Name: Mailing Address: Daytime Telephone Representing Self, Without a Lawyer IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of DO PETITION FOR ANNULMENT OF NON-COVENANT MARRIAGE Petitioner and WITHOUT MINOR CHILDREN [627] Respondent STATEMENTS TO THE COURT, UNDER OATH GENERAL INFORMATION: 1. INFORMATION ABOUT ME, THE PETITIONER Name: Date of Birth Address: Occupation: How long I, the Petitioner, have lived in Arizona: 2. yrs. mos. INFORMATION ABOUT MY PURPORTED SPOUSE, THE RESPONDENT Name: Date of Birth Address: Occupation: How long my purported spouse, the Respondent, has lived in Arizona: _______ yrs. _______mos. 3. INFORMATION ABOUT OUR PURPORTED MARRIAGE Date of purported marriage: City and state or country where purportedly married: 4. 90-DAY RESIDENCY REQUIREMENT [ ] I have, and/or [ ] my purported spouse has, lived or been stationed while a member of the Armed Forces, in Arizona for at least 90 days before filing this action. (IF THIS STATEMENT IS NOT TRUE, YOU CANNOT FILE FOR ANNULMENT UNTIL IT BECOMES TRUE.) Superior Court of Arizona in Yavapai County September 2007 DRA11f Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com 5a. PROPERTY ACQUIRED DURING THE PURPORTED MARRIAGE [ ] [ ] 5b. My purported spouse and I did not acquire any property during the marriage. My purported spouse and I acquired property during the marriage. PROPERTY ACQUIRED BEFORE PURPORTED MARRIAGE (Check all boxes that apply.) [ ] [ ] My purported spouse did not bring any property into the purported marriage. [ ] I have property that I brought into the purported marriage. [ ] 6a. I do not have any property that I brought into the purported marriage. My purported spouse brought property into the purported marriage. DEBTS INCURRED DURING THE PURPORTED MARRIAGE: (check one box) [ ] [ ] My purported spouse and I did not incur any debts during the purported marriage. My purported spouse and I incurred debts during the purported marriage. We should divide the responsibility for the debts incurred during the purported marriage as follows: DESCRIPTION OF DEBT/ AMOUNT OF DEBT: PETITIONER [ [ [ [ [ [ 6b. ] ] ] ] ] ] RESPONDENT [ [ [ [ [ [ ] ] ] ] ] ] SEPARATE DEBTS. (Check all boxes that apply.) [ ] I do not have any debts that were incurred prior to the purported marriage, [ ] My purported spouse does not have any debts that were incurred prior to the purported marriage. [ ] I have separate debt that I incurred prior to the purported marriage that should be paid as described below: [ ] My purported spouse incurred separate debt prior to the purported marriage that should be paid as described below: DESCRIPTION OF DEBT/ AMOUNT OF DEBT: PETITIONER [ [ [ [ [ Superior Court of Arizona in Yavapai County September 2007 ] ] ] ] ] RESPONDENT [ [ [ [ [ ] ] ] ] ] DRA11f Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com 7. CHILDREN AND PREGNANCY (check one) [ ] [ ] [ ] No children have been conceived of the purported marriage. Purported Wife is not pregnant OR Purported Wife is pregnant: Due date AND purported Husband is not the father of the child. OTHER STATEMENTS TO THE COURT UNDER OATH: You must tell the Court the truth. Lying to the Court is a crime and the Court can punish you for lying. The purported marriage between Petitioner and Respondent was and is void for the following reasons: REQUESTS TO THE COURT: A. ANNULMENT: Annul the parties’ purported marriage. B. PROPERTY: Make a fair division of any property acquired during the purported marriage and confirm ownership of property acquired before purported marriage. C. DEBTS: Order each party to pay debts as requested in this Petition. D. OTHER ORDERS I AM REQUESTING (Explain request here): OATH AND VERIFICATION STATE OF ARIZONA County of ) ) ss I, the Petitioner, being duly sworn and under oath, state that I have read this Petition. All the statements in the Petition are true, correct, and complete to the best of my knowledge and belief. Signature SUBSCRIBED AND SWORN to before me this by day of , 20 , . My Commission Expires: Notary Public Superior Court of Arizona in Yavapai County September 2007 DRA11f Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com