Name: Mailing Address: Daytime Telephone: Representing Self, Without a Lawyer For Clerk's Use Only IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of 1300DO Petitioner and PETITION FOR DISSOLUTION OF NON-COVENANT MARRIAGE WITHOUT MINOR CHILDREN Respondent STATEMENTS TO THE COURT, UNDER OATH GENERAL INFORMATION: 1. INFORMATION ABOUT ME, THE PETITIONER: Name: Address: Occupation: How long I, the Petitioner, have lived in Arizona: 2. INFORMATION ABOUT MY SPOUSE, THE RESPONDENT: Name: Address: Occupation: How long my spouse, the Respondent, has lived in Arizona: 3. INFORMATION ABOUT OUR MARRIAGE: Date of Marriage: City and state or country where married: [ ] We do not have a covenant marriage. 4. 90-DAY RESIDENCY REQUIREMENT: [ ] I have, and/or [ ] my spouse has, lived or been stationed while a member of the Armed Forces, in Arizona for at least 90 days before my spouse filed this action. (IF THIS STATEMENT IS NOT TRUE, YOU CANNOT FILE FOR DIVORCE UNTIL IT BECOMES TRUE.) years. months. Date of Birth: years. months. Date of Birth: Superior Court of Arizona in Yavapai County January 2013 Page 1 of 7 DRDA10f American LegalNet, Inc. www.FormsWorkFlow.com INFORMATION ABOUT PROPERTY AND DEBTS: 5a. PROPERTY ACQUIRED DURING THE MARRIAGE: (check one box) [] [] My spouse and I did not acquire any community property during the marriage. 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.) HUSBAND WIFE SELL & SPLIT [] DESCRIPTION OF PROPERTY/ VALUE OF PROPERTY: [] Real estate address: Legal Description: [] [] Real estate address: Legal Description: [] [] [] [] Household furniture and appliances: [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] Superior Court of Arizona in Yavapai County January 2013 Page 2 of 7 DRDA10f American LegalNet, Inc. www.FormsWorkFlow.com HUSBAND [] Household furnishings: [ [ [ [ [ [ [ [ [ [ [] Other items: [ [ [ [ [] Pension/retirement fund/profit sharing/stock plan/401K: [ [ [ [ Motor vehicles: Make Model VIN Lien Holder Make Model VIN Lien Holder ] ] ] ] ] ] ] ] ] ] ] ] ] ] WIFE SELL & SPLIT [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] [ [ [ [ ] ] ] ] [ [ [ [ ] ] ] ] ] ] ] ] [ [ [ [ ] ] ] ] [] [] [] [] [] [] [] Superior Court of Arizona in Yavapai County January 2013 Page 3 of 7 DRDA10f American LegalNet, Inc. www.FormsWorkFlow.com 5b. PROPERTY ACQUIRED BEFORE MARRIAGE (Separate Property): (Check all boxes that apply.) [] [] [] [] I do not have any property that I brought into the marriage. My spouse does not have any property that he or she brought into the marriage. I have property that I brought into the marriage. I want this property awarded to me as described it 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.) DESCRIPTION OF PROPERTY/ VALUE OF PROPERTY: HUSBAND [ [ [ [ ] ] ] ] WIFE [ [ [ [ ] ] ] ] 6a. DEBTS INCURRED DURING THE MARRIAGE: (check one box) [ ] My spouse and I did not incur any community debts during the marriage. [ ] We should divide the responsibility for the debts incurred during the marriage as follows: DESCRIPTION OF DEBT/ AMOUNT OF DEBT: HUSBAND [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] WIFE [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] 6b. 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 that should be paid by me as described below: My spouse has separate debt that he or she or incurred prior to the marriage that should be paid by my spouse as described below: [] Superior Court of Arizona in Yavapai County January 2013 Page 4 of 7 DRDA10f American LegalNet, Inc. www.FormsWorkFlow.com DESCRIPTION OF DEBT/ AMOUNT OF DEBT: HUSBAND [ [ [ [ [ ] ] ] ] ] WIFE [ [ [ [ [ ] ] ] ] ] 7. TAX RETURNS: After the Judge or Commissioner signs the Decree of Dissolution of Marriage (Divorce), we will 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. For previous calendar years, both parties will pay and hold the other harmless from half 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 file separate federal and state income tax returns. Each party will give the other party all necessary documentation to do so. [] [] 8. SPOUSAL MAINTENANCE (ALIMONY) (check the box that applies to you): [ ] Neither party is entitled to Spousal Maintenance (alimony), OR [ ] Petitioner OR [ ] Respondent is entitled to Spousal Maintenance because: (Check one or more of the box(es) below that apply. At least one reason must apply to get spousal maintenance.) [] [] [] [] [] Person lacks sufficient property to provide for his or her reasonable needs; Person is unable to support himself or herself through appropriate employment; Person is the legal decision-maker for the 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 or herself; 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 or herself. AND Spousal maintenance shall be modifiable in accordance with Arizona law, OR The parties acknowledge that the circumstances of their futures are unknown, but each desires that this maintenance award not be modifiable in the future for any reason. Therefore, it is ordered at this time that this spousal maintenance award shall not be modifiable for any reason. [] [] 9. PREGNANCY: (check one) [ ] Wife is not pregnant, OR [] Wife is pregnant: Due date [] [] Petitioner is not the parent of the child, OR Respondent is not the parent o