For Clerk's Use Only Name of Person Filing: _______________________________________ Mailing Address: _______________________________________ City, State, Zip Code: _______________________________________ Day/Evening Phone Number: ____________________________________ Evening Phone Number: _______________________________________ ATLAS Number (if applicable): ___________________________________ Attorney Bar Number (if applicable): ______________________________ Self (Without Attorney) or Representing: Attorney for: Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case Number:_______________________ (Name of Petitioner) AND NOTICE REGARDING CREDITORS ____________________________________ (Name of Respondent) ARIZONA STATE LAW REQUIRES all actions for DIVORCE or LEGAL SEPARATION to include this NOTICE and for the person filing for Divorce or Legal Separation to SERVE this NOTICE on the other party. (ARS 25-318(F).) YOU AND YOUR SPOUSE ARE RESPONSIBLE FOR COMMUNITY DEBTS. The court usually requires/orders one spouse or the other to pay certain community debts in, or through, the Decree of Dissolution or Legal Separation. A court order that does this is binding on the spouses only, not the creditors. You and your spouse are legally responsible for these community debts whether you are married, divorced, or legally separated. These debts are matters of contract between both of you and your creditors (such as banks, credit unions, credit card companies, utility companies, medical providers and retailers). On request, the court may impose a lien against the separate property of a spouse to secure payment of certain community debts. CONTACT CREDITORS: You may want to contact your creditors to discuss the debts and the effects of your divorce/legal separation on your debts. To assist you in identifying your creditors, you may obtain a copy of your spouse's credit report by making a written request to the court for an order requiring a credit reporting agency to release the report to you. The credit report will help you identify accounts, account numbers and account balances. In addition, within thirty (30) days after receipt of a request from a spouse who is party to a divorce or legal separation, which includes the court and case number of the action, creditors are required, by law, to provide information as to the balance and account status of any debts for which you or your spouse may be liable to the creditor. WARNING: If you do not understand this notice, you should contact an attorney for advice about your legal rights and obligations. The following page contains a sample form you may choose to mail to creditors to get information about debts owed by you or your spouse. It is not a required form. DO NOT FILE THE ATTACHED FORM WITH THE COURT. Revised: 11/8/2010 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com REQUEST FOR ACCOUNT INFORMATION FROM CREDITORS You may use this form to request information about debt owed by you or your spouse. If so, send to the creditor. DO NOT FILE THIS PAGE WITH THE COURT. DATE: _______________________________ CREDITOR'S NAME: ________________________________________________________________ CREDITOR'S ADDRESS: _____________________________________________________________ Regarding: Superior Court of Arizona Mohave County Case Name: _____________________________________________________ Case Number: ____________________________________________________ Pursuant to Arizona State Law (ARS 25-318), this letter requests the balance and account status of any debt for which the following individuals may be liable to you. (Arizona law requires that you provide this information within thirty (30) days of receipt of this letter.) INFORMATION ABOUT DEBTORS/SPOUSES: Your Name: __________________________________________________________________________ Your Address: ________________________________________________________________________ ________________________________________________________________________ Your Phone Number: ___________________________________________________________________ Your Spouse's Name: ________________________________________________________________ ______________________________________________________________ Your Spouse's Address: INFORMATION ABOUT THE ACCOUNT: Account Number(s): ____________________________________________________________________ If you have any questions or if I can be of further assistance, please feel free to contact me. Sincerely, Your name: ___________________________________________________________________________ Your signature: ________________________________________________________________________ Revised: 11/8/2010 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com