live with? O Mother O Father
Which Parent will provide Medical Coverage? O Mother O Father
Child Support Information Do you want the Court to order Child Support? O Yes, I want the court to order Child Support O No Child Support to be paid by either parent O There is already a Child Support / Custody order that will be attached to my Petition
If yes, enter the agreed amount below that is to be paid otherwise leave blank and the amount will be determined by the court.
O I will pay support in the amount of $_______________ per month. O My spouse will pay support in the amount of $_______________ per month.
Delivery Options Would you like to receive your documents via e-mail? O Yes O No If yes, e-mail address to send documents: ______________________________________
Address to send Documents: Enter an address ONLY if you do not want e-mail delivery.
_______________________________________________
_______________________________________________
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You will receive an email confirmation once we have received your info & payment.
Documents will be delivered within 3-5 business days or 48-72 hours if you picked e-mail delivery (excluding weekends and holidays) upon receipt of Information and cleared Payment.
