Department Of Health Certificate Of Divorce Dissolution Of Marriage Or Annulment
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Department Of Health Certificate Of Divorce Dissolution Of Marriage Or Annulment Form. This is a District Of Columbia form and can be use in Superior Court Statewide.
Tags: Department Of Health Certificate Of Divorce Dissolution Of Marriage Or Annulment, District Of Columbia Statewide, Superior Court
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GOVERNMENT OF THE DISTRICT OF COLUMBIA
DEPARTMENT OF HEALTH
CERTIFICATE OF DIVORCE,
DISSOLUTION OF MARRIAGE OR ANNULMENT
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TYPE IN
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COURT IDENTIFICATION
(Court File Number)
FILE NUMBER
HUSBAND-NAME
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MIDDLE
LAST
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COUNTY
STATE
DATE OF BIRTH (Mo, Day, Yr)
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WIFE-NAME
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STREET ADDRESS
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CITY, TOWN OR LOCATION
MIDDLE
LAST
MAIDEN NAME
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STREET ADDRESS
CITY, TOWN OR LOCATION
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COUNTY
STATE
DATE OF BIRTH (Mo, Day, Yr)
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DATE OF THIS
MARRIAGE (Mo. Day, Yr.)
CHILDREN UNDER 18 IN THIS FAMILY (Specify)
PLANTIFF
CHECK
HUSBAND
10.
9.
ATTORNEY FOR PLANTIFF-NAME
(Type or Print)
11.
ADDRESS OF ATTORNEY-STREET OR R.F.D. NO.
12.
WIFE
BOTH
OTHER
(Specify)
13.
CITY OR TOWN
STATE
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TYPE OF DECREE
CHECK
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DIVORCE
DISSOLUTION
ANNULMENT
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THIS DECREE IS GRANTED ON (MONTH DAY YEAR.)
ONLY COURT RECORDS CAN INDICATE THE DATE ON
WHICH A DECREE BECOMES FINAL.
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15.
TITLE OF COURT
SUPERIOR COURT OF THE DISTRICT OF COLUMBIA
14.
SIGNATURE OF CERTIFYING OFFICIAL
16.
TITLE OF OFFICIAL
17.
18.
CLERK OF THE COURT
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INFORMATION FOR STATISTICAL PURPOSES ONLY
RACE-HUSBAND
Specify (e.g., White, Black,
American Indian, etc.)
NUMBER OF THIS MARRIAGE
Specify (First, second, etc.)
19.
20.
DHS-1601 (7/97)
WIFE
RACE-WIFE
Specify (e.g., White, Black,
American Indian, etc.)
NUMBER OF THIS MARRIAGE
Specify (First, second, etc.)
21.
22.
THIS CERTIFICATE IS TO BE FILED WITH THE CLERK OF THE COURT WITH THE PETITION
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