Person Filing: Mailing Address: City, State, Zip: Phone Number: Representing Self SUPERIOR COURT OF ARIZONA, COUNTY OF COCONINO In re the marriage of Petitioner (My spouse) Case Number: DO RESPONSE TO PETITION FOR LEGAL SEPARATION WITH CHILDREN Including Affidavit on Minor Children [ ] Contested Custody (I disagree with the custody Petitioner asked for) Respondent (Me) I STATE THE FOLLOWING UNDER OATH: The Parties and the Marriage: My Spouse's Name: Street Address: City, State, Zip: Birthdate: Phone Number: Job title: Number of months/years in a row to date my spouse has lived in Arizona: If not living in Arizona now, my spouse [ ] lived [ ] did not live in Arizona at some point during our marriage. My Name: Street Address: City, State, Zip: Birthdate: Phone Number: Job title: Number of months/years in a row to date I have lived in Arizona: If not living in Arizona now, I [ ] lived [ ] did not live in Arizona at some point during our marriage. The Marriage: Date of Marriage: City and state or country where we were married: Conciliation: [ ] Yes [ ] No: The conciliation provisions have been met or do not apply. Covenant Marriage: [ ] Yes [ ] No: We have a covenant marriage. If yes, a copy of our marriage license is attached. Page 1 of 12 Revised March 2012 Coconino County Law Library Forms American LegalNet, Inc. www.FormsWorkFlow.com Whether I Object to a Decree of Legal Separation: [] I want a legal separation. [] I do not want a legal separation, but I do want a divorce. [] I do not want a legal separation or divorce because the marriage is not irretrievably broken. Military Service: I am not in military service. Residency: [ ] Yes [ ] No: I and/or my spouse lived in Arizona, or my spouse was stationed in Arizona while a member of the Armed Forces, on the date my spouse filed the Petition. Minor Children of the Marriage: Pregnancy: [ ] Yes [ ] No: Wife is pregnant. Baby is due on [ ] Yes [ ] No: Husband is believed to be the father. Minor Children: The following children, who are under 18 and my and the other party's biological or adopted children together, lived in Arizona for at least the six months before the other party filed the Petition or have lived in Arizona since birth. CHILD'S NAME: Birthdate: Where this child lived, dates lived there, and with whom the child lived, over the last 5 years: Address Dates With whom CHILD'S NAME: Birthdate: Where this child lived, dates lived there, and with whom the child lived, over the last 5 years: Address Dates With whom CHILD'S NAME: Birthdate: Where this child lived, dates lived there, and with whom the child lived, over the last 5 years: Address Dates With whom Page 2 of 12 Revised March 2012 Coconino County Law Library Forms American LegalNet, Inc. www.FormsWorkFlow.com [ ] Yes [ ] No: I have participated, as a party or witness or in any other capacity, in another court case, described below, about the custody or parenting time of a child named above. CHILD'S NAME: Case Number: Court Name: Date of Child Custody Determination: Summary of Any Court Order: CHILD'S NAME: Case Number: Court Name: Date of Child Custody Determination: Summary of Any Court Order: [ ] Yes [ ] No: Another court case, described below, involving a child named above, but not about custody or parenting time, could affect this case. CHILD'S NAME: Case Number: Court Name: The case is about: [ ] child support [ ] enforcement of court orders [ ] domestic violence [ ] a protective order [ ] adoption [ ] terminating parental rights [ ] a criminal matter [ ] other: CHILD'S NAME: Case Number: Court Name: The case is about: [ ] child support [ ] enforcement of court orders [ ] domestic violence [ ] a protective order [ ] adoption [ ] terminating parental rights [ ] a criminal matter [ ] other: [ ] Yes [ ] No: Someone other than me or the other parent has physical custody or claims rights of legal or physical custody or visitation with a child named above, as described below. CHILD'S NAME: Other Person's Name: Other Person's Address: Nature of the Claim: CHILD'S NAME: Other Person's Name: Other Person's Address: Nature of the Claim: Child Support Enforcement: [ ] Yes [ ] No: Arizona Child Support Enforcement has been involved in establishing spousal maintenance for me or the other parent or paternity or child support for any child named above, as described below. If yes, I will deliver a copy of this document to CSE on the day I file it. CHILD'S NAME: Name of court: Court case number: CHILD'S NAME: Name of court: Court case number: Summary of the Differences Between What I Say About the Children and What the Other Party Said In the Petition About the Children: Page 3 of 12 Revised March 2012 Coconino County Law Library Forms American LegalNet, Inc. www.FormsWorkFlow.com General Denial: I deny anything stated in the Petition that I have not specifically admitted or qualified. I ASK THE COURT TO ORDER THE FOLLOWING: Legal Separation: [] [] [] Order that my spouse and I be legally separated. Direct that the Petition be changed to a Petition for Divorce. [ ] Yes [ ] No: My spouse and/or I have lived in Arizona for at least 90 days. Dismiss this case because: [] My spouse and I have a covenant marriage. [] The Petition claims our marriage is irretrievably broken, but it is not. [] Neither I nor my spouse lived in Arizona on the date my spouse filed the Petition. Child Custody: [] I agree with the custody the other party asked for in the Petition. OR [] Joint Custody: Award the parents joint custody of the children as stated in the Joint Custody Agreement we signed. No significant domestic violence has occurred between the parties. Sole Custody: Award [ ] me or [ ] my spouse sole legal custody and physical custody of the children. Joint custody is not in the children's best interest because (you must fill in this blank if you ask for sole custody): [] Parenting Time: [] I agree with the parenting time the other party asked for in the Petition. OR [] Order This Parenting Time Plan: The children will be in Father's care at these times: Page 4 of 12 Revised March 2012 Coconino County Law Library Forms American LegalNet, Inc. www.FormsWorkFlow.com At the start of Father's time with the children, [ ] Mother will drop them off or [ ] Father will at this location: pick them up at this time: The children will be in Mother's care at these times: At the start of Mother's time with the children, [ ] Father will drop them off or [ ] Mother will pick them up at this time: at this l