Name: ___________________________________ Address: _________________________________ City, State, ZIP: ____________________________ Daytime Telephone No: ______________________ Representing Self, Without a Lawyer ARIZONA SUPERIOR COURT, PIMA COUNTY ______________________________________ Case No. _________________ Petitioner/Plaintiff and PETITION FOR CONCILIATION ______________________________________ Respondent/Defendant The PETITIONER herein respectfully represents to the Judge of Conciliation Services as follows: 1. A controversy exists between the above-named parties, and the aid of the Conciliation Court is requested to effect a reconciliation or an amicable settlement of such controversy. 2. The name and age of each minor child whose welfare is affected by the controversy is as follows: NAME ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ AGE __________________ __________________ __________________ __________________ 3. To the best of my knowledge, there IS or IS NOT a Family Law case (Annulment, Legal Separation, or Dissolution of Marriage) pending between the spouses. (If there is such an action pending, give the county and case number of the case and state whether you are the Petitioner or the Respondent in that action). County:_________________ Case Number: ______________________ I am the Petitioner Respondent in that action. 4. A Petition for Conciliation 5. My present address and telephone number is. HAS or HAS NOT been filed previously in this Court by either spouse. ____________________________________ APT. ______ ____________________________________ ZIP ________ 6. Home Telephone No. ___________ Work Telephone No. ____________ My spouse's present address and telephone number is: ____________________________________ APT. ______ ____________________________________ ZIP ________ 1 Home Telephone No. ___________ Work Telephone No. ____________ conciliation–petition.form Revised 01.02.08 American LegalNet, Inc. www.FormsWorkflow.com 7. The name and address of other persons who have a relationship to the controversy, and who are named as respondents herein are: ________________________________________________ ____________________________________ APT. _______ ____________________________________ ZIP ________ Home Telephone No. ___________ Work Telephone No. ____________ ________________________________________________ ____________________________________ APT. _______ ____________________________________ ZIP ________ Home Telephone No. ___________ Work Telephone No. ____________ THEREFORE, I ask this court to make such orders in respect to the conduct of the spouses and the subject matter of the controversy as the Court deems necessary and proper to effect a reconciliation of the spouses, or an amicable settlement of the controversies involved. _____________________________ Date _______________________________________________ (Your Signature) Your attorney name, address, telephone: ____________________________________________________________ _____________________________________________________________________________________________ Your spouse's attorney name, address, telephone: ____________________________________________________ _____________________________________________________________________________________________ 2 conciliation–petition.form Revised 01.02.08 American LegalNet, Inc. www.FormsWorkflow.com