JDF 1260 R7/13 ORDER TO CONVERT DECREE OF LEGAL SEPARATION OF CIVIL UNION TO DECREE OF DISSOLUTION OF CIVIL UNION 251 2013 Colorado Judicial Department for use in the Courts of Colorado District Court County, Colorado Court Address: In re the Civil Union of: Petitioner: and Co - Petitioner/Respondent: COURT USE ONLY Case Number: Division Courtroom ORDER TO CONVERT DECREE OF LEGAL SEPARATION OF CIVIL UNION TO DECREE OF DISSOLUTION OF CIVIL UNION This matter comes before this Court on the Co-) Motion to Convert Decree of Legal Separation of Civil Union to Decree of Dissolution of Civil Union pursuant to Colorado Revised Statutes 24714-10-120(2) and 24714-15-107(4). The Court has reviewed the file and considered the Motion, and any response filed. The Court, being fully advised, finds and orders the following: 1. The Court entered a Decree of Legal Separation of Civil Union in this case on (date). 2. At least 182 days have passed since the entry of the Decree of Legal Separation of Civil Union. 3. Proper notice of the Motion to Convert Decree of Legal Separation of Civil Union to Decree of Dissolution of Civil Union was given to the other party. 4. The Motion is GRANTED. 5. The terms of any Court approved separation agreement, parenting plan, and/or support order are hereby incorporated into this Decree of Dissolution of Civil Union. 6. The request to restore name is not detrimental to any person. The Petitioner Co-Petitioner/Respondent is granted a restoration of the prior name . Date: Judge Magistrate CERTIFICATE OF MAILING I certify that on (date), I mailed/faxed/handed this Order to the following: Petitioner Co-Petitioner/Respondent Co-Petitioner Clerk American LegalNet, Inc. www.FormsWorkFlow.com