Intake Questionnaire — Marital Property Agreement

Section 1: General Information

INSTRUCTIONS

Please complete this questionnaire as thoroughly as possible. If a question does not apply, write "N/A."
Approximate values are acceptable where exact figures are not readily available — indicate "approx." where estimated.
Both spouses should complete a separate questionnaire or clearly indicate which answers apply to which spouse.
Attach additional pages if more space is needed for any section.
Supporting documents (statements, deeds, titles) are helpful but not required at this stage. Upload completed questionnaire and any attachments to the shared Dropbox folder.

1A. Client (Karen Bergeron)

Full Legal Name

Date of Birth

SSN (last 4)

Current Mailing Address

City/State/Zip

County

Phone (primary)

Email

Employer

Job Title

Annual Gross Income (salary/wages)

$

Other Income (source & amount)

1B. Spouse (Michael Bergeron)

Full Legal Name

Date of Birth

SSN (last 4)

Current Mailing Address (if different)

Phone (primary)

Email

Employer

Job Title

Annual Gross Income (salary/wages)

$

Other Income (source & amount)

1C. Marriage Information

Date of Marriage

Place of Marriage (city/state)

Type of Marriage

Ceremonial Informal/Common Law

Please upload documents directly to your shared Dropbox folder (Bergeron > Intake Responses). If you need help accessing the folder, contact your attorney.

Section 4: Financial Accounts

List ALL bank, investment, and retirement accounts for both spouses.

For each asset or debt, indicate whether you believe it is separate or community property. If you’re unsure, leave it blank and we’ll discuss.

4A. Bank Accounts (Checking, Savings, CDs, Money Market)

List every account. For joint accounts, note both names.

Institution	Account Type	Owner(s)	Approx. Balance	Date Opened	Sep/Comm?
			$
			$
			$
			$
			$
			$

4B. Investment / Brokerage Accounts

Institution	Account Type	Owner(s)	Approx. Value	Date Opened	Sep/Comm?
			$
			$
			$
			$

4C. Retirement Accounts

Include 401(k), 403(b), IRA, Roth IRA, pension, deferred comp, etc.

Owner	Plan Type	Employer/Institution	Approx. Balance	Pre-Marriage Amt.	Date Opened
			$	$
			$	$
			$	$
			$	$
			$	$
			$	$

For each retirement account, note the approximate balance as of the date of marriage if known.

Retirement accounts may require a QDRO or similar order to divide — this is outside the scope of the flat fee.

4D. Cryptocurrency / Digital Assets

Any cryptocurrency or digital assets?

Yes No

Please upload account statements directly to your shared Dropbox folder (Bergeron > Intake Responses). If you need help accessing the folder, contact your attorney.

Additional Notes or Comments

Section 5: Vehicles & Personal Property

For each asset, indicate whether you believe it is separate or community property. If you’re unsure, leave it blank and we’ll discuss.

5A. Vehicles (Cars, Trucks, Boats, RVs, Trailers, ATVs)

Year/Make/Model	VIN	Title in Name of	Value	Loan Bal.	Sep/Comm
			$	$
			$	$
			$	$
			$	$

For each vehicle with a loan, provide the lender name and monthly payment in the notes section below if needed.

5B. Valuable Personal Property (Items over $1,000)

Jewelry, art, firearms, collectibles, tools/equipment, electronics, antiques, etc.

Description	Owner	Approx. Value	Sep. or Community?
		$
		$
		$
		$

5C. Household Furnishings

You do not need to itemize every piece of furniture. Describe the general approach:

How will household furnishings be addressed?

Divide by agreement Each keeps what they have Other

Please upload vehicle titles and loan statements directly to your shared Dropbox folder (Bergeron > Intake Responses). If you need help accessing the folder, contact your attorney.

Additional Notes or Comments

Section 6: Insurance Policies

6A. Life Insurance

Face Value	Cash Value	Annual Premium
$	$	$
$	$	$
$	$	$

For whole life or universal life policies, please provide the most recent annual statement showing cash surrender value.

6B. Other Insurance

Please upload insurance documents directly to your shared Dropbox folder (Bergeron > Intake Responses). If you need help accessing the folder, contact your attorney.

Additional Notes or Comments

Section 7: Debts & Liabilities

List ALL debts owed by either or both spouses.

For each debt, indicate whether you believe it is separate or community. If you’re unsure, leave it blank and we’ll discuss.

Balance Owed	Interest Rate	Monthly Pmt
$	%	$
$	%	$
$	%	$
$	%	$
$	%	$
$	%	$
$	%	$
$	%	$
$	%	$
$	%	$

Types: Mortgage, HELOC, Credit Card, Student Loan, Vehicle Loan, Personal Loan, Tax Debt, Medical, Business Debt, Other

For each debt listed, please provide the most recent statement showing the current balance.

7A. Tax Liabilities

Any outstanding federal or state tax liability?

Yes No

Tax year(s) and amount owed:

How have you filed taxes during the marriage?

Jointly Separately Mixed

Any pending tax dispute, audit, or installment plan?

Yes No

Please upload debt and tax statements directly to your shared Dropbox folder (Bergeron > Intake Responses). If you need help accessing the folder, contact your attorney.

Additional Notes or Comments

Section 8: Separate Property Claims

Texas Law Note: Under Tex. Fam. Code § 3.001–3.003, separate property includes property owned before marriage, acquired during marriage by gift or inheritance, and personal injury recovery (excluding loss of earning capacity during marriage).

8A. Karen’s Separate Property Claims

List property Karen claims as her separate property and the basis for each claim:

Tip: Supporting documentation (deeds, account statements, inheritance records) strengthens separate property claims. Upload these in Section 14.

8B. Michael’s Separate Property Claims

List property Michael claims as his separate property and the basis for each claim:

Please upload supporting documentation (deeds, account statements, inheritance records) directly to your shared Dropbox folder (Bergeron > Intake Responses). If you need help accessing the folder, contact your attorney.

Section 9: Proposed Division / Terms of Agreement

9A. General Approach — Type of Agreement

Select the primary type of marital property agreement:

Partition & Exchange Agreement
Conversion Agreement — Separate to Community
Conversion Agreement — Community to Separate
Mixed (Partition, Exchange, and/or Conversion)

Legal Note: Under Tex. Fam. Code § 4.102, spouses may partition or exchange community property into separate property. Under § 4.203, spouses may convert separate property to community property. A “mixed” agreement may combine partition, exchange, and conversion provisions.

9B. Agreed Division — Real Property

How will the Louisiana residence be treated?

How will the Friendswood rental situation be addressed?

9C. Agreed Division — Business Interests

How will the business ownership be divided or restructured?

How will future business income be characterized?

Scope Note: Corporate restructuring, stock transfers, and indemnification beyond basic share assignment are outside the flat fee scope and may require additional engagement.

9D. Agreed Division — Financial Accounts

Describe the proposed division of all bank, investment, and retirement accounts:

9E. Agreed Division — Debts

Describe the proposed allocation of all debts and liabilities:

9F. Agreed Division — Vehicles and Personal Property

Describe the proposed division of vehicles and personal property:

Please upload supporting documentation for the proposed division directly to your shared Dropbox folder (Bergeron > Intake Responses). If you need help accessing the folder, contact your attorney.

Section 10: Questions, Concerns, or Additional Information for Your Attorney

Use this space to note anything not covered above — questions you'd like to discuss, concerns about the agreement, additional context, or anything else you'd like your attorney to know.

Section 11: Income & Future Earnings Characterization

Critical Decision: How future income is characterized — as community or separate property — is one of the most consequential provisions in a marital property agreement. Texas law presumes all income earned during marriage is community property. Changing this default requires clear, specific agreement.

For each income source, indicate how you believe it should be characterized. If you’re unsure, leave it blank and we’ll discuss.

11A. Current Income — Karen

Salary ($):

Pay Frequency:

Bonus / Commission ($):

Business Distributions ($):

Rental Income ($):

Other Income ($):

11B. Current Income — Michael

Salary ($):

Pay Frequency:

Bonus / Commission ($):

Business Distributions ($):

Rental Income ($):

Other Income ($):

11C. Future Income Characterization

Default Texas Law: Under Tex. Fam. Code § 3.002, all property acquired during marriage (including earned income) is presumed community property. A marital property agreement under § 4.102 can change this presumption for future income, but the agreement must be clear and specific.

Proposed treatment of Karen’s future earnings:

Community (Texas default) Karen’s Separate Property

Proposed treatment of Michael’s future earnings:

Community (Texas default) Michael’s Separate Property

Proposed treatment of income from separate property (rents, dividends, interest):

Community (Texas default) Separate property of the owning spouse

Tax Advisory: Tax consequences of income characterization are outside the scope of the flat fee. Consult a CPA or tax attorney for advice on how income reclassification may affect filing status, deductions, and estimated payments.

Additional Notes or Comments

Section 12: Spousal Maintenance / Support

Texas Law Note: Under Tex. Fam. Code § 4.003(a)(4), spouses may agree to modify or waive spousal maintenance (alimony) rights in a marital property agreement. Any waiver must be entered voluntarily with adequate disclosure.

Include spousal maintenance waiver in this agreement?

Yes — Mutual waiver (both spouses waive)
Yes — Karen waives maintenance rights only
Yes — Michael waives maintenance rights only
No — Do not include a maintenance waiver

Enforceability Note: A maintenance waiver is unenforceable if it would leave the waiving spouse eligible for public assistance at the time enforcement is sought. Courts may also scrutinize waivers where there is a significant disparity in earning capacity.

Any specific terms regarding maintenance (cap, duration, conditions)?

Section 15: Certification & Signature

I certify that the information provided in this questionnaire is true and correct to the best of my knowledge. I understand that the accuracy of this information is important for the preparation of an enforceable marital property agreement, and that incomplete or inaccurate information may affect the enforceability of the agreement. I understand that the financial disclosure attached to or derived from this questionnaire will be incorporated into the agreement as required by Texas law.

Signature

By typing your name above, you acknowledge this serves as your electronic signature.

Printed Name

Date

Before submitting: Please review all sections for accuracy. Once submitted, your attorney will review the responses and may follow up with clarifying questions. You can still save a draft and return later using your unique link.

THE TALLEY LAW FIRM PLLC

1A. Client (Karen Bergeron)

1B. Spouse (Michael Bergeron)

1C. Marriage Information

Property #1 — Louisiana Residence

Property #2 — Friendswood Rental / Residence

Additional Real Property

Business #1

Additional Business Interests

4A. Bank Accounts (Checking, Savings, CDs, Money Market)

4B. Investment / Brokerage Accounts

4C. Retirement Accounts

4D. Cryptocurrency / Digital Assets

5A. Vehicles (Cars, Trucks, Boats, RVs, Trailers, ATVs)

5B. Valuable Personal Property (Items over $1,000)

5C. Household Furnishings

6A. Life Insurance

6B. Other Insurance

7A. Tax Liabilities

8A. Karen’s Separate Property Claims

8B. Michael’s Separate Property Claims

9A. General Approach — Type of Agreement

9B. Agreed Division — Real Property

9C. Agreed Division — Business Interests

9D. Agreed Division — Financial Accounts

9E. Agreed Division — Debts

9F. Agreed Division — Vehicles and Personal Property

11A. Current Income — Karen

11B. Current Income — Michael

11C. Future Income Characterization

13A. Death & Estate Planning Provisions

13B. Sunset Clause

13C. Dispute Resolution

13D. Independent Counsel for Michael

13E. Additional Terms or Provisions

Tax & Income Documents

Real Property

Financial Accounts

Business Interests

Insurance

Debts & Liabilities

Estate Planning Documents (if they exist)

Other

Submission Successful