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1. What state and county is your legal issue in?*
STATE: West Virginia
2. What city is your legal issue in?*
CITY: Charleston
3. How will you pay for legal services if you decide to hire a lawyer?*
(check all that apply)
4. What is the current status of your relationship?*

5. What are you seeking to do?*

6. Has a court previously entered an order awarding spousal support?
7. If an order has been entered, in what state and county?
8. What is the current amount of monthly child support, if any?
9. What is your age?
10. What is your spouse’s age?
11. What is your approximate annual income?
12. What is your spouse’s annual income?
13. Have you spoken to a lawyer regarding this matter?
14. Please create a summary or title for your legal matter using only a few words.*
15. Please provide any additional relevant information here. Do not disclose any information you wish to remain confidential.*
First Name:*
Middle Name or Initial:
Last Name:*
Phone Number:*
Email:* (this will also be your login username)
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