Date of Birth

MM

DD

YYYY

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you lived in Georgia for the past 6 months?

Yes

No

Date of Birth

MM

DD

YYYY

Phone

(###)

###

####

Address

(if different from Spouse 1)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What type of case is this?

Check all that apply

Child Custody/Visitation Modification

Child Support Modification

Contempt

Legitimation

Other

Were you and your ex ever married?

Yes

No

Have there been any other cases between the parties?

Yes

No

Are there any allegations of domestic violence by either party?

Yes

No

Not sure

Ready to Submit? *

Check either box below, then "Submit" when you have completed your questionnaire.