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Richard Beckerman, Esq.
Brandon Granados, Esq.
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118-35 Queens Blvd Suite 400, Forest Hills, N.Y. 11375
info@bgmatlaw.com
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Home
About Us
Attorneys
Richard Beckerman, Esq.
Brandon Granados, Esq.
Practice Areas
Annulments
Child Custody
Child Support
NYPD/FDNY/DOE Pensions
Retirement Benefits In Divorce
High Asset Divorces
Real Estate in Divorce
Alimony/Maintenance
Counsel Fees
Uncontested Divorces
Contested Divorces
Prenuptial/Postnuptial Agreements
Separation Agreements
Paternity Cases
Reviews
Blog
Contact Us
COVID-19
Online-Form
TELEPHONE NUMBERS:
DAY:
EMAIL:
FEE:
$
APPOINTMENT DATE:
INTAKE BY:
HUSBAND
First Name
Last Name
Address
City/State/Zip
Race
# of Prior Marriage(and how terminated):
S.S.#
DOB
Place of Birth
Highest level of Education
Wife
First Name
Last Name
Address
City/State/Zip
Race
# of Prior Marriage(and how terminated):
S.S.#
DOB
Place of Birth
Highest level of Education
CHILDREN OF THE MARRIAGE: #
UNDER 21:
NAME:
SS#
DOB:
NAME:
SS#
DOB:
NAME:
SS#
DOB:
CHILDREN RESIDE WITH:
Wife
HUSBAND
CUSTODY TO:
WIFE
HUSBAND
JOINT
FAMILY COURT ORDERS:
Country
Date
Docket#
MARITAL RESIDENCE:
PARTIES WERE MARRIED BY A:
Rabbi
Priest
Minister
Neither (civil ceremony)
Wife working?
Y
N
Husband working?
Y
N
Public Assistance?
H
W
Neither
Wife Occupation
annual gross income
Husband Occupation
annual gross income
Are any of the parties in the military service of the U.S. or any other Country?
Y
N
Neither
Will the Defendant sign an affidavit consenting to the divorce?
Y
N
Plaintiff / Defendant Health Plan:
Address:
Group #
Administrator:
Coverage type:
Date of the Marriage:
Place:
Confidential Statistical Information
DRL 240:
1) Have you been a party in an Order of Protection?
Yes
No
List all Family / Criminal Court Docket #’s and Counties
List all Supreme Court Index #’s and Counties
2) Have you been a party in a Child Abuse/Neglect Proceeding(F.Ct 10)
Yes
No
List all family Court Docket #’s and Counties
3) Are you registered under NY State’s Sex Offender Registration Act?
Yes
No
List all names under which you are registered
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