Md. R. Civ. P. Cir. Ct. , Form No. 5
1. Identify yourself and all individuals with whom you reside. For each individual other than yourself, state that individual's age, relationship to you, and marital status. State your own birth date and social security number. (Standard Domestic Relations Interrogatory No. 1.)
2. Describe your educational background. Include in your answer the highest grade you completed; the name and date of any degree, diploma, or certificate you received, and the name of the institution conferring the degree, diploma, or certificate; and any specialized training you have received. (Standard Domestic Relations Interrogatory No. 2.)
3. If you are currently employed in any capacity, identify each current employer and, for each employment, state:
(a) your job title,
(b) your duties,
(c) the number of hours in your average work week,
(d) your regular pay period,
(e) your gross wages per pay period, and
(f) the deductions per pay period made by your employer from your wages. If overtime work was available to you during the past 12 months, state:
(a) the number of overtime hours you worked during the 12 months and your rate of pay for those hours and
(b) the number of overtime hours that were available to you during the 12 months but that you did not work and the rate of pay you would have received if you had worked those hours. (Standard Domestic Relations Interrogatory No. 3.)
4. Describe the nature and amount of any fringe benefits that you receive as a result of your employment. (Standard Domestic Relations Interrogatory No. 4.)
5. If you are unemployed, describe your efforts to obtain employment since you became unemployed, identify each prospective employer and employment agency you have contacted while seeking employment and state the date of each contact. (Standard Domestic Relations Interrogatory No. 5.)
6. If you claim you are physically or mentally unable to work or your capacity to work is limited, state the facts upon which your claim is based and identify all persons with personal knowledge of those facts. (Standard Domestic Relations Interrogatory No. 6.)
7. For each employment that you have had during the past five years other than any current employment, identify each employer and for each employment state:
(a) the dates of employment,
(b) your duties,
(c) your wages, and
(d) your reason for leaving the job. If you were unemployed for any period of time, specify the amount and source of any income that you received while unemployed. (Standard Domestic Relations Interrogatory No. 7.)
8. Identify the sources and amounts of all taxable and non-taxable income you received during the past five years. (Standard Domestic Relations Interrogatory No. 8.)
9. Identify the sources and amounts of any other moneys and credit(s) you received during the past five years with an aggregate value in excess of $250 in any one year, including gifts, loans from others, loans repaid to you by others, sales of assets, and untaxed distributions. (Standard Domestic Relations Interrogatory No. 9.)
10. List each item of property in which you have any interest. For each item listed, state how it is titled, its value, the amount of any present lien or mortgage on the property, the date of acquisition of the property, and the identity of any other person with an interest in the property. If you claim that any property listed is not marital property, state the facts upon which you base your claim, including all sources of funds used for the acquisition of the property and identify all persons with personal knowledge of those facts. (Standard Domestic Relations Interrogatory No. 10.)
11. If you, either alone or with anyone other than your spouse, transferred property during the last five years of your marriage with a value in excess of $250 to any person other than your spouse without receiving full consideration in money or money's worth for the property transferred, identify each person to whom a transfer was made and the property transferred, giving the date and method of transfer and the value of the property at the time of transfer. (Standard Domestic Relations Interrogatory No. 11.)
12. If the information contained on your financial statement submitted pursuant to Rule 9-202(e) or (f) has changed, describe each change. (Standard Domestic Relations Interrogatory No. 12.)
13. State by type and amount all support provided by you for your spouse and children since the date of your separation. (Standard Domestic Relations Interrogatory No. 13.)
14. State the date on which you separated from your spouse and describe the circumstances of the separation. (Standard Domestic Relations Interrogatory No. 14.)
15. If you contend that you are entitled to a divorce because your spouse's conduct toward you or your minor child was cruel or vicious or that your spouse constructively deserted you, describe your spouse's conduct and state the date and nature of any injuries sustained by you or your minor child and the date, nature, and provider of health care services rendered regarding the injuries. Identify all persons with personal knowledge of your spouse's conduct and all persons with knowledge of any injuries you or your minor child sustained as a result of that conduct. (Standard Domestic Relations Interrogatory No. 15.)
16. State the date on which you and your spouse last had sexual relations with each other. (Standard Domestic Relations Interrogatory No. 16.)
17. If you have had sexual relations with a person other than your spouse during your marriage, identify the person(s) with whom you have had sexual relations, state the date of each act of sexual relations, and state the location where each act took place. If you refuse to answer this interrogatory as framed because the answer would tend to incriminate you, so state and answer for the period ending one year prior to the date of your answers. (Standard Domestic Relations Interrogatory No. 17.)
18. If you have had sexual relations with a person other than your spouse during the marriage and you contend that your spouse has forgiven or condoned your actions, state the facts upon which your contention is based. (Standard Domestic Relations Interrogatory No. 18.)
19. If you contend that your spouse is unfit to have custody of the children, state the facts upon which your contention is based and identify all persons having personal knowledge of these facts. If your contention is based on the use of controlled dangerous substances or the abuse of alcohol on specific occasions, identify the substance used, the other persons present at the time of the use, and the date, time, and place of the use. If your contention is based on the repeated use of controlled dangerous substances or the repeated abuse of alcohol, identify the substance and all persons with personal knowledge of the repeated use or abuse. (Standard Domestic Relations Interrogatory No. 19.)
20. If you have sought or received treatment or therapy at any time during the past 10 years for any physical, mental, or emotional condition, including drug addiction or alcoholism, describe the condition and the treatment or therapy provided, state the date or dates of treatment or therapy, and identify all persons providing treatment or therapy. (Standard Domestic Relations Interrogatory No. 20.)
21. If you contend that placing the children in your sole, shared, or joint custody will be in their best interest, specify the facts and circumstances upon which you rely. (Standard Domestic Relations Interrogatory No. 21.)
22. Describe the child care plan you intend to follow when the children are with you. Include in your answer a description of the place where the children will reside, specifying the number of bedrooms, bathrooms, and other rooms, the distance to the school which the children will attend, and the identity of all other persons who will be residing in that household. Identify all persons who will care for the children in your absence, state the hours during which they will care for the children, and the location where the care will be provided. (Standard Domestic Relations Interrogatory No. 22.)
Md. R. Civ. P. Cir. Ct. , Form No. 5
HISTORICAL NOTES
2003 Orders
The November 12, 2003, order, in interrogatory 12, substituted "Rule 9-202(e) or (f) for "Rule 9-203 f.; and rewrote interrogatory 15, which previously read:
"15. If you contend that your spouse's conduct was excessively vicious or that your spouse acted with extreme cruelty or constructively deserted you, describe your spouse's conduct and state the date and nature of any injuries sustained by you and the date, nature, and provider of health care services rendered to you. Identify all persons with personal knowledge of your spouse's conduct and all persons with knowledge of any injuries you sustained as a result of that conduct. (Standard Domestic Relations Interrogatory No. 15.)