Section I - Personal & Contact Information:



Cell phone    


Mailing address:

Street    Apt.

City  State  Zip

Date of birth  


Would you like for us to set your account up to receive text-alerts as your case proceeds?


Section 2 - Other Party's Contact Information:


Cell phone

Mailing or severable address:

Street  Apt.

City  State   Zip

Date of birth  


Section 3- Child information

  Child's Name    
Child #1 


Child #2


Child #3


Child #4




Date of Birth Place of Birth (City and State) Social Security Number
Child #1


Child #2


Child #3


Child #4




Section 4 - Jurisdiction Information

Select all that apply:

Other party lives in Arizona.

Other party will be served in Arizona.

Other party has agreed to have this case heard in Arizona.

Other party lived in Arizona with the child at some point in time.

Other party provided pre-birth expenses and/or support.

The child(ren) lived in Arizona as a result of the acts or directions of the other party.

You and the other party had sexual intercourse in Arizona which resulted in the child's birth.

Other party signed a birth certificate for this (these) child(ren).

Section 5 - Paternity Information

Select all that apply.

Father signed an Affidavit of Paternity.

Father's name is on the birth certificate which is signed by mother and father.

A DNA test show that either you or the other party is the father.

Both mother and father were not married to each other at anytime during the 10 months before the child was born.

Both mother and father were not living together but had sexual intercourse at the probable date of the conception of the child.

Section 6 - Paternity Information (cont)

If you do have an order of paternity, what is the date?

If you do have an order of paternity, what is the name of the court it is from?

If you do have an order of paternity, what is the case number?

Section 7 - Information about Child Support for Child(ren)

Section 8 - Financial Information

Based upon the figures below. Discount Divorce will calculate the child support as per Arizona Child Support Guidelines as required by law.  Ariz.Rev.Stat. 25-320.

 Father's gross monthly income:  $  

 Mother's gross monthly income: $

Day care cost (if any) $    

Medical insurance premium (if any) $  

What percentage of uninsured medical expense will you be responsible for? %

     If you leave this blank, then the percentage will be calculated proportionate to both incomes.

What percentage of visitation travel related expenses will you be responsible for?   %

     If you leave this blank, then the percentage will be calculated proportionate to both incomes.

Does either you or the other party have minor children residing with them from another relationship?

If, yes list their names, dates of birth, and who they live with (myself or my spouse)


(Employment information of NON-Custodial Parent:

Employer  or  Unemployed or   Self-Employed


Section 9-  Legal Decision Making


 If you choose Sole Legal Decision Making  then you must state your reason for that choice. 

Arizona now leans in favor of joint legal decision making. 

If you are seeking sole legal decision making authority that you must demonstrate to the court sufficient grounds to merit this request.



What is Legal Decision Making?

What is Parenting Time?


Section 10- Address of the Child(ren)

List all address or major cross roads for where the child(ren) resided for the last 5 years. Please include month and year. 

Example: 3 East Oak, Phoenix, AZ from 03/05 to 07/07 with mother


19th Ave. & Bell Rd., Phoenix, AZ from 03/05 to 07/07 with mother    

Address   From   Until    


Section 11 - Process Service

You must provide the other party a copy of the legal documents AFTER they have been filed with the Court.

What is the single best way to do this?


Do I need a Process Server? How does Process Service work?

How does Publication / Newspaper Cases work?

Section 12 -Other information or comments  

Section 13-Payment Options

Discount Divorce will immediately begin work on your case as soon as your initial phone consultation is complete and your payment is received.

Payment & Acknowledgement

All costs will be discussed with you in advance, and we will not proceed or charge your card until you instruct us to do so.

Card number required. Note: You are not obligating yourself financially by submitting this form.

Number Exp. Date

CVV No. What is a CVV Number? Type of Card

Terms of Service

I acknowledge that I have read the "Terms of Service" and agree and understand them.

*Applicant Name/Signature: All information contained herein is true and correct

*Date (mm/dd/yyyy):