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Your most recent submitted responses to the separation questionnaire are set out below. If you need to update any section, please click edit to be taken to the original saved questionnaire and make your changes. When you have finished, don’t forget to go to the submission page (page 18) and click “update”.

Client reference:

Personal Details – party 1

Name:
Date of birth: Age:
Address:
Email:
Phone:
Do you have any special medical needs:
Have you been subject to any emotional or physical abuse or been accused of being abusive during the relationship?:
Have the police been involved?
Please provide details (if applicable):
Would you consider discussing the issues arising out of the breakdown in your relationship with a mediator?
Current employment: Employed full time
Have you formed another relationship?:

Personal details – party 2

Name:
Date of birth: Age:
Address:
Phone:
Email:
Does the other party have any special medical needs?:
Would the other party consider discussing the issues arising out of the breakdown in your relationship with a mediator?:
Current employment: Employed full time
Has the other person formed another relationship?:

Relationship & Mediation

Date cohabitation began:
Date of marriage:
Date of separation:
Case number:
Date of petition:
Date of decree nisi/conditional order:
Date of decree absolute/final order:
Have either you or the other party attended any form of mediation?:
What was the outcome?:

Children

Name:
Date of birth:
What is party 1’s relationship to this child?:
What is party 2’s relationship to this child?:
Does this child have any special medical needs?:
Details:
Where does this child live?:
Which stage of education has the child reached?:
Are private school fees/university fees being paid?:
Please give details:
If there is anything else you feel is significant about this child that I should be aware of, please state it here:

The Family Home

Address of the last home you lived in together. This is/was your main home.: 7 St Aldwyns Road
Manchester, Greater Manchester M20 3JF
United Kingdom
Has this property been sold or the tenancy terminated?: Neither of the above.
Is this property owned or rented?: Owned just in party 2’s name
Is there a mortgage on the property?: Yes
What type of mortgage is it?: Part interest only part repayment
Name of mortgage lender: Barclays
Address of the mortgage lender: Barclays Bank
London, NW1 2BN
United Kingdom
Amount outstanding on the mortgage: £360,000
Is the value of the property agreed?: Yes
Agreed valuation: £1,000,000
Estimated estate agency fees: £10,000
How has the valuation been arrived at?: Rightmove
If there are any other details that you think I should be aware of please state them here:

Other Real Property

Bank Accounts

Nickname for account:
Whose account is it?:
Name of Bank:
Type of account:
Balance today:
Please state any other details you feel may be relevant here:

Investments

Whose investment is this?:
Type of investment:
Number of shares etc:
Price per share:
Current value today:
Please state any other details you feel may be relevant:

Insurance Policies

Nickname:
Policy Holder:
Policy Holder:
Name of life assured:
Name of life assured:
Does this policy have a surrender value?
Maturity date:
Surrender value today:
Is this a whole of life policy only that only pays out on the death of the assured person?:
Sum payable on death of the life assured:
Sum payable in respect of critical illness:
Name of person to whom the benefits are assigned:
Monthly premium:
Please state any other details that may be relevant:

Cash

Please provide details of any cash not in a bank account that either party holds:
Cash is held by:
Amount:

Money Owed to Either Party

Please provide details of any money owed to either party:
Amount owed:£

Personal Belongings Worth Over £500

What is the item?:
Who owns this item?:
Is the value agreed?:

Please give any other details that you believe may be relevant:

Business Assets

Name of the business:
What type of business is this?:
Who owns/has a share in this business?:

Please set out any other details you believe may be relevant:

Other Assets

Name of the asset
What type of asset is this?
Who owns/has a share in this asset?

Please give any details you believe may be relevant:

Liabilities

Type of liability:
Whose liability is this?:

Income

Case reference:

Nicola is happy to announce that she will be joining Taylor Rose MW on 12th July 2022 as a consultant solicitor