Edward R. Weinstein, Esq.Edward R. Weinstein, Esq.

In I Divorce In New Jersey, What Type Of Questions Will I Be Asked? part 3

TRUST PROPERTY YOU HOLD

80. List any and all property, assets, or things of value in excess of two-hundred fifty dollars ($250.00) which you hold in trust for anyone, stating as to each:

a. A description of the property, its location, and the name and address of the person(s) for whom you are holding same.

b. The conditions or terms of the trust.

c. How such property was acquired by you and whether you paid any part of the consideration therefore.

d. Each and every asset and value thereof that may be contained in any such trust along with any liabilities of such trust.

e. Submit any and all financial statements or tax returns for the last three (3) years which may pertain to any trust referred to

PROPERTY RECEIVED AS GIFT OR FROM OTHER SOURCE

81. Set forth a list of all monies, stocks, bonds or other things of value received by you by way of gift, from any other source other than inheritance earnings or other reportable income or loans during the course of the marriage, to include:

a. The date(s) and amount(s) received.

b. The name and address of the person(s), firm or corporation from whom received and the relationship, if any, to you.

c. Reasons or basis for receipt of said items.

d. Attach a copy of the federal gift tax return, if filed.

INSURANCE POLICIES/ANNUITIES

82. Does the _________________ own any life insurance policies or annuities?

If your answer is "yes", please set forth for each policy or annuity:

a. The name(s) and address(es) of such insurance company(ies).

b. The number of the policy(ies)

c. The type of policy(ies).

d. The date the policy(ies) was issued.

e. The face amount of the policy(ies), or death benefit.

f. The name of the insurance person(s) on each policy(ies).

g. The amount of the annual premium(s).

h. The total amount of premiums paid on the policy(ies) during the past three (3) years and the names and addresses of each person(s) making such payments.

i. The name and address of each beneficiary named in the policy(ies) and the portions allocated to each beneficiary, for each policy(ies).

j. The date of any change of beneficiary and the name of each beneficiary added or deleted.

k. The date of assignment of the policy(ies) and the name of each assignee, if the policy has been assigned.

l. The name and address of the insurance agent(s) or broker(s) for the policy(ies).

m. The amount and date of each loan made on the policy(ies), if any.

n. The cash surrender value of the policy(ies) on the date of the filing of the divorce complaint in this action.

o. The owner(s), if other than yourself.

FINANCIAL OBLIGATIONS

83. Itemize all debts and obligations owed by you (indicating which are owed jointly with your spouse or with any other person) as of the date hereof, setting forth the following:

(a) name and address of each creditor or obligee;

(b) the amount of each indebtedness;

(c) the date upon which each indebtedness was incurred;

(d) the reason why each indebtedness was incurred;

(e) if any such indebtedness was incurred as a loan, set forth the use to which you put the proceeds of said loan;

(f) all payments made on account of principal and interest for each indebtedness during the past three years;

(g) identify all loan documents, promissory notes, bonds, mortgages and other evidence of obligations and annex copies of the same hereto;

(h) if any indebtedness is in default, set forth the date of default and all facts which have occurred since said date relevant to the indebtedness and the attempt of the creditor or obligee to recover the same; and,

(i) attach all relevant documents.

84. If you have incurred any indebtedness or other obligation between the date of your separation from your spouse and the date hereof, set forth, in detail: (a) the name and address of each creditor or obligee; (b) the amount of each indebtedness; (c) the date each indebtedness was incurred; (d) the reason why said indebtedness was incurred; and, (e) all terms relevant to your obligation to repay the same.

85. If any indebtedness or obligation in Interrogatory #84 was incurred to any retailer, oil company or national credit card company, itemize all purchases made since the date of separation, setting forth the date of each purchase, a description of each item purchased, the price paid for each item and the reason for the purchase. Identify all monthly statements received from each creditor listed and annex a copy of each hereto. Itemize the dates and amounts upon which any payments were made to each said creditor on account of your indebtedness or obligation. Attach all relevant documents.

86. If you have loaned or given money to any relative, friend or anyone else at any time during the marriage, state: (a) name and address of the individual; (b) amount loaned or given: (c) date of gift or loan; (d) a description of any consideration terms or loan; and (e) whether indebtedness is outstanding.

87. State whether there is any money owing to you, including, but not limited to, judgments, notes, contract rights, loans, assignments, etc. If so, state:

(a) the nature and amount of each obligation and the date incurred;

(b) name and address of each debtor and creditor;

(c) conditions of payment

(d) consideration given by you;

(e) collateral or security for obligation;

(f) current balance due; and,

(g) attach writings indicating proof of debt or obligation.

88. Set forth whether you have executed any loan documents as guarantor or surety for any person, firm or corporation within the past three years. If affirmative, set forth: (a) the name of the principal; (b) the amount of the principal obligation; (c) the date upon which the obligation was incurred; and, (d) the name and address of the obligee. Identify each loan document and annex a copy of the same hereto.

89. Are you claiming that your spouse owns or owned, legally or beneficially, directly or indirectly, any asset as to which full description has not been made, or with respect to which there has been any improper or illegal disposition? If the answer is in the affirmative, state the following.

a. identify, with specificity, each such asset;

b. state the date of the acquisition of each such asset, and the person or entity from which each such asset was acquired;

c. state the fair market value of each such asset at the time of acquisition, and at either the present time or at the time of the disposition of the asset; and,

d. if you alleged that any such asset has been disposed of, state the date of disposition and the person or entity to or through which such disposition was effectuated.

90. Set forth the name and address of all persons having knowledge of any facts relevant to the economic issues between you and your spouse and summarize the knowledge which you ascribe to each person.

LEGAL ACTION

91. Are you a _________________ or _________________ in any legal action pending other than this divorce action\?

If you answer is "yes", please set forth:

a. The amount of money which is demanded in the pleadings.

b. The Court in which the action is or was pending, the caption of the case, and the index or docket number.

c. Attach a copy of the pleadings.

CLAIM FOR MONEY OR OTHER

92. If you have an outstanding claim for money or have applied for insurance recoveries, state the amount of money which is demanded and attach copies of all documents existing or submitted to substantiate your claim.

LEGAL DAMAGE/CONTRACT CLAIMS

93. Since the date of your marriage, have you received any money recovery either by way of judgment or settlement of a personal injury or worker's compensation cause of action? If so, state:

a. Date of injury.

b. Title and address of Court.

c. The docket number.

d. Names of all parties to the action.

e. Amount of the gross recovery.

f. Amount of the net recovery.

g. Name and address of your attorney.

ATTACH A COPY OF ANY SUCH JUDGMENT OR CLAIM.

GAMBLING, PRIZES, ETC.

94. State whether the _________________ has received any lottery winnings, gambling winnings, or other monetary or property, prizes or windfalls, with a value of over one-hundred dollars ($100.00), from the date of your marriage up to the present date. If so, indicate the nature thereof, amount received, when you received it, all sums or prizes yet to be received, and the date that you became entitled to receive the winnings or prize.

GIFTS AND OTHERS

95. State whether you have made any gift or any money and/or personal property to friends, relatives, or anyone else since the date of the marriage if there is a value in excess of two-hundred fifty dollars ($250.00). If so, state:

a. The name and address of said person(s) and the relationship of that person(s) to you.

b. The nature of the gift(s) or the amount(s) of money given.

c. The date each gift(s) was given.

d. The reason for such gift(s).

96. As to each of your Federal Income Tax Returns for the last three years, state: (a) gross income and sources thereof; and, (b) next taxable income. Attach copies of all income tax returns including all attachments thereto (including Form TUI-500, New Jersey Unearned Income Tax Return) and W-2 forms for the last three years. Attach last four pay stubs.

97. Attach any employment contracts the _________________ is presently a party to.

98. If there is a wage execution or order to pay out on income earnings, state how much is taken from your earnings each week, for whose benefit and the balance due.

99. What is the probability of your continuing your employment at your present earnings or better in the future?

100. What is the probability of your spouse continuing his/her present employment at present earnings or better in the future?

101. Do you have any stock interest or any other financial interest in your present employer other than as an employee?

102. If answer to Interrogatory Number 101 is in the affirmative, set forth as to any such interest the following: (a) type of interest held, and if stock, amount of shares held; (b) date interest acquired; (c) consideration paid, if any, for such interest; and, (d) present value of such interest.

103. If your stock interest in your employer exceeds 10% of the issued stock of said employer, set forth (a) name and address of all other stockholders holding more than 10% of the issued stock of said company; (b) positions held by each such other stockholder; and (c) salaries received by each such other stockholder.

104. Does any person related to you own more than 10% of the issued stock of your employer?

105. If answer to Interrogatory Number 104 is in the affirmative, set forth: (a) name and address of stock holder; (b) number of shares and percentage of issued stock held by such stockholder; (c) relationship of such stockholder to you; (d) position held y such stockholder; and (e) yearly salary of such stockholder.

106. Set forth any bonuses received by you from your employer in the past four calendar years.

107. If your employer reimburses you for travel and entertainment expenses, for automobile expenses and/or for any other expenses, describe in detail the system by which you advise your employer of the same and by which you receive payment. If expense vouchers are submitted to your employer, identify the same, describe the frequency with which each are submitted and set forth the name and address of the person having care and custody of the same. If you have copies of said vouchers or a record of payment requested and received, annex a copy of each thereto.

If, during the past 36 months, you have had regular access to or use of any vehicle (i.e., automobile, truck, camper, motorcycle, boat, etc.) which is not owned by you, describe each said vehicle fully, including year of manufacture, brand, body style, model designation, etc., and as to each vehicle set forth:

(a) the name and address of the owner;

(b) your relationship with the owner of each vehicle;

(c) if leased, identify the lease documents and annex a copy hereto;

(d) if purchased by any business entity with which you are associated (as employee, partner, consultant, stockholder, director, proprietor or otherwise), set forth the date of purchase and purchase price; and,

(e) if sold during the past 36 months, the date of sale, the name and address of purchaser and the sale price.

108. List each and every overnight personal or business trip which the _________________ has made in the past three years and for each state:

(a) dates of trip (inclusive of departure and return dates);

(b) names and addresses of each person accompanying you;

(c) each location (specifying city, state and business purpose of each said meeting);

(d) if any trip was all or partly for business purposes, set forth the name and address of each business associate with whom you met during said trip, the amount of time spent with each business associate and describe generally the business purpose of each said meeting;

(e) type and class of travel (i.e., train, car, bus, airplane - tourist, first class, group charter, etc.);

(f) total cost of each trip, itemizing:

(i) transportation;

(ii) room;

(iii) meals;

(iv) entertainment;

(v) gratuities;

(vi) personal expenditures (specify each); and

(vii) miscellaneous (specify each).

g. set forth the name and address of each person or entity paying or contributing to the payment of any of the expenses of each trip; specify which expenses were paid by said person or entity and the amount of each payment; if any person or entity reimbursed you for payments made or costs incurred (as distinguished from making payments directly to third parties), set forth the dates and amounts of each reimbursement and specify exactly what expenses were so reimbursed.

BUSINESS VENTURES

109. Set forth the following as to each of the corporations in which you have or had an interest during the past five (5) years:

(a) Corporate name and nature of your interest;

(b) Number of outstanding shares of stock, indicating par and market value;

(c) Number of shares of which you are the legal or beneficial owner, their class and value of same;

(d) Date your interest in corporation was acquired and the number of shares you owned at that time;

(e) The date, cost and amount of additional shares you obtained;

(f) Names and addresses of the shareholders, officers and Board of Directors for each corporation, including the number of shares held by each, the position or office each holds and annual salary;

(g) State any and all money received by you legally or beneficially from each of the corporations for the past five (5) years and up to the present time, stating the nature, amount of payment, and the year in which payments (including, but not limited to, salary, distribution, dividends, return of capital and loans, etc.);

(h) If you are an officer or employee for any of the corporations, state your position and annual salary;

(i) If your salary or position as an officer has changed in the past five (5) years, set forth same;

(j) Name each of the corporations for which you are on the Board of Directors and the amount of money paid for attending meetings;

(k) Set forth the amount of money earned from Board of Directors meetings for each corporation during the past five (5) years;

(l) Specify with particularity all expenses that the corporation pays or for which you are reimbursed (attach copies of all expense agreements);

(m) Set forth the nature of any stock option agreement you have with the corporation;

(n) List the names and account numbers of any banks in which the corporations have or had savings or checking accounts;

(o) If any corporation has a government contract or is receiving a Federal grant, set forth the nature of same, date and contract number and parties to agreement;

(p) Set forth the annual gross sale of each corporation for the past five (5) years;

(q) Describe and attach photocopies of any written agreements between you and the corporation or between you and other shareholders;

(r) List the gross and net earnings of all corporations for the past three (3) years;

(s) Set forth your own capital contribution to the business;

(t) Set forth the net worth of each corporation, specifying among other items assets, equipment, inventory and accounts receivable;

(u) Indicate what corporate records have been prepared during the existence of the corporation, including, but not limited to, account journals, financial statements, cash receipt books, profit and loss statements, balance sheets and statement of earnings; and,

(v) If you ever borrowed or loaned any money from or to the corporation, list the dates of the transaction, amount of money loaned or borrowed, and balance currently due.

110. If you are an officer or director or owner of 25% or more of stock in any corporation, attach copies of the last three (3) Federal Income tax returns filed by each said corporation.

111. If you are a member of a partnership, state the following:

(a) Name and address of all partners;

(b) Your capital contribution to the business;

(c) Your proportionate share in the ownership and profits of the business;

(d) The annual gross profits of the business during the past three (3) years;

(e) Amount of drawings or earnings of each partner in the last three (3) years;

(f) Itemization as to date, amount and purpose of all monies drawn from partnership or charged to your drawing or capital amount during the past three (3) years.

112. Set forth the name and address of each bank in which any partnership in which you have an interest has deposited funds in the last three (3) years, and identify, with specificity, each checking, savings or similar account, the account number, the name of the account and the names of all persons authorized to withdraw funds therefrom.

113. Set forth the name and address of each financial institution from which any partnership in which you have an interest has borrowed funds in the past five (5) years.

114. Itemize all expenses paid by the partnership in the last three (3) calendar years for travel, entertainment, petty cash and personal items, stating as to each item the following:

(a) Date of payment;

(b) Amount of payment; and,

(c) Purpose of payment.

115. Attach copies of the last three (3) partnership returns filed with the Internal Revenue Service.

116. If you are self-employed, state the following:

(a) Place of business;

(b) Trade name used;

(c) Type of business;

(d) Set forth statement of income and expenses and assets and liabilities for the last three (3) calendar years and the name, address and position of the person who prepared it.

(e) Itemize all expenses paid in last three (3) calendar years for travel, entertainment, petty cash and personal items, stating as to each:

(i) Date of payment;

(ii) Amount of payment; and,

(iii) Purpose of payment.

117. Was any business mentioned in the preceding Interrogatory discontinued or was your interest terminated? If so, state: (a) the name and address of the business; (b) the date of discontinuation or termination; (c) the reason for discontinuation or termination; (d) the amount of money or other consideration which you received as a result of the discontinuance or termination; (e) the amount of money or other consideration which you received as a result of the discontinuance or termination.

118. With reference to the enterprises set forth in question 117, state where the books and records thereof are kept, the name and address of the person in whose charge they are, and the name and address of any accountants and auditors whose services are or were used.

119. During the past five (5) years and up to the present time, did you or your business receive any money from a civil suit or settlement or have you or your business retained or consulted with an attorney for any civil action? If so, state (a) the parties; (b) nature of action; (c) docket number; (d) venue; (e) name and address of attorney for insurance company if case met in suit; (f) amount of money received or claimed; (g) name of other party's insurance company; and (h) substance of claim.

120. If, during the past five (5) years up to and including the present, the State of New Jersey or any other State in which your business, corporation or partnership was located, performed or is performing a sales tax audit, indicate (a) date of audit, (b) findings of audit, i.e., was there deficiency and if so, how much additional money were you required to pay; and, (c) if an order or written agreement was entered or executed, attach same.

121. If at any time during the past five (5) years, including the present, you earned any money from a part-time job, including, but not limited to, per diem work and consultant work, set forth:

(a) employer, address and nature of business;

(b) duties;

(c) rate of pay and earnings; and,

(d) dates of employment.

122. If you are presently unemployed, either permanently or temporarily, state: (a) commencement date; (b) the reason; (c) when you expect to return to employment; (d) name and address of last employer; (e) amount of sick pay, workmen's compensation awards, disability, unemployment or insurance benefits; (f) amount of any other judgments or settlements resulting from any claim for injuries causing your unemployment.

123. What contracts with third persons have you entered in the last year other than for routine personal goods and services. Give dates, names and addresses of the third person involved and the nature of the transaction.

CONTRACTS FOR PERSONAL GOODS AND SERVICES

124. Have you entered into any contract(s) with a third person(s) in the last year for personal goods and/or services?

If your answer is "yes", give the dates, names and addresses of third person(s) involved, and attach a copy of the contract(s).

PREMARITAL LIABILITIES

125. Did you owe any money to any creditor at the time of your marriage to your current spouse?

If your answer is "yes", please set forth:

a. The name and address of each creditor and purpose of debt.

b. The balance of each debt at the beginning of this marriage.

c. The source of funds used for payment (if any) of each such debt.

d. The balance of each such debt on the date of filing of the divorce complaint in this action.

EXPENSES

126. Itemize the _________________’s monthly living expenses at the time of answering these Interrogatories.

CHANGES SINCE FILING OF DIVORCE COMPLAINT

127. If your answer to all of the preceding Interrogatories regarding your assets and liabilities are made as of the date of filling of the divorce complaint in this action, has any of this information changed since the filing of the divorce complaint?

If your answer is "yes", please set forth:

a. Nature of asset;

b. Date acquired;

c. Consideration paid or exchanged;

d. Whether the consideration came from a marital asset or from your separate asset or earnings;

e. The name and address of any co-purchaser(s);

f. The name and address of the person(s), business or corporation from which you purchased the asset;

g. The nature and amount of the liability;

h. The purpose for which it was incurred;

i. The name of the creditor;

j. The date on which such liability was incurred.

FINANCIAL RECORD INFORMATION

FINANCIAL RECORDS

128. State the name, description, type and location of all books, papers, records and other financial documents in your possession or control which would reflect your income or assets. If in the possession of another person, state:

a. Their name(s) and address(es);

b. Their relationship to you;

c. A description of all such papers;

d. Attach copies of all tax returns prepared for you for the last three (3) years, together with copies of all profit and loss statements, balance sheets, and any other documents setting forth your assets, liabilities, income and expenses for each of the three (3) years.

ACCOUNTANT

129. Have you employed, or had employed on your behalf, the services of a certified public accountant or a public accountant for yourself, or for your spouse, at any time within the past five (5) years?

If your answer is "yes", for each accountant and/or firm, please set forth:

a. The name and address of the accountant employed.

b. The inclusive dates on which the accountant was employed.

c. Why was the accountant employed?

d. A description of the services performed by each accountant.

ATTACH ANY FINANCIAL STATEMENTS, BALANCE SHEETS, BUDGET OR OTHER FINANCIAL RECORDS PREPARED FOR YOU BY ANY SUCH ACCOUNTANT.

FINANCIAL STATEMENT

130. Have you personally prepared, had prepared for you, or issued any financial statement(s) of your assets and liabilities either individually or for any other business in which you have or had an interest within the past five (5) years?

If your answer is "yes", please set forth:

a. The dates of all such statements.

b. The purposes for which each statement was prepared and issued.

c. The name and address of each person, firm, corporation, partnership, mercantile or trade agency, or other organization to whom they were issued.

d. The name and address of all persons who worked on the preparation of such statements.

ATTACH HERETO A COPY OF EACH SUCH FINANCIAL STATEMENT

CREDIT PURPOSES

131. Have you submitted any financial statement(s) to any financial institution, entity or person for credit purposes in the past five (5) years?

If your answer is "yes", please set forth:

a. The name and address of the person, bank, or financial institution.

b. The date the statement was submitted.

c. Amount of credit sought.

d. Whether the application was approved, and if so, for how much.

e. Amount of money or credit used.

f. Purpose of expenditure of such money or use of such credit.

ATTACH A COPY OF YOUR CREDIT OR LOAN APPLICATION, THE FINANCIAL STATEMENTS AND ANY SUPPORTING DOCUMENTATION WHICH YOU FURNISHED TO SAID ENTITY OR PERSON.

FINANCIAL PLANNER

132. Have you employed the services of a financial planner during the marriage?

If your answer is "yes", please set forth:

a. The name and address of the financial planner.

b. The nature of the services rendered.

ATTACH A COPY OF ANY PLAN OR REPORT PREPARED BY THE FINANCIAL PLANNER FOR YOU, AND A COPY OF EACH AND EVERY INVESTMENT DOCUMENT (STATEMENTS, INSURANCE POLICIES, ANNUITY CONTRACT OR OTHER) FOR EACH INVESTMENT OR PRODUCT SOLD TO YOU BY OR THROUGH THE FINANCIAL PLANNER.

FINANCIAL ADVISOR

133. Identify all financial advisors whose services you or your agents have utilized in the past three (3) years.

DOMESTIC RELATIONS/LEGAL PROCEEDINGS

134. Has the _________________ retained or employed a private investigator in connection with any prior court actions?

If your answer is "yes", attach a copy of the investigator's report, or if oral, summarize it.

INVESTIGATIVE REPORT AND DOCUMENTARY EVIDENCE

135. Has the _________________ retained or employed a private investigator in connection with this action?

If your answer is "yes", attach a copy of the investigator's report, or if oral, summarize it.

COMPLAINT/ANSWER WITNESSES

136. Set forth the names and addresses of each and every person having knowledge concerning the allegations in the complaint and/or answer, or concerning any defense asserted by any party, briefly indicating the nature and extent of each such person's knowledge.

FINANCIAL WITNESSES

137. Set forth the names and addresses of each and every person having knowledge concerning you and your spouse's income or assets or any financial matter to be resolved, briefly indicating the nature and extent of each such person's knowledge.

TRIAL WITNESSES

138. Set forth the names and addresses of any persons the _________________ intends to use as witnesses at the time of trial and if any such witness has given the _________________ a statement or other writing, attach a copy hereto.

EXPERT WITNESSES

139. With regard to any expert witnesses, whether or not retained, consulted, acquired or developed in anticipation of litigation or for trial, state:

a. The name and address of such expert witness.

b. Whether or not such expert witness is expected to testify.

c. A statement of the subject matter (topic and content) of the expected testimony.

d. The area of expertise of the expert.

e. The area on which the expected witness will be sought to qualify.

f. Attach copies of all reports or documents rendered by the expert and if the report is not written, summarize it.

g. A statement of the substance of the facts and opinions to which the expert is expected to testify and summary of the grounds for each opinion.

ATTACH HERETO A COPY OF ANY WRITTEN REPORT, APPRAISAL, STATEMENT OR A SUMMARY OF ANY ORAL REPORT, OR APPRAISER STATEMENT GIVEN TO YOU BY ANY PROPOSED EXPERT WITNESS.

DOCUMENTARY EVIDENCE

140. If there exists any documentary evidence which the _________________ intends to rely upon or introduce into evidence at the time of the trial in this matter substantiating the _________________’s answers to Interrogatories or any material fact in this matter, or contradicting any assertion made by any party or witness, state the nature and contents of each such document, together with the names and addresses of its custodians.

NON-DOCUMENTARY EVIDENCE

141. If there exists any non-documentary physical evidence substantiating these answers to Interrogatories or any material fact in this matter or contradicting any assertion made by any party or witness, state the nature of the evidence, the facts it substantiates or contradicts, together with the names and addresses of its custodians.

ADMISSIONS BY _________________/_________________

142. Describe in detail, the date, manner circumstances and substance of any admission which you contend was made by any party to this action and set forth the names of all persons having knowledge of such alleged admission and, pursuant to R.4:17-4, attach copies of all documents touching upon, pertaining to, or reflecting any such alleged admission.

AUTHORIZATIONS

143. Please sign all of the attached authorizations and return them with your complete answers to these Interrogatories.

CERTIFICATION

I hereby certify that the copies of the written reports or complete summaries of any oral reports of treating physicians or expert witnesses, annexed hereto, are exact copies of the entire written report or reports or complete summaries of any oral report or reports rendered by them; that the existence of other reports or treating physicians or expert witnesses, either written or oral, are unknown to me; and that if such reports become later known or available, I shall serve them promptly upon the propounding party, but in no case later than the time prescribed by the Court Rules.

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: _

RETIREMENT PLAN AUTHORIZATION FORM

TO: _____________________ RE: ______________________

_____________________ ______________________

_____________________ ______________________

You are hereby requested and authorized to disclose, make available and furnish to:

Law Offices of Edward R. Weinstein, LLC

Weinstein Professional Building

214 Highway 18 North, Suite 2A

East Brunswick, New Jersey 08816

All documentation showing all retirement account amounts, types of retirement accounts, plan summaries, annual reports, quarterly reports and all other information pertaining to each and every retirement account in which the above-named individual has an interest.

______________________________

Signature

Social Security # ___________________

Dated: ________________

LIFE INSURANCE AUTHORIZATION FORM

TO: _____________________ RE: ______________________

_____________________ ______________________

_____________________ ______________________

You are hereby requested and authorized to disclose, make available and furnish to:

Law Offices of Edward R. Weinstein, LLC

Weinstein Professional Building

214 Highway 18 North, Suite 2A

East Brunswick, New Jersey 08816

All documentation pertaining to the date on which each policy was issued, the type of policy, any cash surrender values thereon, any loans thereon, the date of each loan, the amount and manner of pay back of each loan, the annual premium for each policy, the face value of each policy and the policy number accounts or copies thereof relating to the accounts of the above-referenced individual and to permit the attorney to inspect and make copies or abstracts thereof.

Copies of this form bearing a photocopy of my signature shall be of the same effect as the same document bearing my original signature.

______________________________

Signature

Social Security # ___________________

Dated: ________________

EMPLOYMENT BENEFITS AUTHORIZATION FORM

TO: _________________________ RE: ________________________

_________________________ ________________________

_________________________ ________________________

You are hereby requested and authorized to disclose, make available and furnish to:

Law Offices of Edward R. Weinstein, LLC

Weinstein Professional Building

214 Highway 18 North, Suite 2A

East Brunswick, New Jersey 08816

All documentation showing each and every employment benefit of the above-named individual and summaries and descriptions of each employee benefit together with the most recent annual report on each employee benefit. This shall include but not be limited to medical insurance, prescription drug insurance, optical insurance, dental insurance, retirement accounts, bond purchases, savings and credit union accounts, flex accounts, life insurance, vacation accounts and annuities.

______________________________

Signature

Social Security # ___________________

Dated: ________________

MORTGAGE AND HOME EQUITY LOAN AUTHORIZATION FORM

TO: ______________________ RE: ___________________

______________________ ___________________

_____________________ ___________________

You are hereby requested and authorized to disclose, make available and furnish to:

Law Offices of Edward R. Weinstein, LLC

Weinstein Professional Building

214 Highway 18 North, Suite 2A

East Brunswick, New Jersey 08816

All information pertaining to the mortgage and/or home equity loan for the above-listed properties. This shall include but not limited to mortgage or loan balance, monthly mortgage or loan payments, amortization schedules, date of obtaining mortgage or loan, history of mortgage or loan payment, escrow account information, tax and insurance payment information.

_____________________________ Signature

Social Security # ___________________

Dated: ________________

MEDICAL AUTHORIZATION FORM

TO: ________________________ RE: ______________________

Name of Patient

________________________ ______________________

Address

________________________ ______________________

You are hereby requested and authorized to disclose, make available and furnish to

Law Offices of Edward R. Weinstein, LLC

Weinstein Professional Building

214 Highway 18 North, Suite 2A

East Brunswick, New Jersey 08816

All documentation showing full and complete copies of all my medical records, doctors reports, hospital records, including X-rays, nurses notes, doctors order sheets, discharge summaries and any other information or items of record which they may request.

______________________________

Signature

Social Security # ___________________

Dated: ________________

BANK AND INVESTMENT AUTHORIZATION FORM

TO: ________________________ RE: _____________________

________________________ _____________________

________________________ ______________________

You are hereby requested and authorized to disclose, make available and furnish to

Law Offices of Edward R. Weinstein, LLC

Weinstein Professional Building

214 Highway 18 North, Suite 2A

East Brunswick, New Jersey 08816

All bank statements, investment accounts, money market accounts and copies of thereof relating to the accounts of the above referenced individual and to permit the attorney to inspect and make copies of abstracts thereof.

______________________________ Signature

Social Security # ___________________

Dated: ________________