Separation Questions

    1) Please enter your Client ID or Div Number:*

    2) What is your phone number?*

    3) Please enter your current name as it appears on your ID (Client Name):*


    4) If needed please enter the name to which you are returning (maiden):

    5) Your address or PO Box:*

    6) Have you or your spouse lived in NC for the past six months?*


    7) Can you print documents sent to your email address?*


    8) Court fees may be waived if you receive one of the following:*

    SNAP/EBTTANFSSINo assistance

    9) Marriage Information:*

    Date Married:

    Date you and your spouse began
    living in separate homes with the intent
    to remain apart from one another.
    (Leave Blank if Not Separated)

    Please enter town and state
    in which you were married:

    10) Please enter your SPOUSE'S name as it appears on their ID:(Defendant's Name)*


    11) Please enter your SPOUSE'S address. (If you do not have your spouse's address. please give me the name and address of your spouse's mother or another close relative, or name and address of your spouse's employer.)

    11) Please give the first name and age (oldest first) of all children born to or adopted by you and your spouse:* (If none, leave "No Children")

    We have had:

    Additional Comments