DRC Family Law Online Inquiry Form

Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone Number(Required)

Employer Name & Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you in the military?(Required)

Dates during which you've been domiciled in Colorado(Required)

Spouse's Name(Required)

First Last

Spouse's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Spouse's Telephone Number(Required)

Spouse's Employer's Name & Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your spouse in the military?(Required)

Dates during which spouse has been domiciled in Colorado(Required)

Date & place of marriage(Required)

Date of physical separation (if applicable)(Required)

Is the wife pregnant?(Required)

Full Name & Birthdate of Children(Required)

Have you participated in any proceedings regarding the children concerning parental responsibilities, decision-making or parenting time?(Required)

If so, identify the court, case number, state, date & type of proceeding(Required)

Do you know of any proceedings that could affect your case such as domestic violence, enforcement of Court orders, restraining orders, parental rights termination or adoptions?(Required)

If so, identify the court, case number, state, date, and type of proceeding(Required)

Does anyone else have physical custody of the children or claim parental responsibility rights, custody or visitation/parenting time?(Required)

If so, identify their names and addresses(Required)

Identify the name, address and relationship of each person that your child has lived with over the past 5 years(Required)

Have the parents or children received benefits or public assistance from the state DHS or County Social Services?(Required)

If so, identify the person(s) receiving benefits, the County & State and Case Number(Required)

Have any temporary or permanent protection/restraining orders been issued against either party within 2 years?(Required)

Have you reached an agreement about the children or child support?(Required)

If so, state the agreement(Required)

Confidential Email Address(Required)

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DRC Family Law Online Inquiry Form

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