Date:  Dec.

19
 Dec. 20
Time start:
Time end:

CLIENT INFORMATION SHEET

D e c e m b e r 1 9 - 2 0 , 2 0 2 2 | F r e e L e g a l C o n s u l t a ti o n

I declare that I have not consulted any lawyer regarding any information
that I would be disclosing during this consultation, and if I did, the information
was not given in view of employing that lawyer.

Signature
A. PERSONAL INFORMATION
Name:
Address:
Citizenship:  Filipino  by birth, or  by naturalization
 Dual citizenship | specifics:
Civil status:  Single  Married  Widowed  Separated 
Telephone No.: Mobile No.:
Email address (if any):
B. Category of consultation (check all that apply)
1. Annulment of Voidable Marriage
¨ Lack of parental consent to the marriage of a person less than 21
years of age
¨ Insanity
¨ Fraud
¨ Force, intimidation, or undue influence (duress)
¨ Physical inability of consummating the marriage (impotence)
¨ Affliction of a sexually-transmitted disease found to be serious and
appears to be incurable
2. Declaration of Absolute Nullity of Void Marriage
¨ Lack of requisites
£ Below 18 years old
£ Solemnizing officer had no legal authority to perform
marriages
£ Solemnizing officer is not licensed
£ Bigamous or polygamous marriages
£ Mistake in the identity of the other spouse
£ Non-compliance with the registration in the civil registries or
 registries of property
¨ Psychological incapacity to perform the essential marital
obligations
¨ Marriage between (incestuous marriages)
£ Ascendants and descendants of any degree
£ Brothers and sisters, whether full or half blood
¨ Marriages against public policy
£ Between collateral blood relatives
£ Between stepparents and stepchildren
£ Between parents-in-law and children-in-law
£ Between adopting parent and adopted child
£ Between surviving spouse of adopting parent and adopted
child
£ Between surviving spouse of adopted child and adopter
£ Between adopted child and legitimate child of the adopter
£ Between adopted children of the same adopter
£ Between parties where one, with intention to marry the
other, killed that other person’s spouse, or his/her own
spouse
3. Legal Separation
¨ Repeated physical violence or grossly abusive conduct
¨ Physical violence or moral pressure to compel a change of religion
or political affiliation
¨ Attempt to corrupt or inducement to engage in prostitution, or
connivance in such corruption or inducement
¨ Final judgement of imprisonment to more than 6 years
¨ Drug addiction or habitual cohabitation
¨ Lesbianism or homosexuality
¨ Contracting a bigamous marriage
¨ Sexual infidelity or perversion
¨ Attempt on the life
¨ Abandonment without justifiable cause for more than 1 year
C. Result of consultation (please do not write below)
1. Reasons for refusing consultation:
¨ With prior and existing lawyer-client relationship
¨ Conflict of interest
2. Result of consultation: