HALIFAX REGIONAL TRIBUNAL

                                Antigonish Branch

                         Preliminary Investigation Form

 

Protocol Number:                                            Case:

 

FOR HEAD OFFICE USE ONLY:

 

Date Received                                               Payment Received                                           

 

 

                                   PETITIONER

 

Name in Full:                                                                        Home Phone                                       

 

Maiden Name (if applicable)                                                          Work Number                                

Address:                                                                                              Postal Code                   

 

Religion                                                   

 

Date and Place of Birth                                                                                                                     

Date and Place of Baptism                                                                                                                

Name of Church of Baptism                                                                                                            

 

Father's Name and Address                                                                                                               

Mother's Name and Address                                                                                                             

Father's Religion                                                   

Mother's Religion                                                    

 

 

                                  FORMER SPOUSE

 

Name in Full:                                                                         Home Phone                                               

Maiden Name (if applicable)                                                     Work Number                                                                                              

Address:                                                                                               Postal Code                      

 

Religion                                    

 

Date and Place of Birth                                                                                                                 

 

Date and Place of Baptism                                                                                                               

 

Name of Church of Baptism                                                                                                             

Father's Name and Address                                                                                                               

Mother's Name and Address                                                                                                             

Had either party been married previously?  If so, give details.                                                             

 

                                                                                                                                                   

                                                                               

 

 

 

 

 

 

 

 

 

Length of Courtship                                                                                                                        

 

Date and Place of Marriage                                                                                                               

 

Dispensations (if applicable)                                                                                                              

 

Names and Dates of Birth of Children                                                                                                

                                                                                                                                                                                                                                                                

Date of Separation                                                                                                                          

 

When did you last see your spouse?                                                                                                  

 

Is there any hope of reconciliation?                                                       

 

Date of Decree Absolute                                                                            

 

Who filed for divorce and on what grounds?                                                                                        

Have you remarried civilly?                                               Date                                                       

 

Place                                                           To Whom?                                                                  

 

Are you living common-law?                                Name                                                                     

Is the other party remarried civilly?                           Date                                                                    

Place                                                        To Whom?                                                                     

 

Is the other party living common-law?                                 Name                                                      

 

Who has custody of the children of the marriage?                                                                               

 

Who supports the children financially?                                                                                              

 

 

Why are you asking for this Decree of Nullity?                                                                                     

 

 

                                                                                                                          

Date                                                                              Signature of Petitioner

 

                                                                                                                          

Date                                                                              Signature of Auditor

 

 

 

Upon completion of this questionnaire, either mail it or bring it to your interview.