Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Lawyer222s Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA MARICOPA COUNTY Case Number: Name of Petitioner / Party A PETITION FOR LEGAL SEPARATION AND WITHOUT MINOR CHILDREN Name of Respondent / Party B STATEMENTS MADE TO THE COURT, UNDER OATH: GENERAL INFORMATION: 1. INFORMATION ABOUT ME, Name: Address: Date of Birth: Job Title: I have lived in Arizona for years and/or months in a row. 2. INFORMATION ABOUT, MY SPOUSE Name: Address: Date of Birth: Job Title: My spouse has lived in Arizona for years and/or months in a row. FOR CLERK222S USE ONLY 251 Superior Court of Arizona in Maricopa County Page 1 of 7 DRLSA10f-080318 ALL RIGHTS RESERVED Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com Case No. 3. INFORMATION ABOUT MY MARRIAGE: Date of Marriage: City and state, or country where we were married: 4. RESIDENCY REQUIREMENT: When I file this document with the Court, either I or my spouse live, or are stationed while a member of the Armed Forces, in Arizona. (WARNING: If this statement is not true, you cannot file for legal separation until it becomes true.) 5. DESIRE TO LIVE SEPARATE AND APART. My marriage is irretrievably broken (my marriage is over) or I and/or my spouse desire to live separate and apart. (This must be a true statement or you cannot file for a Petition for Legal Separation.) 6. PREGNANCY. (Mark the box if it is true) Party A IS NOT pregnant, OR Party B IS NOT pregnant, OR Party A IS pregnant, OR Party B IS pregnant The baby is due on (date), (and, check one box below): Party A and Party B ARE the parents of the child, OR Party A or Party B IS NOT the parent of the child, OR 7. SPOUSAL MAINTENANCE/SUPPORT (ALIMONY). (Check the boxes that apply to you): Neither party is entitled to Spousal Maintenance/Support (alimony), OR Party A OR Party B is entitled to Spousal Maintenance/Support because: (Check one or more of the box(es) below that apply. At least one reason must apply to get spousal maintenance/support.) Person lacks sufficient property to provide for his or her reasonable needs; Person is unable to support him or herself through appropriate employment; Person lacks earning ability in the labor market adequate to support himself or herself; Person made a significant financial or other contribution to the education, training, vocational skills, career, or earning ability of the other spouse; Person had a marriage of long duration, and is now of an age that precludes the possibility of gaining employment adequate to be self-sufficient; and/or Person has significantly reduced that spouse222s income or career opportunities for the benefit of the other spouse. 251 Superior Court of Arizona in Maricopa County Page 2 of 7 DRLSA10f 080318 ALL RIGHTS RESERVED Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com Case No. INFORMATION ABOUT PROPERTY AND DEBTS: 8(a) PROPERTY ACQUIRED DURING THE MARRIAGE: (Check one box) My spouse and I did not acquire community property during the marriage, OR My spouse and I acquired community property during our marriage, and we should divide it as follows: (List the property and the value of the property, and check the box to tell the Court who should get the property.) WARNING: You must be specific. You must describe the property that should go to you and then check the box, and describe the property that should go to your spouse, and check the box. For example, under household furnishing you could say, blue and white living room sofa, and then check the box to say whether it should go to you or to your spouse. Never list an item and then check both Party A box and Party B box. DESCRIPTION OF PROPERTY / VALUE OF PROPERTY: (Party A) (Party B) Value Real estate at: $ Legal Description: Real estate at: $ Legal Description: Household furniture and appliances: (Party A) (Party B) Value $ $ $ $ (Party A) (Party B) Value Household furnishings: $ $ $ $ $ $ 251 Superior Court of Arizona in Maricopa County Page 3 of 7 DRLSA10f 080318 ALL RIGHTS RESERVED Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com Case No. (Party A) (Party B) Value Other items: $ $ $ $ Pension/retirement fund/profit sharing/stock plan/401K: (Party A) (Party B) Value $ $ $ Motor vehicles: (Party A) (Party B) Value Make $ Model Year VIN Lien Holder Make $ Model Year VIN . Lien Holder . 8(b) PROPERTY ACQUIRED BEFORE MARRIAGE. (Check all boxes that apply.) I do not have any property that I brought into the marriage (separate property). My spouse, does not have any property that he or she brought into the marriage. (Separate property). I have property that I brought into the marriage (Separate property). I want this property awarded to me as described below. My spouse, has property that he or she brought into the marriage. I want this property awarded to my spouse as described below. Separate Property: (List the property and the value of the property, and check the box to tell the Court who should get the property.) 251 Superior Court of Arizona in Maricopa County Page 4 of 7 DRLSA10f 080318 ALL RIGHTS RESERVED Use only most current version . American LegalNet, Inc. www.FormsWorkFlow.com Case No. DESCRIPTION OF PROPERTY / VALUE OF PROPERTY: (Party A) (Party B) Value $ $ $ $ 9(a) DEBTS INCURRED DURING THE MARRIAGE: (check one box) My spouse and I did not incur any community debts during the marriage, OR We should divide the responsibility for the community debts incurred during the marriage as follows: DESCRIPTION OF DEBT/ AMOUNT OF DEBT: (Party A) (Party B) Amount $ $ $ $ $ $ 9(b) SEPARATE DEBTS. (Check all boxes that apply.) My spouse and I do not have any debts that were incurred prior to the marriage, OR I have separate debt that I incurred prior to the marriage which should be paid by me as described below: My spouse has separate debt that he or she incurred prior to the marriage which should be paid by my spouse as described below: DESCRIPTION OF DEBT (Party A) (Party B) AMOUNT OF DEBT: $ $ $ $ 251 Superior Court of Arizona in Maricopa County Page 5 of 7 DRLSA10f 080318 ALL RIGHTS RESERVED Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com Case No. 10. TAX RETURNS: (Check the box if it 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 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. For previous years (the years we were married, not including the year the Decree was signed), (check one box) The parties will file joint federal and state income tax returns. 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. OR The parties will file separate federal and state income tax returns. For previous calendar years, each party will pay and hold the other harmless from any income taxes and/or incurred as a result of the filing of that party222s tax return and each party will be awarded 100% of any refund received as a result of the filing of that party222s tax return. 11. WRITTEN AGREEMENT. CHECK ONLY IF TRUE: My spouse and I have a written agreement signed by both of us about the maintenance of a spouse, and division of property/debt, and I have attached a copy of the written agreement. 12. CONCILIATION REQUIREMENTS. The conciliation requirements under Arizona law either do not apply or have been met. (This statement must be true or you cannot file a Petition for Legal Separation. If you do not understand this section, read the instructions that go with this Petition.) REQUESTS TO THE COURT: A. LEGAL SEPARATION: An order of legal separation. B. SPOUSAL MAINTENANCE/SUPPORT (ALIMONY