H-101: Fairfax Model Interrogatories – April, 2002V I R I G I N I A

IN THE CIRCUIT COURT OF FAIRFAX COUNTY

_______________________________, )Plaintiff )

)v. ) In Chancery No. ________________________________________, )

Defendant )

To:{Party}, c/o: {Counsel}

INTERROGATORIES

The following Interrogatories are directed to you pursuant to Rules 4:0 et seq. of the Rules of the Supreme Court of Virginia. You are requested to answer these Interrogatories fully, in writing and under oath, and to serve a copy of your answers upon the undersigned counsel within ___days after service of these Interrogatories.

a. These Interrogatories are continuing in nature and may require you to update the information given pursuant to the supplementation rules of Rule 4:1.E.

b. The word “person,” used in these Interrogatories, includes both the singular and plural, and includes legal entities and organizations as well as individual people.

c. Where the identity or name of a person is requested, state in your answer the full name of the person and, on the “Identification Addendum” attached hereto, state the full name, present or last known home address and business address, and the person’s daytime telephone number.

d. Any requested information, unless privileged, which is known by any of your attorneys, accountants or other agents, acquired while acting on your behalf, shall be given in response to these Interrogatories. To the extent you do not know the precise information requested, provide your best estimate thereof.

e. If additional space is required to fully answer, please continue answer on a separate sheet of paper properly identified (e.g., “continuation of answer to interrogatory number 7”).

f. Interrogatories numbered “ # (M)” are taken from the Model Interrogatories developed by Fairfax Bar Association. Others are added by counsel.

* The drafting attorney should pick the specific date, which will depend upon the length of marriage, the financial history of the parties, other circumstances, etc.

** The Separation date.

- 1 –April, 2002

A. THE FOLLOWING INTERROGATORIES (#1 – #6) ARE FOR USE IN CASES INVOLVING ISSUES OF SUPPORT OR EQUITABLE DISTRIBUTION

[These questions cover areas involving income-earning property, accounts and debts]

1(M) Provide the following information as to all checking, savings, credit union and money market accounts, or CD’s, held in your name and/or your spouse’s name, individually or jointly with any other person, at any time subsequent to ____________, 20__* (excluding IRA, KEOGH and 401-K accounts):

Name of

Institution

Type of

Account

Account no. How

TitledBalance on ____**

Present Balance

2(M) Provide the following information as to all investment accounts such as mutual funds, stocks, bonds, other securities or investment funds (excluding IRA, KEOGH and 401(k) accounts) owned by you and/or your spouse, individually or jointly with any other person, at any time since _________, 20___*:

Name of Account Name of owner(s) Value on _______** Present value

3(M) As to all outstanding notes, accounts receivable, or other debts owed to you and/or your spouse, individually or jointly with any other person, at any time subsequent to ______________, 20___*, provide the following information:

Name of Payor

Terms of

Payment Date Due Current Principal Balance

- 2 –April, 2002

- 3 –April, 2002

4(M) Provide the following information as to all business entities (such as sole proprietorships, corporations, partnerships, trusts, etc.) owned by you and/or your spouse, individually or jointly with any person, at any time subsequent to _______, 20___* (exclude stock in publicly-held corporations, in which you and/or your spouse hold less than 1% of outstanding shares, and which you have disclosed in question no. 2 above):

Name of Entity

Entity

Form Owners

Amount Invested %Owned Present Value

5(M) Provide the following information as to all intangible personal property (e.g. franchises, patents/trademarks/copyrights and other royalty rights, etc.) owned by you and/or your spouse, individually or jointly with any person, subsequent to ___________, 20___*:

Description of Asset

Held by

Acquisition

Date

Amount Invested

Present Value

Income Earned

6(M) Provide the following information as to all current credit cards, personal charge accounts, loans and notes payable, and other debts upon which you and/or your spouse are primarily or in any other way liable:

Creditor Debt Purpose

Account No.

Persons Liable

Balance on _______**

Present Balance

Monthly

Payment

- 4 –April, 2002

B. THE FOLLOWING INTERROGATORIES (#7 - #23) ARE PRIMARILY FOR USE IN CASES INVOLVING ISSUES OF SUPPORT. [These questions cover areas involving employment, income, expenses and debts]

7(M) Give the following information regarding your present employment (please answer separately regarding each job held):

a. Employer’s name and address: b. Position or title: c. Dates of service:

d. Salary history for past two years:

e. Present work schedule:

f. The nature, value and date of all overtime, bonuses, commissions or other compensation in past two years:

g. Describe all fringe benefits, such as insurance coverage (life, health, dental, etc.), auto-mobile use, vacation and sick leave:

h. Approximate dates of expected future promotions or reviews within the coming year and the increments in salary anticipated:

i. If you are employed less than forty (40) hours per week, please specify all reasons why you are not now working full-time:

8(M) If you are unemployed, or been at present employment less than two years, provide the following for each of your previous places of employment during the last two years:

a. Employer’s name and address: b. Position or title: c. Dates of service:

d. Salary history for last two years in job:

e. Work schedule:

f. The nature, value and date of all overtime, bonuses, commissions or other compensation in last two years in job:

g. Describe all fringe benefits, such as insurance coverage (life, health, dental, etc.), automobile use, vacation and sick leave:

h. Reason for termination of employment:

9(M) If you are presently unemployed, or employed less than full-time (35 Hr/Wk):

a. Outline fully your efforts to seek new or full-time employment:

- 5 –April, 2002

b. For each potential employer contacted, provide the following:

(1) Name and address of prospective employer:

(2) Persons you contacted there:

(3) Dates of contacts:

(4) Salary/income advertised, sought or offered (indicate which):

(5) Mode of application (e.g., letter, phone, E-mail):

(6) Present status of application:

c. If and to the extent there were any periods of two weeks or longer during which you did not actively seek new employment, specify each such period, and all reasons therefore:

10(M) If you contend the Court should consider your physical and/or mental condition in determining your ability to work or in determining support:

a. Specify the said conditions with which you are afflicted:

b. Specify the impact of each condition on employment: ___________________________

c. Identify all treating medical care providers for the above stated conditions and the dates of treatment: ____

11(M) If you contend that, in setting support, the Court should consider any special circumstances of a party or of any child, please describe the said circumstances in detail.

ANSWER:

12(M) Provide the following information for each source of income (taxable or not), and gifts, unless previously disclosed herein, including, interest, royalties, dividends, rents, pension payments, social security, disability, payments from all trusts and investments, and from inheritances, etc., from which you and/or your spouse received any total payment in excess of $300 in any twelve month period in the last two years:

Received From Date Gross Amount Reason

- 6 –April, 2002

13(M) State your monthly income and expenses in detail, using the attached income and expense statement. ANSWER:

14(M) If you have health insurance coverage, please provide the following information:

(a) Monthly premium cost you pay:

(b) Monthly premium cost of the same insurance, for:

(1) Self-only coverage:

(2) Self-plus-Spouse coverage:

(3) Self-plus-children coverage:

(c) Name all persons presently covered under your plan:

(d) Name of insurance carrier, policy number, and employer or group:

15(M) The factors set forth below are derived from §20-107.1, Code of Virginia, and are used by the court in determining spousal support. For each such factor which you claim is important for the Court to consider in determining spousal support, state each such factor and claim, including specific facts, actions, dates of occurrence, persons involved and/or witnessing such events, and any related communications:

1. The obligations, needs and financial resources of the parties, including but not limited to income from all pension, profit sharing or retirement plans, of whatever nature;

2. The standard of living established during the marriage;3. The duration of the marriage;4. The age and physical and mental condition of the parties and any special circumstances

of the family;5. The extent to which the age, physical or mental condition or special circumstances of

any child of the parties would make it appropriate that a party not seek employment outside of the home;

6. The contributions, monetary and nonmonetary, of each party to the well-being of the family;

7. The property interests of the parties, both real and personal, tangible and intangible;8. The provisions made with regard to the marital property under equitable distribution;9. The earning capacity, including the skills, education and training of the parties and the

present employment opportunities for persons possessing such earning capacity;10. The opportunity for, ability of, and the time and costs involved for a party to acquire

the appropriate education, training and employment to obtain the skills needed to enhance his or her earning ability;

11. The decisions regarding employment, career, economics, education and parenting arrangements made by the parties during the marriage and their effect on present and future earning potential, including the length of time one or both of the parties have been absent from the job market;

- 7 –April, 2002

12. The extent to which either party has contributed to the attainment of education, training, career position or profession of the other party; and

13. Such other factors, including the tax consequences to each party, as are necessary to consider the equities between the parties.

ANSWER:

16(M) If you claim that the other party should be barred from receiving spousal support, state in detail all facts and circumstances supporting that claim (including acts, dates of occurrence, persons involved and the identities of all witnesses and any communication):

ANSWER:

17(M) If you contend that the Court should consider a time-limited spousal support award, state each reason and each fact supporting such claim.

ANSWER:

18(M) If you contend that the other party should have income imputed to him or her, state each reason and each fact supporting such claim.

ANSWER:

19(M) If you claim an adjustment in your income due to supporting any “other children”, that is children for whom you do not share parentage with opposing party, state the following:

(a) Names and ages of all such children:

(b) With whom each child resides:

(c) If you are paying a regular child support amount for any child, then:

(1) Amount paid: Per:

(2) To whom paid:

(3) Specify agreement or court order requiring such payment:

20(M) The factors set forth below are derived from §20-108.1, Code of Virginia, and are used by the court in determining any deviation from the guideline child support. If you claim the Court should award child support as a deviation from the guideline amount, state each such factor and claim, including specific facts, actions, dates of occurrence, persons involved and/or witnessing such events, and any related communications:

1. Actual monetary support for other family members or former family members;2. Arrangements regarding custody of the children;

- 8 –April, 2002

3. Imputed income to a party who is voluntarily unemployed or voluntarily under-employed; provided that income may not be imputed to the custodial parent when a child is not in school, child care services are not available and the cost of such child care services are not included in the computation;4. Debts of either party arising during the marriage for the benefit of the child;5. Debts incurred for production of income;6. Direct payments ordered by the court for health care coverage, maintaining life insurance coverage, education expenses, or other court-ordered direct payments for the benefit of the child and costs related to the provision of health care coverage;7. Extraordinary capital gains such as resulting from sale of the marital abode;8. Age, physical and mental condition of the child or children, including extraordinary medical or dental expenses, and child-care expenses;9. Independent financial resources, if any, of the child or children;10. Standard of living for the family established during the marriage;11. Earning capacity, obligations and needs, and financial resources of each parent;12. Education and training of the parties and the ability and opportunity of the parties to secure such education and training;13. Contributions, monetary and nonmonetary, of each party to the well-being of the family;14. Provisions made with regard to equitable division of marital property;15. Tax consequences to the parties regarding claims for dependent children and child care expenses;16. A written agreement between the parties which includes the amount of child support;17. A pendente lite decree, which includes the amount of child support, agreed to by both parties or by counsel for the parties; and18. Such other factors, including tax consequences to each party, as are necessary to consider the equities for the parents and children.

ANSWER:

21(M) For each work-related day care provider used in the past year, specify:

(a) Identity of provider:

(b) Days and hours of care:

(c) Your work schedule during days of provided care:

(d) Cost of the care, and cost basis (hourly, weekly, etc.):

(e) Average monthly cost for past 12 months:

- 9 –April, 2002

22(M) If you are proposing that the court consider any alternative to the day care set forth above, give all reasons and details regarding said alternative day care.ANSWER:

[Note: See Interrogatory Questions #41, #42 and #43 for other day care questions]

23(M) If you claim any addition to the basic support obligation for extraordinary medical expenses of a child:

(a) Identify all medical providers and the child for whom services were rendered, dates of treatment, description of medical condition, treatment provided and detail all unreimbursed costs of treatment and any payment plan used in paying such medical expenses.

ANSWER:

(b) State the amount you propose to be added to the basic support for extraordinary medical expenses on a monthly basis and the rationale and calculation for such claim.

ANSWER:

C. THE FOLLOWING INTERROGATORIES (#24 - #37) ARE PRIMARILY FOR USE IN EQUITABLE DISTRIBUTION. [These questions cover areas involving property and its acquisition and disposition. See also questions in Section A]

24(M) As to all real estate interests presently held in your name or your spouse’s name, individually or jointly with any other person, provide the following information:

Property Address

How Titled/

Held

Acquisition Date

Acquisition

Cost/Value

Current Fair

Market Value

Mortgage Balance

- 10 –April, 2002

25(M) As to all real estate interests previously held in your name or your spouse’s name, individually or jointly with any other person, at any time subsequent to __________* provide the following information:

Property Address

How Titled/

Held

Date of

Acquisition

Price/Value at

Acquisition

Proceeds of Disposition

Date of

Disposition

26(M) Provide the following information as to all life insurance policies and annuities owned by you or your spouse at any time subsequent to _______________________:*

Company Name

Type of

Policy

Insured’s Name Policy #

Outstanding

LoansFace Value

Beneficiary & % Interest

Surrender Value

27(M) Provide the following information as to all major items of household furnishings/personal effects having estimated resale value in excess of $500.00 per item or set (e.g., furniture collections, silver, china, etc.) owned by you and/or your spouse, individually or jointly with any other person, at any time subsequent to _________________:*

Description of

Item Name of Owner(s) Date Acquired

Cost/Value at

Acquisition Present Value

- 11 –April, 2002

28(M) Provide the following information as to all motor vehicles, trailers, boats or airplanes owned by you and/or your spouse, individually or jointly with any other person(s), at any time subsequent to _______________:*

Year Make/Model Names on Title

Acquisition Cost Acquisition

Date

Present Lien Total

Present Market Value

29(M). If any person has held any property for the benefit of you and/or your spouse, subsequent to ________________*, provide the following information as to all such property:

Description of

Item

Owned by Held by Held at (location) Date Acquired Present

value

30(M). If you and/or your spouse have stored any money, documents or other items in any safe deposit boxes, vaults, safes, or other places of deposit or safekeeping subsequent to _______________*, provide the following information as to all such items:

Name of place where stored:

Address where stored:

Box # or other ID:

Items stored:

- 12 –April, 2002

If no longer stored there, place of relocation:

OR disposition of goods:

- 13 –April, 2002

31(M) For each asset, with a value over $500, previously owned, wholly or partly, by you and/or your spouse, which was disposed of since _________________*, but has not been mentioned in your answers to other Interrogatories herein, provide the following information:

Description of Item Owned or Held By

Acquisition cost Acquisition Date

Disposal Date

Present Value

32(M) For each asset, with a value over $500, owned wholly or partly by you and/or your spouse, which was acquired since _________________*, provide the following information:

Description of Item Owned or Held By

Acquisition cost Acquisition Date

Present Value

33(M) Provide the following information as to all Individual Retirement Accounts (IRA’s), 401(k), 403(b), Thrift savings, Simplified Employee Pension Plans (SEP’s), Keogh Plans, or any other form of defined contribution plan, held in your name, or your spouse’s name, at any time subsequent to __________________:*

Name of

Institution

Type of

Account

Account #

Name on

Account

Balance

Date of

Marriage

Balance

On ________

______ **

Balance

Now

34(M) As to each defined benefit pension plan, such as military pension, government pension or other such pension or annuity which may pay, or is now paying, an annuity benefit upon retirement, to which you are or may be entitled to receive benefits by reason of your past or current employment, please state the following:

a. Name of Plan: Type of Plan:

b. Identity of plan administrator:

c. Is it vested? If not, when will it vest?

d. When are you first eligible to retire and receive a benefit?

- 14 –April, 2002

e. When do you expect to retire and receive a benefit?

f. Date you began employment for creditable service toward pension:

g. Number of months of creditable service as of the separation date:

h. Payment options:

i. Calculation basis for determining annuity benefit:

35(M) For each asset you claim to be your separate property, or are partially your separate property, provide the following:

a. Identity of asset for which the claim is made:

b. Percent or dollar portion you claim to be separate:

c. State all reasons you contend this portion or percent is separate: d. Provide a complete tracing of any of your separate funds into the current property: e. Identify each person who participated in any transaction which forms a part of the factual basis for your claim:

36M) If you claim a marital interest in any property owned by your spouse, based upon a claim that the property has substantially increased in value during the marriage due to significant personal efforts or investment by you or your spouse, or as a result of contributions of marital property, state each such claim and the facts and rationale relevant to such claim

ANSWER:

37(M) The factors set forth below are derived from §20-107.3, Code of Virginia, and are used by the Court in determining the equitable distribution of marital property and/or a monetary award. For each such factor which you claim is important for the Court to consider in determining equitable distribution, state the factor and each such claim, including specific facts, actions, dates of occurrence, persons involved and/or witnessing such events, and any related communications:

1. The contributions, monetary and nonmonetary, of each party to the well-being of the family;

2. The contributions, monetary and nonmonetary, of each party in the acquisition and care and maintenance of such marital property of the parties;

3. The duration of the marriage;

4. The ages and physical and mental condition of the parties;

- 15 –April, 2002

5. The circumstances and factors which contributed to the dissolution of the marriage, specifically including any ground for divorce;

6. How and when specific items of such marital property were acquired;

7. The debts and liabilities of each spouse, the basis for such debts and liabilities, and the property which may serve as security for such debts and liabilities;

8. The liquid or nonliquid character of all marital property;

9. The tax consequences to each party; and

10. Such other factors as the court deems necessary or appropriate to consider in order to arrive at a fair and equitable monetary award.

ANSWER:

D. THE FOLLOWING INTERROGATORIES (#38 – #51) ARE PRIMARILY FOR USE IN CASES INVOLVING CUSTODY OR VISITATION.

38(M) If you believe that the other party is not fit to have custody of a child, state in detail what you allege to be the factors and circumstances which bring you to that conclusion (including specific facts, actions, dates of occurrence, the persons involved and the identities of all persons witnessing each such event):

ANSWER:

39(M) If you believe you are the more appropriate primary physical custodian for a child, state in detail what you allege to be the reasons which bring you to that conclusion (including specific facts, actions, dates of occurrence, all persons involved witnessing each such event):

ANSWER:

40(M) The factors set forth below are derived from §20-124.3, Code of Virginia, and are considered by the Court in awarding custody and or visitation. For each such factor which you claim is important for the Court to consider in awarding custody/visitation, state the factor and each such claim, including specific facts, actions, dates of occurrence, persons involved and/or witnessing such events, and any related communications:

1. The age and physical and mental condition of the child, giving due consideration to the child's changing developmental needs;

2. The age and physical and mental condition of each parent;

- 16 –April, 2002

3. The relationship existing between each parent and each child, giving due consideration to the positive involvement with the child's life, the ability to accurately assess and meet the emotional, intellectual and physical needs of the child;

4. The needs of the child, giving due consideration to other important relationships of the child, including but not limited to siblings, peers and extended family members;

5. The role which each parent has played and will play in the future, in the upbringing and care of the child;

6. The propensity of each parent to actively support the child's contact and relationship with the other parent, including whether a parent has unreasonably denied the other parent access to or visitation with the child;

7. The relative willingness and demonstrated ability of each parent to maintain a close and continuing relationship with the child, and the ability of each parent to cooperate in and resolve disputes regarding matters affecting the child;

8. The reasonable preference of the child, if the court deems the child to be of reasonable intelligence, understanding, age and experience to express such a preference;

9. Any history of family abuse.

ANSWER:

41(M). If you contend that the Court should order joint legal custody, state in detail what you allege to be the factors and circumstances supporting that conclusion (including specific facts, actions, dates of occurrence, the persons involved and the identities of all persons witnessing each such event):

ANSWER:

42(M) Please provide the following information concerning your child care arrangements for periods when you are absent from a child overnight:

Name/Address of provider:

Number of days used in past year:

Where is the care provided? ________________________________________

Your expected travel/absence schedule in next year:

How long have you used this provider?

Are any changes in the use of this care provider anticipated in the coming year? If so, state all such changes:

43(M) Please provide the following information for each child care provider you have employed or anticipate employing in the future when you need child care for reasons other than work (e.g., social engagements, classes, recreational activities):

- 17 –April, 2002

Name/Address of provider:

Age of provider (if younger than 18): ___Number of times used in past year:

Where was the care provided? ________________________________________________ .

Reason(s) for needing child care:_____________________________________________

Are any changes in the use of this care provider anticipated in the coming year? If so, state all such changes:

[Note: See Interrogatory #21 and #22 for other day care questions re Custody]

44(M) If any child presently is left without adult supervision, during days on which the child are in your care, or you expect that any child will be unsupervised while in your care during the next year, please describe the relevant circumstances and times when the child is left without adult supervision while in your care.

ANSWER:

45(M) As to each child, set forth your proposed calendar showing when each parent should have the child during the coming year, as well as all factors and circumstances which you contend support this schedule. Show all holidays, summer vacation, etc.

ANSWER:

46(M) With respect to your health:

a. Describe the general condition of your health at present:

b. Specify any and all physical and/or mental disabilities and chronic ailments with which you are afflicted:

c If, within the past five years, you have received treatment, counseling, therapy or testing from any psychologist, psychiatrist, or other mental health professional, please specify all such dates and describe all such conditions for which you were treated: d. Identify all treating professionals for each condition described:

47(M) List all post-high school educational institutions that you attended, giving the dates of attendance, major courses of study, if any, and any diplomas or degrees received.

ANSWER:

- 18 –April, 2002

48(M) If any other adult resides in your household, or stays there more than one night per month on the average, specify:

a. The person’s name: b. Relationship to you:

c. How frequently does he/she spend the night?

49(M) If a child is in school, please specify:

a. Name of school:

b. Location of school:

c. Grade attended this academic year:

d. List each subject and grade for the past grading period: e. List any academic or behavior problems the child has had in the past year that any school personnel have brought to your attention:

50(M) Describe your residence, including:

a. Type of residence (e.g., single-family home, townhouse, apartment, etc.):

b. The number of bedrooms in the house: . c. The sleeping arrangements for each household member: .

E. THE FOLLOWING INTERROGATORIES ARE FOR USE IN ALL CASES

52(M) Provide the following information with respect to each expert you expect to call to testify in this case as to any matter at issue in these proceedings. Set forth the subject matter on which the expert is expected to testify, the substance of the facts and opinions to which the expert is expected to testify and a summary of the grounds for each opinion.

(1) Name: Profession:

Address: Phone:

Education:

Employment Background:

Subject Matter of Testimony:

Substance of Facts and Opinions and the Grounds Therefore:

- 19 –April, 2002

(1) Name: Profession:

Address: Phone:

Education:

Employment Background:

Subject Matter of Testimony:

Substance of Facts and Opinions and the Grounds Therefore:

53(M) State in detail each and every fact which you contend supports the following allegations made in your pleadings. Include specific facts, actions, dates of occurrence, the persons involved and the persons witnessing such events:

A. [Allegation]

B. [Allegation]

54(M) State in detail each and every fact which you contend supports your denial of the allegations made in your response to our pleadings. Include specific facts, actions, dates of occurrence, the persons involved and the persons witnessing such events:

A. [Allegation-Denial]

B. [Allegation-Denial]

- 20 –April, 2002