JDF 1257 R 5 - 1 4 DECREE OF DISSOLUTION OR LEGAL SEPARATION OF CIVIL UNION Page 1 of 2 District Court County, Colorado Court Address: In re the Civil Union of: Petitioner: and Co - Petitioner/Respondent: COURT USE ONLY Case Number: Division Courtroom DECREE OF DISSOLUTION OF CIVIL UNION OR LEGAL SEPARATION OF CIVIL UNION This matter was reviewed by the Court on (date). Petitioner Co - Petitioner Respondent Appeared in person Appeared in person Did not appear Signed a Non - Appearance Affidavit Signed a Non - Appearance Affidavit Was represented by an attorney Attorney Name: Was represented by an attorney Attorney Name: The Court has read the Non - Appea rance Affidavit. The Court has considered the testimony and evidence presented. The Court has considered any Financial Statements filed and makes the following findings and orders: 1. The Court has jurisdiction over the parties because: The parties filed jointly on (date). The Respondent (name) was served with a Summons on (date) in (county). The Respondent signed a waiver of service on (date). The Court has subject - matter jurisdiction based on publication on (date). Other jurisdiction . 2. At least one party was domiciled in Colorado for more than 91 days before the Petition was filed Neither party currently resides in Colorado, however, the civil union was obtained in Colorado. 3. At least 91 days have passed since the Court acquired jurisdiction over the Co - Petitioner or Respondent or since the Court acquired jurisdiction ove r the subject matter based on publication. 4. The civil union between the parties is irretrievably broken. 5. The Separation Agreement between the parties is found to be not unconscionable as to support, maintenance (partner support) , and division of property , and is incorporated herein. 6. All provisions in the Parenting Plan regarding the children are in the best interests of the children, including residence, allocation of parental responsibility (including decision - making responsibilities and parenting t ime), and any other orders necessary to effectuate the best interests of the children. American LegalNet, Inc. www.FormsWorkFlow.com JDF 1257 R 5 - 1 4 DECREE OF DISSOLUTION OR LEGAL SEPARATION OF CIVIL UNION Page 2 of 2 7. The name change request is not detrimental to any person. The Court therefore o rders : The civil union is dissolved and a Decree of Dissolution of Civil Union is entered. A Decree of Legal Separation of Civil Union is entered. Either party may apply to convert this decree to a Decree of Dissolution of Civil Union after 182 days has passed and the other party has been given written notice of the request. Each pa rty shall perform all of the applicable provisions of the separation agreement or permanent orders. The Separation Agreement (Civil Union) filed on (date) is incorporated into this Decree. or The Parenting Plan (Civil Union) filed on (date) is incorporated into this Decree. or It is in the best interests of the parties that the Court has entered a Decree, even though there are no permanent orders on this date. or Permanent orders are set forth below: Any Support Order entered will become part of this Decree. A Protection/Restraining Order was issued on (date). The Protection/Restraining Order is: Vacated. Continued to (date) pursuant to 24713 - 14 - 10 6(1)(c) , C.R.S. No changes have been made to the existing Protection/Restraining Order Changes have been made to the existing Protection/Restraining Order, as follows. If the Protection Order has been modified, the party requesting the modification must serve a copy of the modified Temporary or Permanent Protection Order, as applicable, on the other party. The is granted a resto ration of the prior name . Other: Date: Judge Magistrate American LegalNet, Inc. www.FormsWorkFlow.com