Fast Virginia Divorce – Intake Form FastVirginiaDivorce.com Intake Form What Service Are You Interested In? * 5 - Week ($525 + $92 Filing Fees) 2 - Week ($725 + $92 Filing Fees) Publication ($1500 + $92 Filing Fees + $250 Est. Publication Fee) Name * Name Name Name Name Email * Cell Phone * Spouse's Full Legal Name * Date of Marriage * Date of Separation * Have You OR Your Spouse Lived In Virginia Longer Than Six (6) Months? * Yes No Please reconnect with us once you reach that milestone, and we’ll be happy to help you proceed. Would you like FastVirginiaDivorce.com to reach back out when you hit that time frame? Yes No Virginia law requires that at least one (1) party lives in Virginia for at least 6-months before filing for divorce. Are both parties fully in agreement and willing to sign the documents, acknowledging that all rights and claims are being waived? * Yes No If you answered “No,” your matter requires a different process than what we offer. Would you like us to to refer you to The Law Offices of Daniel J. Miller for further assistance? Yes No Will you require a name change for you and or your spouse? Yes No Additional fee per name change applies Do you and your spouse have any minor children together? * Yes No If you answered “Yes,” your matter may requires a different process than what we offer. Do you already have an order in place and just looking for a divorce now? Yes No Unfortunately, FastVirginiaDivorce.com will not be able to assist you with your case. Would you like us to pass your information over to our parent company The Law Offices of Daniel J Miller to further assist? Yes No To confirm, you already have a custody order in place that you are comfortable keeping as-is for now, and your main goal right now is just to finalize the divorce. Is that correct? Yes No Privacy Policy: All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 128-bit SSL encryption. If you have any questions, please don't hesitate to contact our office at 757-801-3900. We look forward to working with you! E-AFFIRMATION By submitting this form, I confirm that I have read, understand, and agree to the terms of the privacy agreement above. THANK YOU! Send confirmation email with the submitted responses to Email Submit If you are human, leave this field blank.
