COMPLAINT FOR DISSOLUTION OF MARRIAGE STATE OF NEBRASKA FORM NO. DC 6:4(1) Rev. 1/08 Neb. Rev. Stat. 42-353 CASE NUMBER: (assigned by Clerk of Court) (No Children) IN THE DISTRICT COURT OF ___________________ COUNTY, NEBRASKA (county where Complaint filed) ____________________________, (your full name) Plaintiff, vs. ___________________________, (spouse’s full name) Defendant. ) ) ) ) ) ) ) ) ) COMPLAINT FOR DISSOLUTION OF MARRIAGE (No Children) I ___________________________________, without assistance of an attorney, (your full name) ask this Court for a Dissolution of Marriage. In support of my Complaint, I state that the following items are true: 1. I live at _____________________________________, in (your street address) _________________________________________________________________. (city, county, and state where you live) 2. My spouse’s address is ________________________________________ (spouse’s street address) in __________________________________________. (city, county and state where spouse lives) 3. Either my spouse or I have lived in the state of Nebraska for more than one year prior to the filing of this Complaint, with the bona fide intention of making this state our permanent home. 1 American LegalNet, Inc. www.FormsWorkflow.com 4. At the time I filed this action, either my spouse or I was living in ___________________ County, Nebraska. (county where Complaint filed) 5. We were lawfully married on ___________________________________ (date of marriage) in __________________________________________. (city and state of marriage) 6. Neither my spouse nor I am a party to any other pending actions for divorce, separation, or dissolution of marriage in this state or in any other state. 7. My spouse is not a member of the Armed Forces of the United States or its 8. My marriage is irretrievably broken. 9. No child or children were born to or adopted by my spouse or me and none allies. are expected, or all of our children are age 19 or older. 10. During the course of the marriage, my spouse and I have accumulated certain items of property, which should be equitably divided between us. 11. My spouse and I have incurred certain debts and obligations during the marriage, and the liability for payment of these debts and obligations should be equitably divided between us. 12. I wish my former name, _______________________________________, (former or maiden name, including first, middle, and last names) to be restored to me. 13. I want this dissolution of marriage proceeding heard by a district court judge. 2 American LegalNet, Inc. www.FormsWorkflow.com 14. Check the box that applies: [ ] There are no existing restraining orders, protection orders, or criminal no-contact orders regarding either party. OR [ ] There are one or more existing restraining orders, protection orders, or criminal no-contact orders involving one or more of the parties. Details are as follows: (a) Type of order: __________ restraining; __________ protection; __________ criminal no-contact. (b) Name of court, case number, and date of order for each order: ________________________________________________ (name of court, case number and date of each order) ________________________________________________ ________________________________________________ ________________________________________________ WHEREFORE, I request the court: A. Dissolve my marriage. B. Equitably divide the property and debts between my spouse and me. C. Restore to me my former name of: ________________________________________________. (former name, including first, middle and last names) D. Grant any further relief that may be just. 3 American LegalNet, Inc. www.FormsWorkflow.com ________________________________ Plaintiff (print name) ________________________________ Signature ________________________________ Street address ________________________________ City, State, ZIP code ________________________________ Telephone number 4 American LegalNet, Inc. www.FormsWorkflow.com