Name: Mailing Address: Daytime Telephone ATLAS #: Representing Self, Without a Lawyer IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of DO RESPONSE TO PETITION FOR LEGAL SEPARATION OF NON-COVENANT MARRIAGE WITH MINOR CHILDREN Petitioner and and Response to Request for Order of Paternity [640] Respondent STATEMENTS TO THE COURT, UNDER OATH 1. INFORMATION ABOUT MY SPOUSE, THE PETITIONER Name: Date of Birth Address: Occupation: yrs. How long your spouse, the Petitioner, has lived in Arizona: [ ] 2. The Petitioner is enlisted in the military, and [ ] has OR been deployed for at least one day during the past 6 months. INFORMATION ABOUT ME, THE RESPONDENT Name: Address: Occupation: How long you, the Respondent, have lived in Arizona: [ ] mos. [ ] has not Date of Birth yrs. The Respondent is enlisted in the military, and [ ] has OR been deployed for at least one day during the past 6 months. 3. [ ] has not INFORMATION ABOUT OUR MARRIAGE Date of Marriage: City and state or country where married: [ ] We do not have a covenant marriage. 4. mos. ABOUT THE LEGAL SEPARATION [ ] I want to be legally separated from my spouse, OR [ ] I do not want to be legally separated from my spouse because my marriage is over Superior Court of Arizona in Yavapai County 9/07 Page 1 of 12 American LegalNet, Inc. www.FormsWorkflow.com and I want to be divorced. 5. RESIDENCY REQUIREMENT [ ] I live, and/or [ ] my spouse lives or is stationed while a member of the Armed Forces, in Arizona at the time I file this Petition. 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.) DESCRIPTION OF PROPERTY/ VALUE OF PROPERTY: HUSBAND WIFE [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ Real estate address: SELL & SPLIT Legal Description: Real estate address: Legal Description: [ ] Household furniture and appliances: Superior Court of Arizona in Yavapai County 9/07 ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] Page 2 of 12 American LegalNet, Inc. www.FormsWorkflow.com HUSBAND [ ] WIFE SELL & SPLIT Household furnishings: [ [ [ [ [ [ [ [ [ [ ] [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] [ [ [ [ ] ] ] ] [ [ [ [ ] ] ] ] ] ] ] ] [ [ [ [ ] ] ] ] Other items: Pension/retirement fund/profit sharing/ stock plan/401K: Motor vehicles: Make Model VIN Lien Holder [ ] [ ] [ ] [ ] Make Model VIN Lien Holder 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 below. Superior Court of Arizona in Yavapai County 9/07 Page 3 of 12 American LegalNet, Inc. www.FormsWorkflow.com [ ] 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 ] ] ] ] ] [ [ [ [ [ 5c. SUMMARY OF WHAT I, THE RESPONDENT, ASK FOR ON PROPERTY THAT IS DIFFERENT FROM WHAT MY SPOUSE ASKED FOR IN THE PETITION. (Summarize what is different between your plan for division of property and what your spouse asked for in the Petition.) 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 [ [ [ [ [ [ 6b. ] ] ] ] ] ] WIFE [ [ [ [ [ [ ] ] ] ] ] ] 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 9/07 Page 4 of 12 American LegalNet, Inc. www.FormsWorkflow.com DESCRIPTION OF DEBT/ AMOUNT OF DEBT: HUSBAND [ [ [ [ WIFE ] ] ] ] [ [ [ [ ] ] ] ] 6c. SUMMARY OF WHAT I, THE RESPONDENT, ASK FOR ON DEBTS THAT IS DIFFERENT FROM WHAT MY SPOUSE ASKED FOR IN THE PETITION. (Summarize what is different between your plan for division of debt and what your spouse asked for in the Petition.) 7. TAX RETURNS: (Check this box if this is what you want). After the Judge or Commissioner signs the Decree of Legal Separation, we will pay federal and state taxes as follows: [ ] [ ] For previous calendar years, both parties will pay and hold the other harmless from ½ of all additional income taxes if any and other costs, and each will share equally in any refunds. [ ] 8a. 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 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. 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 custodian of a 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; Superior Court of Arizona in Yavapai County 9/07 Page 5 of 12 American LegalNet, Inc. www.FormsWorkflow.com [ ] 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. 8b. SUMMARY OF WHAT I WANT REGARDING SPOUSAL MAINTENANCE THAT IS DIFFERENT FROM WHAT MY SPOUSE ASKED FOR IN THE PETITION. 9. CHILD(REN) OF THE PARTIES WHO ARE LESS THAN 18 YEARS OLD The following child(ren) are under age 18 and were born during the marriage or adopted by me and my spouse: (Attach extra pages if necessary). Child’s Name Birth date Address Length of time at address Names and addresses of persons lived with for the past five (5) years Present addresses of person(s) lived with [ ] The [ ] Petitioner parent OR [ ] Respondent is not the biological or adoptive Child’s Name Birth date Address Length of time at address Names and addresses of persons lived with for the past five (5) years Present addresses of person(s) lived with [ ] The [ ] Petitioner parent OR Superior Court of Arizona in Yavapai County 9/07 [ ] Respondent is not the biological or adoptive Page 6 of 12 American LegalNet, Inc. www.FormsWorkflow.com The following child(ren) are under age 18 and were born prior to the marriage and are common to me and my spouse: (Attach extra pages if necessary). Child’s Name Birth date Address Length of time at address: Names and addresses of persons lived with for the past five (5) years Present addresses of person(s) lived with [ ] The [ ] Petitioner OR [ ] Respondent is not the biological or adoptive parent 10. CUSTODY OR PARENTING TIME CASES INVOLVING THE MINOR CHILD(REN): [ ] I HAVE [ ] I HAVE NOT been a party or a witness in court, in this state or any other state, involving the custody or parenting time of any child(ren) named above. (If so, explain below, using extra pages if necessary.) Name of child: Court state Court location Court case number Status How the child is involved: Summary of any court order: 11. PENDING/PAST CASES RELATED TO MINOR CHILD(REN): (check one box) [ ] I DO [ ] I DO NOT know of any court case, in this state or any other state, that could affect this case, including enforcement, domestic violence, protective orders, drugs, sex offenses, termination of parental rights and adoptions. (If so, explain below, using extra pages if necessary. Court state Court case number Nature of the proceeding: Date of Conviction 12. Court location Status CUSTODY OR PARENTING TIME CLAIMS OF ANY OTHER PERSON: (Check one box) [ ] I KNOW [ ] I DO NOT KNOW the name and address of any person, other than the Petitioner or the Respondent, who has physical custody of the child(ren) or claims rights of legal custody, physical custody or parenting time of any child(ren) named above. (If so, explain below, using extra pages if necessary.) Name of each child: Name of person with the claim: Address of person with the claim: Nature of the claim: Superior Court of Arizona in Yavapai County 9/07 Page 7 of 12 American LegalNet, Inc. www.FormsWorkflow.com 13. PREGNANCY (check one) [ ] Wife is not pregnant OR [ ] Wife is pregnant: Due date [ ] AND, (check one box below): The Petitioner and Respondent are the parents of the child OR [ ] [ ] 14. Petitioner is not the parent of the child OR Respondent is not the parent of the child. WRITTEN AGREEMENTS. CHECK ONLY IF TRUE: [ ] For our child(ren), my spouse and I have a written agreement signed by both of us about: [ ] Custody; [ ] Parenting time; [ ] Child support. [ ] [ ] My spouse and I have a written agreement unrelated to the child(ren) and signed by both of us about I am filing the ORIGINAL Agreement. 15. [ ] The Attorney General's office is involved in this case (TANF, IV-D, etc.) 16. SUMMARY OF WHAT I SAY ABOUT OUR CHILD(REN) THAT IS DIFFERENT FROM WHAT MY SPOUSE ASKED FOR IN THE PETITION. (Summarize what is different between what you say about the child(ren), and what your spouse said in the Petition.) OTHER STATEMENTS TO THE COURT UNDER OATH: Check what your position is on each statement, and explain your answer when asked to do so: 17. CONCILIATION: (Check only one box). [ ] The conciliation requirements under Arizona law, A.R.S. § 25-381.09 either do not apply or have been met OR [ ] I do not want to leave separately and apart and there are reasonable prospects of reconciliation. The conciliation requirements under Arizona law, A.R.S. § 25-381.09 either apply or have not been met. Explain to the court why you disagree: [ ] I AM FILING A PETITION FOR CONCILIATION. 18. CHILD CUSTODY JURISDICTION. (Check only one box). [ ] This court has jurisdiction to decide child custody matters under Arizona law because the child(ren) has/have lived in Arizona for at least 6 months before the Petition was Superior Court of Arizona in Yavapai County 9/07 Page 8 of 12 American LegalNet, Inc. www.FormsWorkflow.com filed. [ ] 19. This court does not have jurisdiction to decide child custody matters under Arizona law because the child(ren) has/have not lived in Arizona for at least 6 months before this Petition was filed. Explain: (There are other reasons why the court may not have jurisdiction due to the residence of the child(ren). See a lawyer for help.) GENERAL DENIAL. I deny anything stated in the Petition that I have not specifically admitted, qualified or denied. REQUESTS TO THE COURT: (Check the boxes you want.) A. REGARDING LEGAL SEPARATION: [ ] [ ] Change this case to a divorce case because my marriage is over. [ ] B. Legally separate the parties; Legally separate the parties, but refuse to decide child custody matters due to lack of jurisdiction as stated in Paragraph 20 above. SPOUSAL MAINTENANCE (ALIMONY): [ ] Neither party shall pay spousal maintenance (alimony) to the other party, OR [ ] Petitioner OR [ ] Respondent is ordered to pay the other party the sum of $ per month spousal maintenance BEGINNING AFTER THE Decree is signed. Each payment shall be made by the first day of each month thereafter and shall continue until [ ] the receiving party is remarried or deceased OR [ ] until (date) . All payments shall be made through the Clerk of the Court by automatic wage assignment until all required payments have been made under the Decree. Payments made shall be included in receiving spouse's taxable income and are tax deductible from the paying spouse's income as required by law. [ ] In accordance with the parties' agreements, [ ] The spousal maintenance award shall be modifiable in accordance with Arizona law, OR [ ] The spousal maintenance award shall NOT be modifiable for any reason. [ ] D. Make a fair division of all community property as requested in this Response. COMMUNITY DEBTS: [ ] Order each party to pay community debts as requested in the Petition, and to pay any other community debts unknown to the other party. Order each party to pay and hold the other party harmless from debts incurred by him or her since the parties separation on . Superior Court of Arizona in Yavapai County 9/07 Page 9 of 12 American LegalNet, Inc. www.FormsWorkflow.com E. SEPARATE PROPERTY: [ ] Award each party his or her separate property. F1. PATERNITY: Order that is is not the natural father of the child(ren) named above, born prior to the marriage of the parties. Current legal name F2. Change legal name to: CHILD CUSTODY AND VISITATION: Award custody and visitation of the minor child(ren) common to the parties as follows: [ ] SOLE CUSTODY: Sole custody of the minor child(ren) awarded to [ ] Petitioner or [ ] Respondent subject to parenting time for the noncustodial parent as follows: 1. [ ] 2. 3. [ ] [ ] Reasonable parenting time pursuant to the Yavapai County Child Access Guidelines; Reasonable parenting time pursuant to the attached Parenting Plan; Supervised parenting time. Supervised parenting time is in the best interest(s) of the child(ren) because unrestricted parenting time would seriously endanger the child(ren)'s physical, mental, moral or emotional health. These facts support my claim: [ ] [ ] 4. Name of person who will supervise The cost of supervised parenting time shall be paid by [ ] Petitioner OR [ ] Respondent OR [ ] shared equally. [ ] No parenting time: (check and explain ONLY if you want the other party to have no parenting time): No parenting time between the child(ren) and the other party is in the best interests of the child(ren) because any parenting time would seriously endanger the child(ren)'s physical, mental, moral or emotional health. These facts support my claim: OR [ ] JOINT CUSTODY: Petitioner and Respondent agree to act as joint custodians of the minor child(ren) as set forth in the Joint Custody Agreement. (A Joint Custody Agreement signed by both parents must be attached) AND [ ] OR [ ] Domestic violence has not occurred during this relationship; Domestic violence has not been significant. However, domestic violence has occurred as described in the Petition for Order of Superior Court of Arizona in Yavapai County September 2007 Page 10 of 12 DRLSC31f American LegalNet, Inc. www.FormsWorkflow.com Protection(s) filed below: OR [ ] or as described Joint custody is in the best interest of the child(ren) even though domestic violence has occurred because Furthermore, the [ ] Petitioner AND/OR [ ] Respondent has/have taken classes, participated in counseling or taken steps to avoid further domestic violence as described below: G. CHILD SUPPORT: Support payments will begin on following the entry of the Legal Separation Decree. These payments, and a fee for handling, will be paid through the Clerk of the Court/Clearinghouse and collected by automatic wage assignment. [ ] [ ] Order that child support shall be paid by [ ] Petitioner OR [ ] Respondent in a reasonable amount as determined by the Court under the Arizona Child Support Guidelines and according to the Parent’s Worksheet, which shall be filed with this Petition. OR Order that child support be paid in an amount that deviates from the Guidelines because: [ ] Application of the Guidelines is inappropriate or unjust because [ ] The parties have signed a written agreement free of duress and coercion with knowledge of the amount of support that would have been ordered by the Guidelines but for the agreement. A copy of the agreement is attached. H. INSURANCE AND HEALTH CARE EXPENSES FOR CHILD(REN): Order that [ ] Petitioner [ ] Respondent pay for the health, medical, and dental insurance coverage for the minor child(ren) common to the parties. Petitioner and Respondent will pay for all reasonable unreimbursed medical, dental, and health-related expenses incurred for the child(ren) in proportion to their respective incomes as described in the Parents' Worksheet. I. TAX EXEMPTION: The parties will claim the child(ren) as income tax dependency exemptions on federal and state income tax returns and as allowed by federal and state tax laws as follows: Parent entitled to claim [ ] Mother [ ] Father [ ] Mother [ ] Father [ ] Mother [ ] Father [ ] Mother [ ] Father Superior Court of Arizona in Yavapai County September 2007 Name of child Page 11 of 12 Current tax year Later tax years DRLSC31f American LegalNet, Inc. www.FormsWorkflow.com J. OTHER ORDERS I AM REQUESTING (Explain request here): OATH AND VERIFICATION STATE OF County of ) ) ss I, the Respondent, being duly sworn and under oath, state that I have read this Response. All the statements in the Response are true, correct, and complete to the best of my knowledge and belief. Signature SUBSCRIBED AND SWORN to before me this 20 day of __ , by My Commission Expires: , . Notary Public Copy mailed, hand-delivered or faxed this date to the person named below and at the address below: Date By: Superior Court of Arizona in Yavapai County September 2007 Page 12 of 12 DRLSC31f American LegalNet, Inc. www.FormsWorkflow.com