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Harris Tate
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Business Law
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Shareholder Agreements
Share Purchases and Sales
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Care of Children and Child Support
Separation and Divorce
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First Name
*
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*
Address
Address Line 1
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City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
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Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
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Hungary
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India
Indonesia
Iran (Islamic Republic of)
Iraq
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Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Occupation
Lawyer
Date of Birth
Age
Are you:
Married
Civil Union
De Facto
Years Committed
Length Of Relationship
Years Married
Date of Separation
Do you have any children?
Yes
No
Children
Name
*
Date of Birth
Age
Health Concerns?
Financial Concerns?
Immediate Issues?
Assets of Parties/Relationship
Do you have a family home?
*
Yes
No
Homes
Address
*
Year purchased
Value when purchased
Current value
Valuation Obtained
Please choose
Yes
No
Valuation provided
Please choose
Yes
No
Owner/s (names or Trust name)
Separate or Relationship Property?
Add
Remove
Do you have other Houses/Land/Property?
*
Yes
No
Houses/Lands/Properties
Address
*
Year purchased
Value when purchased
Current value
Valuation Obtained
Please choose
Yes
No
Valuation provided
Please choose
Yes
No
Owner/s (names or Trust name)
Separate or relationship property
Please choose
Separate
Relationship property
Add
Remove
Do you own a business?
*
Yes
No
Businesses
Name
*
Year set up/purchased
Estimated Value
No of Shares
Directors
Shareholders
Valuation obtained?
Yes
No
Main Assets
Main Liabilities
EOY Accounts Provided
Yes
No
Separate or relationship property
Please choose
Separate
Relationship property
Add
Remove
Do you have any Trusts?
*
Yes
No
Trusts
Name
*
Year set up
Settlor(s)
Trustees
Final Beneficiaries
Discretionary Beneficiaries
Main Assets
Main Liabilities
EOY Accounts Provided
Yes
No
Add
Remove
Add Shares/Investments?
*
Yes
No
Shares/Investments
Company Name
*
No of shares
Value when purchased
Current value
Date purchased
Statement provided
Please choose
Yes
No
Separate or relationship property
Please choose
Separate
Relationship Property
Add
Remove
Other investments?
*
Yes
No
Other Investments
Name / Type
*
No of shares
Value when purchased
Current value
Date purchased
Statement provided
Please choose
Yes
No
Separate or relationship property
Please choose
Separate
Relationship property
Add
Remove
Bank accounts?
*
Yes
No
Bank Accounts
Joint / Separate
*
Bank name
*
Type of account
Account no
Balance of account (credit/debit)
Statement provided
Please choose
Yes
No
Separate or relationship property
Please choose
Separate
Relationship propert
Add
Remove
Kiwisaver?
*
Yes
No
Kiwisaver
Company name
*
Balance
*
Date set up
*
Statement provided
*
Please choose
Yes
No
Separate or relationship property
*
Please choose
Separate
Relationship Property
Add
Remove
Life insurance policies?
*
Yes
No
Life insurance policies
Company name
*
Policy owner
*
Insured value
*
Surrender Value?
*
Add
Remove
Motor vehicles?
*
Yes
No
Motor vehicles
Make / model
*
Registration
*
Purchase date
*
Estimated value
*
Separate or Relationship Property
*
Please choose
Separate
Relationship property
Valuation provided
*
Please choose
Yes
No
Add
Remove
Other vehicles?
*
Yes
No
Other vehicles
Type
*
Make / model
*
Registration
*
Purchase date
*
Estimated value
*
Separate or Relationship Property
*
Please choose
Separate
Relationship property
Valuation provided
*
Please choose
Yes
No
Add
Remove
High value chattels / furniture?
*
Yes
No
High value chattels / furniture
Chattel type
*
Purchase date
*
Value when first purchased
*
Current value
*
Add
Remove
Pets?
*
Yes
No
Pets
Name
*
Type
*
Add
Remove
Liabilities
Mortgage secured over family home
Bank
Balance
Statement provided
Please choose
Yes
No
Add
Remove
Mortgage secured over other house/land/property
Bank
Balance
Statement provided
Please choose
Yes
No
Add
Remove
Bank overdraft
Bank
Balance
Statement provided
Please choose
Yes
No
Add
Remove
Credit cards
Bank
Balance
Statement provided
Please choose
Yes
No
Add
Remove
Hire purchases
Entity
Item
Balance
Statement provided
Please choose
Yes
No
Add
Remove
Personal loans
Bank
Balance
Statement provided
Please choose
Yes
No
Add
Remove
Business loans
Bank
Balance
Statement provided
Please choose
Yes
No
Add
Remove
Other Debts (including secured and unsecured)
Type of liability
Entity
Amount owed
Statement provided
Please choose
Yes
No
Add
Remove
Other information
Previous relationship property agreements
Yes
No
Child support in place?
Yes
No
Parenting orders or agreements in place?
Yes
No
Existing wills?
Yes
No
Further information
Submit
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