Print Form Clear Form 3400 - Pre-Trial Memorandum Filed Uniform Settlement Pretrial Conference Memorandum IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, DOMESTIC RELATIONS DIVISION IN RE THE MARRIAGE/CIVIL UNION (Rev. 7/30/12) CCDR 0043 ____________________________________________________ PETITIONER AND No. __________________________________ Calendar: ____________________________ ____________________________________________________ RESPONDENT UNIFORM SETTLEMENT PRETRIAL CONFERENCE MEMORANDUM PREPARED BY: ______________________________________ (Petitioner or Respondent) (Add Addendum if more space is required.) Date of Civil Union/Marriage: _________________________ Petitioner's Age D/O/B: ______________________________ Petitioner's Occupation: ______________________________ Date of Separation: ______________________________ Respondent's Age D/O/B: _______________________ Respondent's Occupation: _____________________ Income from all sources to date (as calculated for child support purposes): Last year's gross: Last year's net: Assets: (from Schedules A & C) Petitioner: ________________ Petitioner: ________________ Respondent: ________________ Respondent: ________________ Civil Union/ P Non-Civil Union/ R Non-Civil Union/ Marital Value1 Non-MaritalValue Non-Marital Value $ ____________ $ ____________ $ ____________ $ ____________ $ ____________ $ ____________ $ ____________ $ ____________ $ ____________ $ ____________ $ ____________ 0.00 $ ____________ (1) Equity in real estate (2) Cash/cash equivalents (3) Investment accounts/securities (4) Business interests (including Partnerships, Corporations, LLCs) (5) Stock Options/ESOs (other employment benefits) (6) Cash value of life insurance (7) Equity in motor vehicles, RVs, boats, aircraft (8) Personal property (9) IRA accounts, deferred compensation, annuities, 401(k), profit-sharing (10) Pension plans (11) Other property TOTAL ASSETS: ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ 0.00 ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ 0.00 ____________ ____________ ____________ ____________ ____________ LESS LIABILITIES (from Schedules B & C): (excluding liens on real estate, motor vehicles, RVs, boats, aircraft) $ ____________ Assets Less Liabilities: $ ____________ Reimbursement Claim (from Schedule D): $ ____________ Dissipation Claim(s) (from Schedule E): $ ____________ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS 1 Value listed should reflect most current value of asset (Page 1 of 10) Child(ren)'s Information: Name(s) ___________________________________School Child Attending: _________________________________ Birthdate(s) ________________________________School Expenses/Tuition: ___________________________________ Health/Education Issues:______________________________________________________________________________ Name(s) ___________________________________School Child Attending: _________________________________ Birthdate(s) ________________________________School Expenses/Tuition: ___________________________________ Health/Education Issues:______________________________________________________________________________ Name(s) ___________________________________School Child Attending: _________________________________ Birthdate(s) ________________________________School Expenses/Tuition: ___________________________________ Health/Education Issues:______________________________________________________________________________ Name(s) ___________________________________School Child Attending: _________________________________ Birthdate(s) ________________________________School Expenses/Tuition: ___________________________________ Health/Education Issues:______________________________________________________________________________ Other Issues Pertaining to Parties; Petitioner Health: ________________________________________ Respondent _______________________________________________ _______________________________________________ Current Income Disputes and Basis: ______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ Educational History (Highest degree attained) _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ GROUNDS: (Specify party alleging grounds); _______________________________________________ _______________________________________________ _______________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ *See Schedule H if there are Custody or Visitation Issues (Rev. 7/30/12) CCDR 0043 (Page 2 of 10) SCHEDULE A CIVIL UNION/MARITAL ASSETS (Add Addendum if more space is required.) 1. Real Estate Title in P/R Date Value Value Liens Net Equity Address ___________________________ ___________________________ ___________________________ ___________________________ _____________ _____________ _____________ _____________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ 0.00 Total Equity in Real Estate: ____________________________________________________________________________ 2. Cash/Cash Equivalents If Institutions/Account No. (Use last 3 digits of account no.) Title Date Valued Value __________________________ __________________________ __________________________ __________________________ ________________________ __