Name of Person Filing: Your Address: Your City, State, Zip Code: Your Telephone Number: ATLAS Number (if applicable): Attorney Bar Number (if applicable): Self (Without Attorney) OR Representing Attorney for Petitioner OR Respondent FOR CLERK’S USE ONLY SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case Number: (Name of Petitioner) PETITION FOR DISSOLUTION OF A NON-COVENANT MARRIAGE (DIVORCE) -- WITH MINOR CHILDREN (Name of Respondent) STATEMENTS TO THE COURT, UNDER OATH OR AFFIRMATION: 1. INFORMATION ABOUT ME, THE PETITIONER: Name: Address: Date of Birth: Job Title: Starting with today number of months/years in a row, you, the Petitioner, have lived in Arizona: 2. INFORMATION ABOUT, MY SPOUSE, THE RESPONDENT: Name: Address: Date of Birth: Job Title: Starting with today number of months/years in a row the Respondent, has lived in Arizona: 3. INFORMATION ABOUT MY MARRIAGE: Date of Marriage: City and state or country where we were married: The following statements MUST BE TRUE for you to use this document and to qualify for divorce in Arizona AND you must check the boxes to indicate that the statements are true or your case may not proceed. We do not have a covenant marriage (If not sure, refer to the INSTRUCTIONS for information). Our marriage is broken beyond repair (“irretrievably broken”) and there is no hope of reconciliation. We have tried to resolve our problems through Conciliation Services or going to Conciliation Services would not work. This court has jurisdiction to decide child custody matters under Arizona law. 4. 90 DAY REQUIREMENT: (This statement MUST be true before you can file for divorce in Arizona.) I OR my spouse have lived in Arizona or have been stationed in Arizona while a member of the Armed Forces, for at least 90 days before I filed this action. 5. DOMESTIC VIOLENCE: (If you intend to ask for joint custody, there must have been no significant domestic violence in your marriage. A.R.S. 25-403.03. Check the box to make a true statement: Significant domestic violence has or has not occurred during this marriage. ©Superior Court of Arizona in Maricopa County July 17, 2008 ALL RIGHTS RESERVED COM DRDC15f Page 1 of 7 Use only most current version American LegalNet, Inc. www.FormsWorkflow.com Case No. 6. CHILDREN OF THE PARTIES WHO ARE LESS THAN 18 YEARS OLD (check one box): There are no children under the age of 18 either born to, or adopted by, the parties. NOTE: IF YOU CHECKED THIS BOX, STOP. YOU SHOULD BE USING THE PETITION PACKET TO GET A DIVORCE WITHOUT CHILDREN. The following child(ren) are under age 18 and were born to or adopted by my spouse and me: (Attach extra pages if necessary). Child’s Name: Birthdate: Address: Length of Time at Address: Child’s Name: Birthdate: Address: Length of Time at Address: Child’s Name: Birthdate: Address: Length of Time at Address: Child’s Name: Birthdate: Address: Length of Time at Address: 7. PREGNANCY and PATERNITY: (check one box) Wife is not pregnant, OR Wife is pregnant The baby is due on (date), (and, check one box below): The Petitioner and Respondent are the parents of the child, OR Petitioner is not the parent of the child, OR. Respondent is not the parent of the child. A minor child or minor children was/were born before the marriage. The husband is the father of that minor child / those minor children named below: 8.a. COMMUNITY PROPERTY: (check one box) My spouse and I did not acquire any community property during the marriage, OR My spouse and I acquired community property during our marriage, and we should divide it as follows: Petitioner Respondent Value Real estate located at: $ Legal Description: (Quote from the DEED) ©Superior Court of Arizona in Maricopa County July 18, 2008 ALL RIGHTS RESERVED COM DRDC15f Page 2 of 7 Use most current version American LegalNet, Inc. www.FormsWorkflow.com Case No. Petitioner Respondent Value Real estate located at: $ Legal Description: (Quote from the DEED) Household furniture and appliances: Petitioner Respondent Value $ $ $ $ $ Household furnishings: Petitioner Respondent Value $ $ $ $ $ $ Other items: Petitioner Respondent Pension/retirement fund/profit sharing/stock plan/401K: Petitioner Respondent Motor vehicles: Petitioner Respondent Make Year: Model VIN _______________________ Lien Holder_____________________ ©Superior Court of Arizona in Maricopa County July 18, 2008 ALL RIGHTS RESERVED COM Year: Value $ $ $ $ Value $ Petitioner Respondent Make Model VIN Lien Holder Value $ $ $ $ Value $ DRDC15f Page 3 of 7 Use most current version American LegalNet, Inc. www.FormsWorkflow.com Case No. 8.b. SEPARATE PROPERTY: (Check all boxes that apply.) I do not have any property that I brought into the marriage or separate property. My spouse, the Respondent does not have any property that he or she brought into the marriage or separate property. I have property that I brought into the marriage or I have separate property. I want this property awarded to me as described below. My spouse, the Respondent, has property that he or she brought into the marriage or has separate property. I want this property awarded to my spouse as described below. Separate Property: (On the next page, list the property and the value of the property, and check the box to tell the Court who should get the property.) Description of Separate Property 9.a. Petitioner Respondent Value $ $ $ $ COMMUNITY DEBTS: (check one box) My spouse and I did not incur any community debts during the marriage, OR We should divide the responsibility for the debts incurred during the marriage as follows: DESCRIPTION OF DEBT 9.b. Petitioner Respondent Amount Owed $ $ $ $ $ $ SEPARATE DEBTS: (Check all boxes that apply.) My spouse and I do not have any debts that were incurred prior to the marriage or separate debt; I have separate debt or debt that I incurred prior to the marriage that should be paid by me as described below; My spouse has separate debt or debt that he or she incurred prior to the marriage that should be paid by my spouse as described below. DESCRIPTION OF DEBT 10. Petitioner Respondent Amount Owed $ $ $ TAX RETURNS: (Check this box if this is what you want). After the judge or commissioner signs the Decree of Dissolution of Marriage (Divorce), we will, subject to IRS Rules and Regulations, pay federal and state taxes as follows: For previous years (the years we were married, not including the year the Decree was signed), the parties will file joint federal and state income tax returns. In addition, for previous calendar years, both parties will pay, and hold the other harmless from,1/2 of all additional income taxes if any and other costs, and each will share equally in any refunds. For the calendar year (the year that the Decree is signed) and all future calendar years, each party will, subject to IRS Rules and Regulations, file separate federal and state income tax returns. Each party will give the other party all necessary documentation to do so. ©Superior Court of Arizona in Maricopa County July 18, 2008 ALL RIGHTS RESERVED COM DRDC15f Page 4 of 7 Use most current version American LegalNet, Inc. www.FormsWorkflow.com Case No. 11. SPOUSAL MAINTENANCE/SUPPORT (ALIMONY) (check the box that applies to you): Neither party is entitled to spousal maintenance/support (alimony), OR Petitioner OR Respondent is entitled to spousal maintenance/support because: (Check one or more of the box(es) on the next page that apply. At least one reason must apply to get spousal maintenance/ support.) Person lacks sufficient property to provide for his/her reasonable needs; Person is unable to support himself/herself through appropriate employment; Person is the custodian of a child(ren) whose age or condition is such that the person should not be required to seek employment outside the home; Person lacks earning ability in the labor market adequate to support himself/herself; and Person contributed to the educational opportunities of the other spouse or had a marriage of long duration and is now of an age that precludes the possibility of gaining employment adequate to support himself/herself. 12. WRITTEN CUSTODY AGREEMENT: (Check the boxes that apply, if they apply) My spouse and I have a written agreement signed by both of us about the custody, parenting time and child support for our minor child(ren). I have attached a copy of the written agreement. REQUESTS TO THE COURT: A. DISSOLUTION (DIVORCE): Dissolve our marriage and return each party to the status of a single person; NAMES: I took the name of my spouse at the time of marriage and I want to restore my last name to the name I used before this marriage or to my maiden name. My complete married name is: I want my name restored to: (List complete maiden or legal name before this marriage): WARNING: If you are not the person who is requesting to have your former name restored, the court must have a written request from the party who wants his or her name restored to change the name. B. PATERNITY and MINOR CHILD(REN)’S NAMES: Declare the husband to be the father of the following named minor child(ren) born before the marriage and (optional) change the legal name of those minor children to the name listed on the right, below : Current Legal Name (OPTIONAL) Change the name of the child to: New Name ©Superior Court of Arizona in Maricopa County July 18, 2008 ALL RIGHTS RESERVED COM DRDC15f Page 5 of 7 Use most current version American LegalNet, Inc. www.FormsWorkflow.com Case No. C. CHILD CUSTODY AND PARENTING TIME: Award custody and parenting time of the children under the age of 18 years and common to the parties, whether by birth or adoption, as follows: (Check either the sole custody box or the joint custody box. If you check the sole custody box, check only one box related to visitation.) C.1. SOLE CUSTODY of the minor child(ren) awarded to subject to parenting time as follows: Petitioner OR Respondent, Reasonable Parenting time rights to the parent not having custody, as will be described in the Parenting Plan attached to the Divorce Decree. Supervised Parenting time between the minor children and the Petitioner OR Respondent is in the best interest of the minor children because: (Explain the reasons for need for supervised visitation. Use extra paper if necessary.) Name of the person who will supervise: Requested restrictions on parenting time: (explain here) The cost of supervised parent/child access will be paid by the parent being supervised; the parent having custody; shared equally by the parties. No parenting time rights to the parent not having custody is in the best interests of the child(ren) because: (Explain the reasons for no parenting time. Use extra paper if necessary): C.2. OR JOINT CUSTODY: Petitioner and Respondent agree to act as joint custodians of the minor child(ren) as set forth in the Joint Custody Agreement signed by the parties, if the court agrees with the Joint Custody Agreement. (For joint custody, there must have been no “significant” domestic violence in your marriage. A.R.S. 25-303.03) D. CHILD SUPPORT: Order that child support will be paid by: E. MEDICAL, DENTAL, VISION CARE FOR MINOR CHILDREN: Order that Petitioner, OR Respondent in a reasonable amount as determined by the court under the Arizona Child Support Guidelines. Support payments will begin on the first day of the first month following the entry of the divorce decree. These payments, and a fee for handling, will be paid through the Support Payment Clearinghouse and collected by automatic wage assignment. Petitioner is responsible for providing: Respondent is responsible for providing: medical medical dental dental vision care insurance. vision care insurance. Petitioner and Respondent will pay for all reasonable unreimbursed medical, dental, and health-related expenses incurred for the child(ren) in proportion to their respective incomes. ©Superior Court of Arizona in Maricopa County July 18, 2008 ALL RIGHTS RESERVED COM DRDC15f Page 6 of 7 Use most current version American LegalNet, Inc. www.FormsWorkflow.com Case No. F. TAX EXEMPTION: The parties will claim the children as income tax dependency exemptions on federal and state income tax returns as follows: Parent entitled to claim Petitioner Respondent Petitioner Respondent Petitioner Respondent Petitioner Respondent Name of minor child Current tax year Later tax years G. SPOUSAL MAINTENANCE (ALIMONY): H. COMMUNITY PROPERTY: Make a fair division of all community property. I. COMMUNITY DEBTS: Order each party to pay community debts as requested in the Petition, and to Order spousal support to be paid by Petitioner, or Respondent in the amount of per month beginning with the first day of the month after the Judicial Officer signs the Decree and continuing until the person receiving spousal maintenance remarries or either party is deceased, or for a period of months. These payments, and a fee for handling, will be paid through the Support Payment Clearinghouse. pay any other community debts unknown to the other party. Order each party to pay and hold the other party harmless from debts incurred by him/her since the parties separation on or the date the Respondent was served with the Petition for Dissolution. J. SEPARATE PROPERTY and DEBT: Award each party his/her separate property and make each party pay his/her own separate debt. K. OTHER ORDERS I AM REQUESTING (Explain request here): OATH OR AFFIRMATION AND VERIFICATION I swear or affirm that the information on this document is true and correct under penalty of perjury. Signature Date Sworn to or Affirmed before me this: by (date) Printed Name Seal/My Commission Expires: Deputy Clerk or Notary Public ©Superior Court of Arizona in Maricopa County July 18, 2008 ALL RIGHTS RESERVED COM DRDC15f Page 7 of 7 Use most current version American LegalNet, Inc. www.FormsWorkflow.com