IN THE SUPERIOR COURT OF DEKALB COUNTY STATE OF GEORGIA , Civil Action Plaintiff, vs. Case Number , Defendant. FINAL JUDGMENT AND DECREE OF DIVORCE WITH MINOR CHILDREN (WITHOUT SETTLEMENT AGREEMENT) , 20 . The Plaintiff appeared This action came before the Court for trial on pro se. The Defendant G also appeared [or] G did not appear. The Court heard the evidence and considered the matter. Upon consideration of this case, upon evidence submitted as provided by law, it is the judgment of the Court that a total divorce be granted between the parties to this case. It is hereby ordered that the marriage contract entered into between the parties is hereby set aside from this date, and fully dissolved. Plaintiff and Defendant in the future shall be held and considered as separate and distinct persons, altogether unconnected by any nuptial union or civil contract whatsoever, and both shall have the right to remarry. THE COURT HEREBY FINDS THAT the parties have minor children together, who are listed below: Child’s Name Date of Birth Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 1 of 13 American LegalNet, Inc. www.FormsWorkflow.com THE COURT HEREBY ORDERS THE FOLLOWING: 1. CUSTODY [Check and complete only one of these, either (a) or (b). Do not check both (a) and (b).] G (a) The shall have sole temporary and permanent custody of the children. shall have physical custody of the children, and the parties shall have G (b) The joint legal custody of them. The parties shall consult each other and try to reach a joint decision on all major issues concerning the children’s education, health care and religious upbringing. However, if the parties are not able to reach a joint decision concerning one of these major issues, the on the issue. shall make the final decision 2. VISITATION [Check and complete only one of these, either (a), (b) or (c). Do not check more than one.] G (a) The shall have the right of reasonable visitation with the minor children, at any time by mutual consent of the parties, provided that the beginning and ending times of the visitation have been put into writing and signed by both parties before the start of the visitation. In arranging visitation, the parties shall take into consideration the requirements of the children’s school work, their activities, and child care arrangements. Unless otherwise agreed by the parties in writing, the drop-off and pick-up for . The visitation shall be at shall notify the at least 24 hours in advance of any scheduled visitation if he/she does not intend to exercise that visitation opportunity. The shall arrive to pick up the children for visitation within that visitation opportunity. minutes of the scheduled time, or shall lose shall have the right to If the parties cannot agree on specific visitation, the visitation according to the schedule attached to this Final Judgment and Decree as “Exhibit A.” G (b) No visitation is ordered at this time. G (c) The shall have visitation with the minor children as follows: Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 2 of 13 American LegalNet, Inc. www.FormsWorkflow.com 3. OTHER PARENTAL RIGHTS [Check (a) or as many of the others as apply below. Do not check (a) if you check any of the others.] G (a) None of the parental rights listed below in (b) through (d) is ordered at this time. G (b) Addresses and Telephone Numbers — The parties shall provide each other with their current home address and telephone number, as well as a telephone number to call in case of emergency; they shall also notify each other of any change in the address or telephone numbers, at least 30 days prior to the change. G (c) Telephone Communication — Neither party shall do anything to interfere with the children communicating with the other party. Each party shall have the right to call and talk to the children when they are in the care of the other party, up to one time each day, between the hours of p.m. Calls shall be made at the expense of the calling parent. a.m. and G (d) School Information — Both parties shall have equal access to the school records of the children, and both shall have the right to be provided information by the school concerning their children’s progress in school. G (e) Health Information — Each party shall be entitled to complete, detailed information from any physician, dentist or other health care provider attending any of the children. Each party shall notify the other of the children’s major illnesses and medical treatments. 4. CHILD SUPPORT [Check and complete only one of these, either (a) or (b). Do not check both (a) and (b).] G (a) This issue is not addressed in this Final Judgment, either because the Court lacks personal jurisdiction over the Defendant, or because the parties have not asked the Court to decide the issue of child support. G (b) The shall pay to the , for the support of the minor children, the sum of Dollars ($ ) per month, beginning on , 20 . The child support shall continue monthly thereafter until each child reaches the age of eighteen, dies, marries, or otherwise becomes emancipated; except that if a child becomes eighteen years old while enrolled in and attending secondary school on a full-time basis, then the child support shall continue for the child until the child has graduated from secondary school or reaches twenty years of age, whichever occurs first. Continuing Garnishment - Whenever, in violation of the terms of this Judgment, there shall have been a failure to make the support payments, so that the amount unpaid is equal to or greater than the amount payable for one month, the payments required to be made may also be collected by the process of continuing garnishment for support. Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 3 of 13 American LegalNet, Inc. www.FormsWorkflow.com Application of Child Support Guidelines - The Husband’s gross monthly income is $ (before taxes); the Wife’s gross monthly income is $ (before taxes). The applicable percentage of gross income that should be applied under O.C.G.A. § 19-6-15(b) is as follows: One child . . . . . . . . . . . Two children . . . . . . . . Three children . . . . . . . Four children . . . . . . . . Five or more . . . . . . . . . The amount of child support in this Judgment is 17% to 23% 23% to 28% 25% to 32% 29% to 35% 31% to 37% % of the ’s gross monthly income. In reaching this amount of support, the Court has considered the list of special circumstances under the child support guidelines at OCGA §19-6-15. The Court finds that none of these special circumstances exist, except those checked below: 9 9 (1) (2) 9 9 9 9 9 9 9 9 9 9 (3) (4) (5) (6) (7) (8) (9) (10) (11) 9 9 9 (12) 9 9 9 9 (13) (14) (15) (16) 9 9 (17) (18) Ages of the children; A child’s extraordinary medical costs or needs in addition to accident and sickness insurance, or a child’s medical costs or needs, because no insurance is available; Educational costs; Day-care costs; Shared physical custody or extended visitation; A party’s other support obligations to another household; Income that should be imputed to a party because of suppression of income; In-kind income for a party, who is self-employed, such as reimbursed meals or a company car; Other support being provided by a party, such as payment of a mortgage; A party’s extraordinary needs, such as payment of a mortgage; Extreme economic circumstances, including but not limited to: (i) Unusually high debt structure; (ii) Unusually high income of a party (over $75,000 per year); or (iii) Unusually low income of a party (under 125% of the federal poverty level); Historical spending in the family for the children which varies significantly from the percentage table; Considerations of the economic cost-of-living factors of the community of the parties; In-kind contribution of a party; The income of the custodial parent; The cost of accident and sickness insurance coverage for dependant children included in this Agreement; Extraordinary travel expenses to exercise visitation or shared physical custody; The following factor which the parties believe should be considered in order to be fair and just: (19) . No special circumstances apply in this case. G Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 4 of 13 American LegalNet, Inc. www.FormsWorkflow.com 5. INCOME DEDUCTION ORDER [Check and complete only one of these, either (a), (b) or (c). Do not check more than one.] G (a) No Income Deduction Order shall be entered, because the Court does not have personal jurisdiction over the Defendant. G (b) An Income Deduction Order shall be entered by the Court, under OCGA § 19-6-32, for payment of the child support and alimony (if any) provided in this Judgment. The Income Deduction Order shall take effect: [To finish (b), you must check and complete either (1) or (2). Do not check both.] G (1) immediately. G (2) upon accrual of a delinquency equal to one month’s support. The Income Deduction Order may be enforced by serving a “Notice of Delinquency,” as provided in OCGA § 19-6-32 (f). G (c) The Court finds that there is good cause not to enter an immediate Income Deduction Order because, as provided in OCGA § 19-6-32(a.1)(1)(A), it would not be in the best interests of the parties’ children and any previously ordered child support has been paid in a timely manner, or because the parties have agreed in writing that an Income Deduction Order is not immediately necessary. 6. HEALTH INSURANCE FOR CHILDREN [Check and complete either (a), (b) or (c); or both (b) and (c) together. Do not check (a) if you check either (b) or (c).] G (a) This issue is not addressed in this Final Judgment, either because the Court lacks personal jurisdiction over the Defendant, or because neither party has asked the Court to address the issue of health insurance in this action. G (b) The shall maintain a policy of medical, dental and hospitalization insurance for the benefit of the minor children, until each child reaches the age of eighteen, dies, marries, or otherwise becomes emancipated; except that if a child becomes eighteen years old while enrolled in and attending secondary school on a full-time basis, then the insurance shall continue for the child until the child has graduated from secondary school or reaches twenty years of age, whichever occurs first. The shall provide the with an insurance identification card or such other acceptable proof of insurance coverage and shall cooperate with the submitting claims under the policy. All money received by the processed under the insurance policy shall be paid to the service provider within five (5) days of the G (c) The in for claims or to the applicable health care receiving the money. shall provide verification of the amount paid for the children’s share of the cost of medical, dental and hospitalization insurance. The for shall reimburse the % of the cost within fifteen (15) days after receiving the verification. Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 5 of 13 American LegalNet, Inc. www.FormsWorkflow.com 7. OTHER HEALTH CARE EXPENSES FOR THE CHILDREN [Check and complete either (a), (b) or (c). Do not check more than one.] G (a) This issue is not addressed in this Final Judgment, either because the Court lacks personal jurisdiction over the Defendant, or because neither party has asked the Court to address the issue of the children’s health care expenses in this action. G (b) The shall be responsible for all expenses incurred for the children’s health care (including medical, dental, mental health and hospital care) that are not covered by insurance. The shall provide verification to the incurred for the children’s health care. The of amounts paid or shall reimburse the or pay the health care provider directly within fifteen (15) days after receiving the verification of a particular health care expense. G (c) The shall pay % and the shall pay % of all expenses incurred for the children’s health care (including medical, dental, mental health and hospital care) that are not covered by insurance. The party who incurs a health care expense for one of the children shall provide verification of the amount to the other party. That other party shall reimburse the incurring party (or pay the health care provider directly) for the appropriate percentage of the expense, within fifteen (15) days after receiving the verification of a particular health care expense. 8. LIFE INSURANCE FOR THE BENEFIT OF THE CHILDREN [Check and complete either (a), (b) or (c). Do not check more than one.] G (a) This issue is not addressed in this Final Judgment, either because the Court lacks personal jurisdiction over the Defendant, or because neither party has asked the Court to address the issue of life insurance for the benefit of the children in this action. G (b) The children depend on the for financial support, and therefore the shall maintain a policy of insurance on his/her life, with a face amount of at least $ , for the benefit of the minor children. The policy shall be maintained for so long as at least one of the children is a minor or is otherwise entitled to support under this Final Judgment. G (c) The children depend on both of the parties for financial support, and therefore each party shall maintain a policy of insurance on his/her life, with a face amount of at least $ , for the benefit of the minor children. Both policies shall be maintained for so long as at least one of the children is a minor or is otherwise entitled to support under this Final Judgment. Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 6 of 13 American LegalNet, Inc. www.FormsWorkflow.com 9. ALIMONY. [Check and complete only one of these, either (a), (b) or (c). Do not check more than one.] G (a) This issue is not addressed in this Final Judgment, either because the Court lacks personal jurisdiction over the Defendant, or because neither party has asked the Court to address the issue of alimony in this action. G (b) The shall pay to the Dollars ($ as alimony, the sum of ) per month, beginning on , and continuing monthly thereafter, [To finish (b), you must check and complete either (1) or (2). Do not check both (1) and (2)] G (1) until the recipient remarries or dies. G (2) for a period of . G (c) Neither party is entitled to receive alimony from the other party. 10. PROPERTY DIVISION. [Check and complete either (a), (b) or (c). Do not check more than one.] G (a) This issue is not addressed because the Court does not have personal jurisdiction over the Defendant. G (b) The parties have already made a division of their marital property, including any real estate, vehicles, household furniture, furnishings, household goods, equipment, bank accounts, pensions and other personal property. Neither party shall claim any of the property in the possession of the other party as of the date of this Final Judgment. G (c) The parties possess various items of marital property, which shall be divided as provided in this Final Judgment. The parties shall transfer possession and title to their property as follows: [If you have chosen (c), check and complete only the parts that apply, from (1) through (4) below.] G (1) Marital Home - The marital home of the parties, located at the following address: legal description on the deed to the property: Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society , which has the following Page 7 of 13 American LegalNet, Inc. www.FormsWorkflow.com shall be conveyed to the in fee simple. The shall be responsible for all taxes, assessments and mortgage loan payments on the home after the date of . [If you have chosen and completed the preceding paragraph (1), concerning a marital home, you may also check and complete (A) or (B), or both (A) and (B), but neither one is required.] G (A) The shall have a lien against the home in the amount of Dollars ($ ). Upon the sale or transfer of the home, the lien shall be paid. G (B) The shall immediately begin making reasonable efforts to refinance the outstanding mortgage/mortgages on the marital home, so that the shall no longer be liable on the mortgage loan(s). If the is not able to refinance by , 20 , the home shall then be listed for sale at a reasonable price, and all reasonable offers to purchase the home shall be accepted until sold. G (2) Mobile Home - The parties’ mobile home, which is described as a , with Vehicle Identification Number (VIN) of transferred to the . The payments on the mobile home after the date of shall be shall be responsible for all loan . G (3) Vehicles - The vehicles owned by the parties shall be transferred or retained as follows: Year/Make/Model of Vehicle Vehicle ID # (VIN) Goes to The party listed above for each vehicle shall be responsible for all car loan payments, ad valorem taxes, registration fees and insurance on that vehicle accruing after the following date: . G (4) Other Personal Property - The parties own various other items of personal property, which shall be transferred to the party listed below (on the following page), on or before , 20 . Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 8 of 13 American LegalNet, Inc. www.FormsWorkflow.com To the Wife To the Husband Except as otherwise specifically provided in this Final Judgment, the transfers listed above shall , and each party shall execute all documents be completed no later than necessary to promptly complete the transfer. Upon the failure of either party to execute and deliver any deed or other document necessary to complete the transfers required by this Final Judgment, this Judgment shall constitute and operate as the properly executed document. The county auditor, county recorder, Department of Motor Vehicles, and all other public and private officials are authorized and directed to accept this Judgment or a properly certified copy of it in lieu of the document regularly required for the conveyance or transfer. Except as provided in this Judgment, the parties have divided their marital property, including any real estate, vehicles, household furniture, furnishings, household goods, equipment, bank accounts, pensions and other personal property. Neither party shall claim any of the property in the possession of the other party as of the date of this Final Judgment, except as provided in this Final Judgment. 11. DEBTS. [Check and complete either (a), (b) or (c). Do not check more than one.] G (a) This issue is not addressed in this Final Judgment because the Court does not have personal jurisdiction over the Defendant G (b) The parties have no outstanding joint or marital debts. Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 9 of 13 American LegalNet, Inc. www.FormsWorkflow.com G (c) The responsibility for payment of the parties’ joint and marital debts shall be as follows: Creditor Amount Responsible Party $ $ $ $ $ $ $ The responsible party listed above for each debt shall hold the other party harmless for any collections on that debt. If legal action is brought against the other party to recover that debt, the responsible party shall indemnify or hold the other party harmless and, in addition, to pay all attorney’s fees and costs of collection which the other party may incur as a result of the legal action. 12. BANKRUPTCY CONSTRUCTION OF THIS JUDGMENT The Court finds that, but for the payments and transfers provided in this Final Judgment, the receiving party’s financial independence would be impaired. Therefore, it is the Court’s intention that if either party ever seeks bankruptcy protection, the amounts payable under this Agreement should not be dischargeable in bankruptcy under 11 United States Code Section 523(a)(5), as the payments are in the nature of spousal or child support and maintenance. Alternatively, the payments should be nondischargeable in bankruptcy under 11 United States Code Section 523(a)(15). 13. RESTRAINING ORDER (Check and complete (a) or (b) below. Do not check both.) G (a) No permanent restraining order is entered in this action. G (b) The shall be permanently restrained and enjoined from assaulting, beating, wounding, threatening, harassing and stalking the . This provision shall be enforceable by the Court’s contempt power. G 14. RESTORATION OF NAME (Optional — Check and complete only if applicable.) The Wife’s former name of Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society shall be restored. Page 10 of 13 American LegalNet, Inc. www.FormsWorkflow.com G 15. OTHER SPECIAL PROVISION (Optional — Check and complete only if applicable.) This decree entered on , 20 . JUDGE DeKalb County Superior Court Stone Mountain Judicial Circuit pro se Final decree with child w-o agree Rev 3-06.wpd Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 11 of 13 American LegalNet, Inc. www.FormsWorkflow.com “Exhibit A” - Visitation Schedule If the parties cannot agree on specific visitation, the shall have the right to visitation according to the schedule below. To resolve any conflicts in the visitation provided under this schedule, the holiday visitation provided under paragraph (b) shall have priority over the weekend and summer visitation in paragraphs (a) and (c). (a) Weekends — The first and third weekends of every month, from Friday at 6:00 p.m. until Sunday at 6:00 p.m. The first and third weekends shall be defined as the weekends containing the first and third Fridays of the month. [NOTE: When filling out the Holiday section, please check only one preference and be careful not to check the same years for both parents. For example, if you check Even-number years for Father to have Spring vacation, then you should not also check Even-number years for Mother to have Spring vacation.] (b) Holidays — The children shall spend holidays with each parent on the following schedule: Holiday With Father With Mother Spring vacation, from 6:00 p.m. on the day school lets out for vacation, until 6:00 p.m. on the day before the children return to school. If none of the children is enrolled in school, this vacation shall be for up to one week (seven consecutive days) during the months of March or April; provided that the visiting parent shall give written notice of the chosen week to the other parent at least 30 days prior to the beginning of this visitation. 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years Easter weekend, 6:00 p.m. Friday to 6:00 Sunday, provided that it does not conflict with Spring vacation above. 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years Mother’s Day, from 9:00 a.m. to 6:00 p.m. Not applicable Every year Memorial Day weekend, 6:00 p.m. Friday to 6:00 p.m. Monday 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years Father’s Day, from 9:00 a.m. to 6:00 p.m. Every year Not applicable Fourth of July, from 10:00 a.m. to 10:00 p.m. 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years Labor Day weekend, 6:00 p.m. Friday to 6:00 p.m. Monday 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years Final Decree of Divorce With Children — rev. 3/8/06 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society Page 12 of 13 American LegalNet, Inc. www.FormsWorkflow.com Holiday With Father With Mother Thanksgiving weekend, 6:00 p.m. Wednesday to 6:00 p.m. Sunday 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years First part of Christmas vacation, from 6:00 on the day school lets out for vacation, until 12:00 noon on December 25th. If none of the children is enrolled in school, this visitation shall be from 6:00 p.m. on December 20th until 12:00 noon on December 25th. 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years Latter part of Christmas vacation, from 12:00 noon on December 25th to 6:00 p.m. on the day before the children return to school. If none of the children is enrolled in school, this visitation shall be from 12:00 noon on December 25th until 6:00 p.m. on January 1st. 9 Even-number years 9 Odd-number years 9 Odd-number years 9 Even-number years (c) Summer Vacation — weeks during the children’s summer vacation from school. However, if none of the children is enrolled in school, this summer visitation shall be taken during the months of June, July and August, until such time as one of the children begins to attend school. The weeks may be taken consecutively or non-consecutively, but shall be taken in increments of at least seven (7) consecutive days. The parent with visitation shall give written notice of the chosen weeks to the other parent on or before March 1st (so that both parties will have ample time to make camp and child care arrangements for the summer). Final Decree of Divorce With Children — rev. 3/8/06 Page 13 of 13 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society American LegalNet, Inc. www.FormsWorkflow.com