Page 1 of 8 DR-100 (5/19)(cs) AS 25.24.200-.260 PETITION FOR DISSOLUTION OF MARRIAGE (NO MINOR CHILDREN) Civil Rule 90.1(a), f(2)(A)-(B), (i)(1) IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT In the Matter of the Dissolution ) of the Marriage of ) ) ) ) CASE NO. ) Party B. ) PETITION FOR DISSOLUTION ) OF MARRIAGE (NO MINOR CHILDREN) We consent to the court's jurisdiction and request a decree of dissolution of marriage. Our marriage has broken down and we no longer want to be married. We agree this petition is the entire agreement Has either spouse filed an action for legal separation before filing this action? Yes No If yes, please list the case number, date, and place of filing: A. Children 1.Do you have any children (currently under age 19) born or adopted during your marriage? Yes No 2.Do you have any children together (currently under age 19) from before your marriage? Yes 3.Is one of you now pregnant? Yes No If you checked "yes" in response to any of the above questions, you should not use this form. You must use Packet No. 1 unless paternity has been legally disestablished. (If it has been, attach to this petition a copy of the documentation disestablishing paternity.) 1.Length of residence in Alaska: 2.Residence address: (street address) (city) (state) (zip) 3.Home phone:Cell phone: 4.Mailing address: (box or street number) (city) (state) (zip) 5.Email Address*: * I authorize the court to email me court documents in this case to the email address above. 6.Occupation: Work phone: 7.Most recent employer: Print or Signature of Party A Signature of Party B American LegalNet, Inc. www.FormsWorkFlow.com AS 25.24.200-.260 Page 2 of 8 DR-100 ()(cs) PETITION FOR DISSOLUTION OF MARRIAGE (NO MINOR CHILDREN) Civil Rule 90.1(a), f(2)(A)-(B), (i)(1) C. Party B 1.Length of residence in Alaska: 2.Residence address: (street address) (city) (state) (zip) 3.Home phone:Cell phone: 4.Mailing address: (box or street number) (city) (state) (zip) 5.Email Address*: * I authorize the court to email me court documents in this case to the email address above.6.Occupation: Work phone: 7.Most recent employer: D. Date and Place of Marriage. Date of marriage: Place of marriage: (city and state): E. Health Care and Health Insurance Does either spouse need medical care or treatment? Yes No If yes, state which spouse and describe the care or treatment needed: Is either spouse covered by health insurance (through an employer or otherwise)? Yes No If yes, state which spouse and the amount paid for the insurance by the spouse or spouses: F. Domestic Violence Has either spouse been involved in any of the following during the marriage: 1.a criminal charge of a crime involving domestic violence,2.a domestic violence protective order under AS 18.66.100 - 18.66.180,3.injunctive relief against domestic violence under former AS 25.35.010 or 25.35.020, or4.a domestic violence protective order issued in another jurisdiction and filed with the courtin this state under AS 18.66.140? Yes No If yes, describe below: Has there been any domestic violence during the marriage (whether or not the police were involved or anything was filed in court)? Yes No G. Has either spouse received advice from an attorney about divorce or dissolution? Yes No If yes, state which spouse(s): Is either spouse represented by an attorney? Yes No If yes, state which spouse(s): Signature of Party A Signature of Party B American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 8 AS 25.24.200-.260 DR-100 ()(cs)PETITION FOR DISSOLUTION OF MARRIAGE (NO MINOR CHILDREN) Civil Rule 90.1(a), f(2)(A)-(B), (i)(1) II.FINANCIAL INFORMATIONEach party must attach a copy of their most recent federal tax return, W2, and at least tworecent paystubs. If work is seasonal, show yearly income. If income or deductions will changeafter the dissolution, file documents showing expected income and deductions. The followingincome and deductions are monthly yearly.A.Income (Do not list ATAP or SSI below.) Party A Party B Gross wages $ $ Value of employer - provided housing/food/etc. 1 $ $ Unemployment compensation $ $ Permanent fund dividend (PFD) $ $ Other: $ $ $ $ TOTAL INCOME $ $ B. Deductions Allowable Under Civil Rule 90.3 Federal, state and local income tax $ $ Social security tax (FICA) or self - employment tax $ $ Medicare tax $ $ Employment security tax (SUI) $ $ Mandatory retirement contributions $ $ Mandatory union dues $ $ Voluntary retirement contributions if plan earnings are tax - free or deferred, up to 7.5% of gross wages & self - employ. income when combined with mand . contrib. $ $ Other mandatory deductions (specify): $ $ A limony ordered in other cases and currently paid 2 $ $ Child support ordered for prior children 3 $ $ In - kind support for prior children 4 $ $ Health insurance for parent (limited to 10% of wages) 5 $ $ TOTAL DEDUCTIONS $ $ C. Net Income TOTAL INCOME from section A $ $ TOTAL DEDUCTIONS from section B $ $ Subtract deductions from income to get NET INCOME $ $ Signature of Party A Signature of Party B 1 This also includes COLA, military BAH, and BAS. 2 Includes spousal support ordered in other cases and currently paid. 3 4 For more information, see Prior Child Deduction Chart and Civil Rule 90.3(a)(1)(D). 5 This deduction cannot be more than 10% of gross wages and self-employment income (90.3(a)(1)(F)). American LegalNet, Inc. www.FormsWorkFlow.com Page 4 of 8 DR-100 ((cs)PETITION FOR DISSOLUTION OF MARRIAGE (NO MINOR CHILDREN) AS 25.24.200-.260 Civil Rule 90.1(a), f(2)(A)(B), (i)(1) D. Monthly Expenses Party A Party B Housing and u tilities $ $ Food $ $ Transportation $ $ Medical $ $ Other $ $ $ $ $ $ E. BANKRUPTCY. Party A Party B filed for bankruptcy and that case is pending. III. PROPERTY AND DEBT INFORMATION, AND AGREEMENT OF Below is a list of our assets and debts, and our agreement about dividing our assets and debts.We believe the division below is fair and just. A. Assets[Describe all your property and its value. Then check the boxes showing whether it was acquired during the marriage, who possesses it now, and to whom you want it awarded.] 1.Do you have a written community property agreement or a community property trustunder Alaska law (AS 34.77)? Yes No Include this property in the lists below. 2. Real Property (land and buildings) Acquired During Marriage Currently Possessed By To Be Awarded To provide s treet address or le gal desc ription Value yes no A B JT A B JT * $ $ $ $ [Note: An award of real property to the parties jointly does not convey a right of survivorship. Consult an attorney with concerns about your right of survivorship. AS 13.12.804(a)(2).] *For jointly awarded real property at address: a. We will sell the property and split any profit with % to Party A and % to Party B. Until the property is sold, Party A Party B will make all payments and decisions about the property, and will be will not be reimbursed from sale proceeds before any profit is paid. b. One of us will buy the other out. Party A Party B will buy the other interest in the property in an amount equal to % of the fair market value. We also agree that the amount of this payment will be $ or we will have a licensed appraiser or real estate broker determine the We will select the appraiser or broker together. c. Other: Use separate sheets for other real property to be awarded jointly. Print or Type Signature of Party A Signature of Party B American LegalNet, Inc. www.FormsWorkFlow.com Page 5 of 8 DR-100 ((cs)PETITION FOR DISSOLUTION OF MARRIAGE (NO MINOR CHILDREN) AS 25.24.200-.260 Civil Rule 90.1(a), f(2)(A)(B), (i)(1) 3. Motor Vehicles (include make, model, license or reg . number, & / or vehicle ID number, for each vehicle, mobile home, ATV, boat , snow machine, etc. ) Acquired During Marriage Currently Possessed By To Be Awarded To Value yes no A B JT A B JT $ $ $ $ $ $ $ $ 4. OtherPersonal Property (furniture, appliances,jewelry, computers, guns, tools, bank accounts,etc.) For bank or other financialaccounts, youmay list the last 3 digits of theaccount numberand the name of financialinstitution. Acquired During Marriage Currently Possessed By To Be Awarded To Value yes no A B JT A B JT $ $ $ $ $ $ $