Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Lawyer's Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR FOR CLERK'S USE ONLY Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Regarding the Marriage of Case Number: (if divorce, separation, or annulment already filed) Petitioner PETITION FOR CONCILIATION COURT SERVICES Respondent *if divorce, separation, or annulment already filed, list Petitioner and Respondent as they appear on Petition in that case. Name of Judge assigned to your divorce, separation or annulment case (if applicable) I, 1. 2. 3. 4. 5. , respectfully state to the court: A controversy or disagreement exists between my spouse and me. The help of the court is requested to effect reconciliation or an amicable settlement of the controversy. I fully understand that this Petition may not be withdrawn from Conciliation Court Services until the minimum required conferences have been concluded, or until the court ends the proceedings. To the best of my knowledge, there is OR case pending between my spouse and myself. A Petition for Conciliation Court Services by either spouse in the last year. is not an annulment, legal separation, or divorce has not been previously filed in this court has OR My present address and telephone number is: Street Address: City, State, Zip Code Telephone Number: � Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PCO DRADC14f-120414 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case No. 6. My spouse's present address and telephone number is: Street Address: City, State, Zip Code Telephone Number: 7. The names and ages of each minor child, including any stepchildren, whose welfare may be affected by the controversy between my spouse and me are: (Use additional sheets of paper if necessary.) Name and Age: Name and Age: Name and Age: Name and Age: Name and Age: OR There are no minor children whose welfare might be affected by the results of the controversy between my spouse and me. I believe we may be able to reconcile (stay or get back together and continue the marriage) or achieve an amicable adjustment of the controversy. Do you or the other party need an interpreter? Yes No 8. 9. If yes, for what language?___________________________________ RELIEF REQUESTED. Therefore, I request that the parties be ordered to attend Conciliation Court Services in an effort to effect a reconciliation of the spouses, or an amicable settlement of the controversies involved. Today's Date: Your Signature Your attorney's name, address and telephone number: (if applicable) Attorney's Name: Address: City, State, Zip Code: Telephone Number: Your spouse's attorney's name, address, and telephone number: (if applicable) Attorney's Name: Address: City, State, Zip Code: Telephone Number: � Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PCO DRADC14f-120414 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com