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Kenneth Vercammen & Associates
A Law Office with Experienced Attorneys for Your New Jersey Legal Needs
2053 Woodbridge Ave.
Edison NJ 08817
732-572-0500
1-800-655-2977

Child Support Emancipation Questionnaire

KENNETH VERCAMMEN & ASSOCIATES, PC

ATTORNEY AT LAW

www.NJLaws.com

Child Support Emancipation Questionnaire

Please fill out and return to our Office.

(Please Print)

NAME __________________________________________________________

ADDRESS _______________________________________________________

CITY ___________________________ STATE _______ ZIP _______________

CELL-PHONE ___________________________________ (Area Code Needed)

PHONE-DAY ________________________ NIGHT _______________________

E-MAIL ADDRESS _________________________________________________

TYPE OF MATTER: ________________________________________________

ADVERSARY PARTIES IF ANY: ________________________________________

REFERRED BY: ___________________________________________________

If referred by a person, is this a client or attorney? If internet, which search engine & terms used.

TODAY’S DATE: ___________________________

DESCRIPTION OF MATTER (USE BACK OF PAPER IF NECESSARY):

QUESTIONS TO ASK ATTORNEY: ______________________________________

Child Support EmancipationQuest non PI G3 rev 5/13/08

The Court now requires this information on a Motion:

Revised Family Part Case Information Statement

NOTICE: Under NJ. Court Rule. 5:5-2, this Statement must be fully completed, filed and served, with all required attachments, in accordance with Court Rule 5:5-2 based upon the information available. If the Motion is for reduction in child support and not termination of child support, a complete case information statement must be filed. In those cases where the Case Information Statement is required, it shall be filed within 20 days after the filing of the Answer or Appearance. Failure to file a Case Information Statement may result in the dismissal of a party’s pleadings.

PART A - CASE INFORMATION:

Date of Statement

________________

Date of Divorce (post-Judgment matters):

Date(s) of Prior Settlement Statement(s):

________________

________________


Your Birthdate: _______________

Birthdate of Spouse: ___________

Date of Marriage: _____________


Date of Divorce Complaint: ______

Does an agreement exist between parties relative to any issues?

Yes _____ No ________ If yes, ATTACH a copy (if written) or a summary (if oral)

1. Name and Address of Parties:

Other Partys Name: _______________________________________

Street address ______________________City ______ State/Zip _____

2. Name, Address, & Birthdate of all Child(ren); Person with whom Child(ren) Resides:

a. Child(ren) From This Relationship

Childs Full Name

Address

Birthdate

Who living with

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

b. Child(ren) From Other Relationships

Childs Full Name

Address

Birthdate

Persons Name

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

PART B - MISCELLANEOUS INFORMATION:

1. Name and Address of Your Employer (Name and Address of Business if Self-Employed)

Name of Employer _____________ Address: ________________

- STATEMENT OF SPECIAL PROBLEMS (Provide a Brief Narrative Statement of Any Special Problems Involving This Case): As example, state if the matter involves complex valuation problems (such as for a closely held business) or special medical problems of any family member, etc.

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment.

DATED: ________________________________

SIGNED: ________________________________

IF THE MOTION IS TO REDUCE CHILD SUPPORT, THE COURT WILL REQUIRE YOU ATTACH THE FOLLOWING REQUIRED DOCUMENTS:

1. A full and complete copy of your last federal and state income tax returns with all schedules and attachments. ___________

2. Your last calendar years W-2 statement and 1099s. ___________

3. Your three most recent pay stubs. ___________

4. Bonus information including, but not limited to, percentage overrides,

timing of payments, etc.; the last three statements of such bonuses,

commissions, etc. ___________

5. Your most recent corporate benefit statement or a summary thereof,

showing the nature, amount and status of retirement plans, savings plans,

income deferral plans, insurance benefits, etc. ___________

6. Any agreements between the parties. ___________

7. A statement of prior/pending cases. (Part B-4). ___________

8. Health Insurance and Life Insurance Information. ___________

Is Insurance available through Employment/Business? Yes No

Explain: __________

ADDITIONAL INFORMATION-REQUIRED IF MOTION

If motion is to reduce child support and not a motion for termination, all the following information must be provided to the court.

1. How often are you paid?

2. What is your annual salary?

3. Have you received any raises in the current year? ( ) Yes ( ) No If yes, provide the date and the gross/net amount.

4. Do you receive bonuses, commissions, or other compensations, including distributions, taxable or non-taxable, in addition to your regular salary? ( ) Yes ( ) No If yes, explain:

5. Do you receive bonuses, commissions, or other compensations, including distributions, taxable or non-taxable, in addition to your regular salary during the current or immediate past calendar year? ( ) Yes ( ) No If yes, explain:

6. Do you receive cash or distributions not otherwise listed? ( ) Yes ( ) No If yes, explain:

7. Have you received income from overtime work during either the current or immediate past calendar year? ( ) Yes ( ) No If yes, explain:

8. Have you been awarded or granted stock options, restricted stock or any other non-cash compensation or entitlement during the current or immediate past calendar year? ( ) Yes ( ) No If yes, explain:

9. Have you received any other supplemental compensation during either the current or immediate past calendar year? ( ) Yes ( ) No If yes, state the date(s) of receipt and set forth the gross and net amounts received. Also describe the nature of any supplemental compensation received.

10. Have you received income from unemployment, disability and/or social security during either the current or immediate past calendar year? ( ) Yes ( ) No If yes, state the date(s) of receipt and set forth the gross and net amounts received.

11. List the names of the dependents you claim:

12. Are you paying or receiving any alimony? ( ) Yes ( ) No If yes, how much and to whom paid or from whom received?

13. Are you paying or receiving any child support? ( ) Yes ( ) No If yes, list names of children, the amount paid or received for each child and to whom paid or from whom received.

14. Is there a wage execution in connection with support? ( ) Yes ( ) No If yes, explain.

15. Has a dependent child of yours received income from social security, SSI or other government program during either the current or immediate past calendar year? ( ) Yes ( ) No If yes, explain the basis and state the date(s) of receipt and set forth the gross and net amounts received.

16. Explanation of Income or Other Information:

Child Support EmancipationQuest non PI G3


Kenneth Vercammen was the Middlesex County Bar Municipal Court Attorney of the Year
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Kenneth Vercammen is the Managing Attorney at Kenneth Vercammen & Associates in Edison, NJ. He is a New Jersey trial attorney has devoted a substantial portion of his professional time to the preparation and trial of litigated matters. He has appeared in Courts throughout New Jersey each week for litigation and contested Probate hearings.

Mr. Vercammen has published over 125 legal articles in national and New Jersey publications on elder law, probate and litigation topics. He is a highly regarded lecturer on litigation issues for the American Bar Association, NJ ICLE, New Jersey State Bar Association and Middlesex County Bar Association. His articles have been published in noted publications included New Jersey Law Journal, ABA Law Practice Management Magazine, and New Jersey Lawyer.

He is chair of the Elder Law Committee of the American Bar Association General Practice Division. He is also Editor of the ABA Estate Planning Probate Committee Newsletter and also the Criminal Law Committee newsletter. Mr. Vercammen is a recipient of the NJSBA- YLD Service to the Bar Award. And past Winner "General Practice Attorney of the Year" from the NJ State Bar Association. He is a 22 year active member of the American Bar Association. He is also a member of the ABA Real Property, Probate & Trust Section.

He established the NJlaws website which includes many articles on Elder Law. Mr. Vercammen received his B.S., cum laude, from the University of Scranton and his J.D. from Widener/Delaware Law School, where he was the Case Note Editor of the Delaware Law Forum, a member of the Law Review and the winner of the Delaware Trial Competition.

RECENT SPEAKING ENGAGEMENTS ON WILLS, ELDER LAW, AND PROBATE

Edison Adult School -Wills, Elder Law & Probate- 2007, 2006, 2005, 2004, 2003, 2002 [inc Edison TV], 2001, 2000,1999,1998,1997
Nuts & Bolts of Elder Law - NJ Institute for Continuing Legal Education/ NJ State Bar ICLE/NJSBA 2008, 2007, 2006, 2005, 2004, 2003, 2002, 2000, 1999, 1996
Elder Law and Estate Planning- American Bar Association Miami 2007
Elder Law Practice, New Ethical Ideas to Improve Your Practice by Giving Clients What They Want and Need American Bar Association Hawaii 2006
South Plainfield Seniors- New Probate Law 2005, East Brunswick Seniors- New Probate Law 2005
Old Bridge AARP 2002; Guardian Angeles/ Edison 2002; St. Cecilia/ Woodbridge Seniors 2002;
East Brunswick/ Halls Corner 2002;
Linden AARP 2002
Woodbridge Adult School -Wills and Estate Administration -2001, 2000, 1999, 1998, 1997, 1996
Woodbridge Housing 2001; Metuchen Seniors & Metuchen TV 2001; Frigidare/ Local 401 Edison 2001; Chelsea/ East Brunswick 2001, Village Court/ Edison 2001; Old Bridge Rotary 2001; Sacred Heart/ South Amboy 2001; Livingston Manor/ New Brunswick 2001; Sunrise East Brunswick 2001; Strawberry Hill/ Woodbridge 2001;
Wills and Elder Law - Metuchen Adult School 1999,1997,1996,1995,1994,1993
Clara Barton Senior Citizens- Wills & Elder Law-Edison 2002, 1995
AARP Participating Attorney in Legal Plan for NJ AARP members 1999-2005

Contact the Law Office of
Kenneth Vercammen & Associates, P.C.
at 732-572-0500
for an appointment.

The Law Office cannot provide legal advice or answer legal questions over the phone or by email. Please call the Law office and schedule a confidential "in office" consultation. The Law Office now accepts payment by American Express, Visa and Master Card.

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Ken Vercammen articles

Directions to Ken Vercammen and Associates
Ken Vercammens Resume



Disclaimer This web site is purely a public resource of general New Jersey information (intended, but not promised or guaranteed to be correct, complete, or up-to-date). It is not intended be a source of legal advice, do not rely on information at this site or others in place of the advice of competent counsel. The Law Office of Kenneth Vercammen complies with the New Jersey Rules of Professional Conduct. This web site is not sponsored or associated with any particular linked entity unless specifically stated. The existence of any particular link is simply intended to imply potential interest to the reader, inclusion of a link should not be construed as an endorsement.

Kenneth Vercammen handles Wills, Last Will and Testament, probate contests, estate administration, inheritance tax, executor, surrogate, Living Wills, estates, trusts, undue influence, administrator, elder law, elderlaw, senior citizen, eldercare, guardianship, trusts, estates, Avoid Probate, Personal Injury, Deceased, Estate Planning, New Jersey Lawyer, New Jersey Attorney, New Jersey Lawyers, New Jersey Law Firm, New Jersey Legal Service, New Jersey New Jersey legal, New Jersey law, NJ Lawyer, NJ Attorney, NJ Attorneys, NJ Lawyers, NJ Law Firm, Middlesex County, Monmouth County, Mercer County, Somerset County, Union County, Ocean County, Cranbury Police, East Brunswick, Edison, Highland Park, Jamesburg, Old Bridge, Metuchen, Monroe, New Brunswick, North Brunswick, Perth Amboy, Piscataway, Plainsboro, Sayreville, South Brunswick, South Plainfield, Woodbridge, Superior Court, attorney, attorneys, Law Firm, 08817, 07095,08816, 08901, 08903

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