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Settlement Conference Memorandum Form. This is a Illinois form and can be use in Lake Local County.
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Tags: Settlement Conference Memorandum, 171-182, Illinois Local County, Lake
IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
LAKE COUNTY, ILLINOIS
IN RE THE MARRIAGE OF
)
)
)
Petitioner,
)
)
)
)
Respondent. )
and
Gen. No.:
SETTLEMENT CONFERENCE MEMORANDUM
Submitted by:
Date:
Date of Marriage:
Date Action Filed:
Prior Settlement Conf.:
No
Date of Separation:
Yes (date)
Ages of Children:
Date of Trial:
Parenting Plan has been presented and approved by the court:
The parties have attended mediation:
No
No
Yes (date)
Husband
Name:
Yes (date)
Wife
Age:
Name:
Age:
Residence: (city/state)
Residence: (city/state)
Attorney:
Attorney:
Health:
Health:
(condition/explain)
(condition/explain)
How long:
Employer:
How long:
Employer:
Education:_______________________________
Education:_______________________________
Address:
Address:
Occupation:
Occupation:
Gross Income per year:
Gross Income per year:
§505 Net Income per year:
§505 Net Income per year:
Other Income:
Other Income:
Custody issues in dispute:
Custody
Modification
Visitation
Removal
Other:
Child Rep:
Mediator:
Date of referral:
604(b) Advisor:
Report date:
604.5 Evaluator:
Report date:
Brief description of issues:
Page 1 of 3
171-182 (R 04/06)
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IRMO:
Gen. No.
Support/Maintenance disputes: Each party must submit an 11.02 Financial Affidavit.
Child Support:
513 Claims:
Maintenance:
Dependency exemption:
Payment of collateral expenses:
Other:
Property disputes: Each party must submit a proposed balance sheet in a form approved by
the court.
Valuation:
Classification:
Percentage Division:
Dissipation (be specific):
Reimbursement to marital estate:
Attorney’s fees:
Debts:
Other:
Prepared by:
Attorney's Name: _
Address:
City:
Phone:
State:
Zip Code:
Fax:
ARDC:
Page 2 of 3
171-182 (R 04/06)
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CASE NAME:
GEN. NO.
BALANCE SHEET OF ASSETS AND DEBTS
ORDINARY ASSETS
VALUE
HUSBAND
WIFE
VALUE
HUSBAND
WIFE
VALUE
HUSBAND
WIFE
AMOUNT
HUSBAND
WIFE
HUSBAND
WIFE
TOTAL
PERCENTAGE
DEBTS
TOTAL
PERCENTAGE
TAX DEFERRED ASSETS
TOTAL
PERCENTAGE
SUMMARY OF ALL ASSETS AND DEBTS
Total Ordinary Assets
Total Debts
Total Tax Deferred Assets
TOTAL
OVERALL PERCENTAGE DISTRIBUTION OF NET ESTATE
Value of non marital estates
Page 3 of 3
171-182a (R 04-06)
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