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Thank you for taking the time to complete this questionnaire.
Whilst many questions are optional, please try to tell us as much information as possible, even if it is just an approximation or a guess. This will allow us to understand your circumstances and best prepare to assist you. Please note that, by using this online questionnaire, you are not receiving legal advice or a legal service. No engagement for legal services is formed unless and until you enter into a costs agreement with us.
Please check the box below to continue with questionnaire
(Required)
I understand that this questionnaire is not providing me with any legal advice
Your details
To start, please tell us your name and the name of your partner or spouse (or any other person to which your concern relates – not your children).
Full Legal Name
(Required)
Do you have a previous name or another name you are known by?
Yes
No
Eg. a maiden name
Your previous or other names
How do you describe your gender?
Male (he/him)
Female (she/her)
Non-binary person (they/them)
Prefer not to say
Other
Your Date of Birth
(Required)
DD slash MM slash YYYY
What is your contact number?
(Required)
Contact Number Safety
Do NOT contact on phone until confirmed
Please check this box if you do NOT want us to contact you on this number until we’ve corresponded by email
What is your email address?
What is your Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Do you have a different postal address?
Yes
No
If different, what is you postal address?
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Address safety
Do NOT send correspondence to this address until confirmed
For safety reasons, please check this box if you do not wish us to send correspondence to this address until we have checked with you first
Are you an Australian citizen?
Yes
No
Of which country are you a citizen?
Are you of Aboriginal or Torres Strait Islander origin?
Yes
No
Are you receiving assistance from or represented by Djirra?
Yes
No
About the other party
Please note that we will not contact the other party without your prior consent. These details are simply required for our own internal purposes.
Other party's full name
Does the other party have a previous name or another name they are known by?
Yes
No
Unsure
Please list the previous or other names they are/have been known as.
What is the other party's date of birth?
DD slash MM slash YYYY
Other party's gender identity
Male (he/him)
Female (she/her)
Non-binary person (they/them)
Unsure
Other
Is the other party an Australian citizen?
Yes
No
Of which country is the other party a citizen?
What is the other party's contact number?
What is the other party's email address?
Are you and the other party living together?
Yes
No
Address (if known)
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Is the other party of Aboriginal or Torres Strait Islander origin?
Yes
No
Is the other party receiving assistance from or represented by Djirra?
Yes
No
Unsure
How can we help you?
Please select from the options below what assistance you are requiring from us? Select all that apply
Separation/Divorce
Parenting arrangements
Property settlement
Financial Agreement
Spousal maintenance
Child support
Family violence/Intervention Order
Child Protection/Children’s Court
Adoption
Surrogacy/Fertility Law
Something else
Please tell us what you would like assistance with.
In your own words, what would you like to achieve?
Do you currently have any proceedings before the court?
Yes
No
Next court date/s
The relationship
On this page, you’ll provide us with a basic timeline of your relationship. Don’t worry if you don’t know the exact dates, we are only trying to gain an overall picture.
When did you and the other party commence a relationship?
DD slash MM slash YYYY
Did you and the other party ever live together?
Yes
No
When did you and the other party commence living together?
DD slash MM slash YYYY
Did you and the other party marry?
Yes
No
When did you marry?
DD slash MM slash YYYY
Have you and the other party separated?
Yes
No
When did you separate?
DD slash MM slash YYYY
Which best describes your current situation?
I am considering separating from the Other Party but we have not discussed it
We have discussed separating
Have you and the other party divorced?
Yes
No
What was the date of your divorce?
DD slash MM slash YYYY
Children
If you have any children relevant to your relationship (including step-children and adopted children), this is where you can tell us about them. Generally, family law only relates to children that are under 18 years of age, however, you can include adult children as well, as they may be relevant to your circumstances (such as if they are dependent on you or the other party).
Are there any children relevant to the relationship?
Yes
No
Children Details
Child’s Full Name
Date of birth
Child’s gender identity
Who is the Parent/Guardian of the child?
Were they born in Australia
Are they a citizen of Australia?
Do they have any health concerns?
What are their health concerns?
Actions
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Delete
There are no
Entries.
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Maximum number of entries reached.
Contributions at the start of the relationship
Financial, non-financial and homemaker/ parenting contributions may be relevant to your property settlement. To start, the following questions relate to the financial contributions (i.e., all of the property, liabilities and assets) of you and the other party at the start of your relationship. Where possible, try to answer as many questions as you can. It’s okay to provide approximate dollar values. If you are unsure, you can leave those answers blank for now.
Assets at the start of the relationship
Did you or the other party have any assets at the start of your relationship?
Yes
No
Unsure
Please list all Assets brought into the relationship
Asset Type
Owner
Estimated Value of Asset at that time
Actions
Edit
Delete
There are no
Entries.
Add Entry
Maximum number of entries reached.
Liabilities at the start of the relationship
Did you or the other party have liabilities/debts at the start of your relationship?
Yes
No
Unsure
Please list all libabilities/debts brought into the relationship
Type of liability
Who owned the liability/debt?
Estimated value of liability/debt
Actions
Edit
Delete
There are no
Entries.
Add Entry
Maximum number of entries reached.
Contributions during the relationship
Were you employed during the most of the relationship?
Yes
No
Were you looking after children (and therefore not working)?
Yes
No
Are you currently employed? (Including self-employed)
Yes
No
No – currently looking for work
Your current estimated annual income
Was the other party employed during most of the relationship?
Yes
No
Was the other party looking after children (and therefore not working)?
Yes
No
Is the other party currently employed? (Including self-employed)
Yes
No
No – currently looking for work
Unsure
Other party's estimated annual income
Contributions to the family and household
Who performed each of the following activities more often?
Preparing meals:
Me
About the same
Other party
Housework:
Me
About the same
Other party
Gardening and outdoor maintenance?
Me
About the same
Other party
School pickup and drop-off:
Me
About the same
Other party
Organising activities for children:
Me
About the same
Other party
Not applicable
Assisting children with homework:
Me
About the same
Other party
Not applicable
Playing with children (Including games and sports):
Me
About the same
Other party
Not applicable
Assisting children with personal hygiene (Including bathing and cleaning teeth):
Me
About the same
Other party
Not applicable
Current assets
Please list all assets
Type of Asset
Description (address, banking institute, car make & model)
Owner
Estimated value of asset
Actions
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Delete
There are no
Entries.
Add Entry
Maximum number of entries reached.
Current liabilities / debts
Please list all liabilities / debts
Type of liability / debt
Description (address, bank, lender etc)
Owner
Estimated value of liability
Actions
Edit
Delete
There are no
Entries.
Add Entry
Maximum number of entries reached.
Superannuation
Please list all your superannuation funds
Name of superannuation fund
Type of fund
Estimated super balance
Actions
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There are no
Entries.
Add Entry
Maximum number of entries reached.
Please list all the other parties superannuation funds (if known)
Name of superannuation fund
Type of fund
Estimated super balance
Actions
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Delete
There are no
Entries.
Add Entry
Maximum number of entries reached.
Investment income
Do you or the Other party earn income from investments?
Me
Other party
Both parties
No
What is your annual income from investments?
What is their annual income from investments?
What is the estimated annual income from these investments?
Government benefits
Do you or the other party receive government benefits?
Me
Other party
Both parties
No
What is the annual benefit you receive?
What is the annual benefit they receive?
Other income
Do you or the other party receive any other income?
Me
Other party
No
What is your annual total of all other income you recieve?
What is the annual total of all other income they receive?
Please list any lump sum income received during the relationship
Type of lump sum payment
Details of payment
Amount
Actions
Edit
Delete
There are no
Entries.
Add Entry
Maximum number of entries reached.
Living arrangements
Who has remained in the family home?
Me
Other party
No one
Which best describes the other party's current living arrangements?
In a rented property
With family
With friends
Other
Further description of other party's living arrangements (optional)
Which best describes your living arrangements?
In a rented property
With family
With friends
Other
Further description of the your living arrangements (optional)
Who do the child/ren live with most of the time?
With me
With the other party
Other arrangements
How many nights do the children spend with the other party? For example, 2 nights each fortnight.
How many nights are spent with the you? For example, 2 nights each fortnight.
Please detail these arrangements
More information
Use this box to tell us any further information you think we should know