SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF SUFFOLK -------------------------------------------------------------------------X Plaintiff, - against Part No.: Defendant. -------------------------------------------------------------------------X PRELIMINARY CONFERENCE STIPULATION/ORDER CONTESTED MATRIMONIAL Index No.: PRESIDING: Justice of the Supreme Court The parties and counsel have appeared before this Court on preliminary conference on this matter held pursuant to 22 NYCRR �202.16. at a (1) NET WORTH: A sworn statement of net worth as of date of commencement of the action: G has been filed with the Court, OR G will be filed with the Court no later than ________________. RETAINER: A signed copy of each party's attorney's retainer agreement: and client's bill of rights statement: G has been filed with the Court, OR G will be filed with the Court no later than ________________. (2) A. BACKGROUND INFORMATION: Attorney for the Defendant: Attorney for the Child(ren): Attorney for the Plaintiff: Phone: Fax: Email: Phone: Fax: Email: Phone: Fax: Email: revised 6.4.12 American LegalNet, Inc. www.FormsWorkFlow.com page 2. (2) (3) SUMMONS: COMPLAINT: Date filed: Date served: G The Plaintiff has served a Verified Complaint on _____________*. G OR The Plaintiff will serve a Verified Complaint on or before ____________*. *This date shall be the date used to determine the timeliness of a Notice of Discontinuance [CPLR �3217(a)] . (4) (5) (6) DATE OF MARRIAGE: ________________________ DATE OF BIRTH: OCCUPATION: & EMPLOYER: Plaintiff: ____________ Defendant: ____________ Defendant: ___________________ ___________________ Plaintiff: _________________ _________________ (7) CHILDREN : List the name(s) and date(s) of birth of parties' child(ren) (8) ORDERS OF PROTECTION G There has not been an Order of Protection issued involving the parties in this case. OR G There has been an Order of Protection issued involving the parties in this case. The order was issued on______________________ by the ________ ____ Court. The order was issued against the: protection of the G plaintiff G defendant, and the order was issued for the G plaintiff G defendant G the parties' children . Attach copy of order. (9) OTHER ORDERS The following other orders involving the parties have previously been issued: G No other orders. G Nature of Order: __________________________________________________ Issuing Court : __________________________ Date Issued: _____________ Attach copy of order. Nature of Order: ___________________________________________________ Issuing Court : __________________________ Date Issued: ______________ Attach copy of order. (10) TRANSLATOR G Neither party is in need of a translator, a translator in the (11) OTHER AGREEMENTS Prenuptial: G None exists Postnuptial: Separation: OR G Plaintiff and/or G Defendant is requesting language. OR OR OR G None exists G None exists G Date of Agreement __________________ G Date of Agreement __________________ G Date of Agreement __________________ . . American LegalNet, Inc. www.FormsWorkFlow.com Any challenge(s) by the Plaintiff shall be asserted no later than Any challenge(s) by the Defendant shall be asserted no later than page 3. B. GROUNDS FOR DIVORCE: The issue of fault is: G Resolved: The parties agree that basis to obtain a divorce on the grounds of OR will proceed on an uncontested . requested. A trial of this issue shall G Unresolved: be held on a jury trial G is OR G is not . C. CUSTODY: G There are no children (if checked then proceed to Section D.) If there are an existing orders, agreements or stipulations with regard to custody, parenting time, visitation, and/or decision making - attach a copy of same hereto. (1) The issue of custody is: G unresolved OR G resolved (if resolved explain below). (2) The issue of parenting time is : G unresolved OR G resolved (if resolved explain below). (3) Issues related to decision making are: G unresolved OR G resolved (if resolved explain below). In the event that an Attorney for the Child(ren) or forensic evaluator has not been previously appointed, any appointment of an attorney for the child or forensic evaluator shall be by separate order which shall designate the attorney for the child appointed, the manner of payment, source of funds for payment and each party's responsibility for such payment. (4) Attorney for the Child(ren) [Check the appropriate boxes]: G The parties are NOT requesting the appointment of an Attorney for the Child(ren) at this time, but reserve the right to make such request at a later time. OR G The parties are requesting that an Attorney for the Child(ren) be appointed by the Court. ---------------- G The parties agree that the cost for the Attorney for the Child(ren) be paid _______% by the plaintiff and________% by the defendant, subject to reallocation by the Court. OR G The parties do not agree on allocation of the cost of an Attorney for the Child(ren) and request that the court determine the allocation thereof. American LegalNet, Inc. www.FormsWorkFlow.com page 4. (5) Forensic Evaluator [Check the appropriate boxes]: G The parties are NOT requesting the appointment of a forensic evaluator at this time, but G reserve the right to make such request at a later time. OR The parties are requesting that a forensic evaluator be appointed by the Court. ----------------- G The parties agree that the cost for the forensic evaluator be paid _________% by the plaintiff and ________% by the defendant, subject to reallocation by the Court. OR G The parties do not agree on allocation of the cost of a forensic evaluator and request that the court determine the allocation thereof. D. (1) FINANCIAL: Maintenance is: G unresolved OR G resolved as follows: ______________________________________________________________________. (2) Child Support is: G unresolved OR G resolved as follows: ______________________________________________________________________. (3) Equitable Distribution is: G unresolved OR G resolved (if resolved explain below and attach any orders, agreements or stipulations regarding the same hereto) ______________________________________________________________________. Attorney's Fees: G unresolved OR G resolved (if resolved explain below and attach any orders, agreements or stipulations regarding the same hereto) ______________________________________________________________________. (4) E. OTHER: List all other causes of action and ancillary relief issues that are unresolved: