Bexar County Forms

2. Low Cost Child Custody Evaluation

4. General Information
6. Name*
7. Email:*
9. Address*
10. Date of Birth*
    Date of Birth
12. City*
13. State*
14. Zip*
16. Marital Status*
    -- Select One --SingleMarriedWidowedDivorced
17. Spouse Name
19. Children Information
21. Name*
22. Gender*
    -- Select One --MaleFemaleN/A
23. Date of Birth
    Date of Birth
25. Name
26. Gender
    -- Select One --MaleFemaleN/A
27. Date of Birth
    Date of Birth
29. Name
30. Gender
    -- Select One --MaleFemaleN/A
31. Date of Birth
    Date of Birth
33. Attorney Information
35. Attorney's Name
36. Office Telephone
38. I Understand I Am Providing The Following Information Contained In This Application Under Oath Under Penalties Of Perjury. Information Contained In This Application Are Within My Personal Knowledge And Are True And Correct.
40. Have you filed an Affidavit of Inability to Pay Costs requesting the Court waive court costs in this case:*

    1. Yes

    1. No
42. I am currently receiving the following public assistance:*

    1. Food Stamps/EBT
    2. Medicaid

    1. Housing
    2. TANF

    1. CHIPS
    2. Supplemental Security Income (SSI)

    1. Other
    2. None
44. Other:
    Please upload a copy of the most current letter showing the assistance you receive.
    
    Please Note: DO NOT include paperwork with sensitive personal information (Social Security numbers, driver’s license numbers, bank account information, routing numbers, medical information, passport numbers, or passwords. )
46. I am currently:*

    1. Employed
    2. Unemployed

    1. Retired
47. Please provide your last date of unemployment
    Please provide your last date of unemployment
49. Please provide your employer's name and address:
51. Please provide your total net income:
53. I currently live:*

    1. Alone
    2. With spouse

    1. With spouse & children
    2. With children

    1. With my parents or other relatives
    2. With someone else

    1. In shelter or a facility
55. Provide name(s) and age(s) of dependents:
57. I own:

    1. Home
    2. Undeveloped Lot
    3. Motor Vehicle

    1. Retirement/Pension/IRA
    2. Checking Account(s)

    1. Savings Account
    2. Business
59. What is the Year & Make?
60. Please provide the balance in the account
61. Please provide the balance in the account
63. I Am Unable To Pay The Full Cost Of The Child Custody Evaluation And Request Assistance In Paying The Cost. All Information Provided In This Application Is True And Correct.*
    Do You Agree? Please Type Your Full Name
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field