3400-Pre-Trial Memorandum Filed Uniform Settlement Pretrial Conference Memorandum (Rev. 07/20/16) CCDR N043 A IN RE: IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, DOMESTIC RELATIONS DIVISION Marriage Civil Union Legal Separation Allocation of Parental Responsibilities Visitation (Non-Parent) Support Parentage of: No.: ___________________________________ Calendar: ______________________________ ______________________________________________________ Petitioner and ______________________________________________________ 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 DOB: ____________________________________ Petitioner's Occupation: ___________________________________ Date of Separation: ______________________________ Respondent's Age DOB: __________________________ Respondent's Occupation: _________________________ I ( Petitioner Last Year's Gross: $ ______________ Last Year's Net: $ ______________ A ( S A & C) ) Respondent $ _______________ $ _______________ Civil Union/ Marital Value1 $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ $ ___________________ P Non-Civil Union/ Non-Marital Value ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ R Non-Civil Union/ Non-Marital Value ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ (1) Equity in real estate (2) Cash/cash equivalents (3) Investment accounts/securities (4) Business interests (including Partnerships, Corporations, LLC's) (6) Cash value of life insurance (7) Equity in motor vehicles, RVs, boats, aircraft (8) Personal property (5) Stock Options/ESOs (other employment benefits) $ ___________________ (9) IRA accounts, deferred compensation, annuities, 401(k), profit-sharing $ ___________________ (10) Pension plans (11) Other property TOTAL ASSETS: $ ___________________ $ ___________________ $ ___________________ 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): 1 Value listed should reflect most current value of asset ___________________ ___________________ ___________________ ____________________ ____________________ ____________________ $ ___________________ $ ___________________ $ _________________ _________________ __________________ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 1 of 10 3400-Pre-Trial Memorandum Filed Uniform Settlement Pretrial Conference Memorandum (Rev. 07/20/16) CCDR N043 B C Name(s): Birthdate: 'I __________________________ __________________________ School Child Attending: _____________________________ School Expenses/Tuition: _____________________________ Health/Education Issues: _________________________________________________________________________ Name(s): Birthdate: __________________________ __________________________ School Child Attending: _____________________________ School Expenses/Tuition: _____________________________ Health/Education Issues: _________________________________________________________________________ Name(s): Birthdate: __________________________ __________________________ School Child Attending: _____________________________ School Expenses/Tuition: _____________________________ Health/Education Issues: _________________________________________________________________________ Name(s): Birthdate: __________________________ __________________________ School Child Attending: _____________________________ School Expenses/Tuition: _____________________________ Health/Education Issues: _________________________________________________________________________ O I P P 1 Petitioner Health: ___________________________________________ _________________________________________________ _________________________________________________ Current Income Disputes and Basis: _________________________________________________ _________________________________________________ _________________________________________________ Educational History: (Highest degree attained): _________________________________________________ _________________________________________________ _________________________________________________ Respondent __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ 1 See Schedule H if there are issues regarding Allocation of Parental Responsibilities / Parenting Time / Visitation. DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 2 of 10 3400-Pre-Trial Memorandum Filed Uniform Settlement Pretrial Conference Memorandum (Rev. 07/20/16) CCDR N043 C SCHEDULE A CIVIL UNION/MARITAL ASSETS (Add Addendum if more space is required.) 1. R E Address Title in P/R Date Value Value Liens Net Equity A.___________________ B. ___________________ C. ___________________ D.___________________ ____________ ____________ ____________ ____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ ____________ ____________ ____________ ____________ __________ __________ __________ __________ Total Equity in Real Estate: __________________________________________________________________________ 2. C /C E Title Date Valued Value If Institutions/Account No. (Use last 3 digits of account no.) A._______________________ B. _______________________ C. _______________________ D._______________________ __________________________ __________________________ _____________