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Affidavit Of Plaintiff For Uncontested Divorce Form. This is a Hawaii form and can be use in Family Court Statewide.
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Tags: Affidavit Of Plaintiff For Uncontested Divorce, Hawaii Statewide, Family Court
STATE OF HAWAI‘I
FAMILY COURT
_________ CIRCUIT
CASE NUMBER
AFFIDAVIT OF PLAINTIFF
(FOR UNCONTESTED DIVORCE)
FC-D NO.
This document is prepared by
u
PLAINTIFF
(Your Full Name)
Plaintiff
u
Atty. for Plaintiff
_________________________________________________
Name
_________________________________________________
VS.
_________________________________________________
Address
_________________________________________________
DEFENDANT
(Your Spouse’s Full Name)
STATE OF HAWAI‘I
CITY AND COUNTY OF HONOLULU
)
)
)
City, State, Zip
_________________________________________________
Phone
SS.
Plaintiff in the above-entitled action, being first duly sworn on oath, deposes and says that:
1. Plaintiff’s full name and address is:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
2. Legal Representation:
2a. u Plaintiff is representing him/herself.
2b. u Plaintiff is represented by the attorney named above.
3. Service of process on Defendant was made by:
3a. u Personal Service: A Proof of Service or Affidavit of Service has been filed showing that the Defendant
was personally served with the Complaint and Summons on _______________________ by a person
(Mo/Day/Yr)
authorized to serve of legal documents.
3b. u Certified or Registered Mail: The Complaint and Summons was served upon Defendant by certified or
registered mail. A Statement of Mailing or Affidavit of Mailing and an original return receipt signed by the
Defendant on ________________ have been filed. Plaintiff recognizes Defendant’s signature on the return
(Mo/Day/Yr)
receipt.
3c. u Appearance and Waiver: Defendant acknowledged receipt of a filed copy of the Complaint and Summons
and signed an Appearance and Waiver on ______________________. Plaintiff recognizes Defendant’s
(Mo/Day/Yr)
signature on the Appearance and Waiver.
3d. u Publication: The Affidavit of Publication was filed on _________________.
(Mo/Day/Yr)
4. u Default.
4a. u More than twenty (20) days have passed since the service of the Complaint
and Summons on the Defendant. No responsive pleading has been filed.
Neither Plaintiff nor Plaintiff’s attorney has received any communication
from Defendant or Defendant’s attorney concerning this case since the Complaint was served.
4b. u An order granting the Motion for Entry of Default was filed
on___________________.
(Mo/Day/Yr)
12/98
AFFIDAVIT OF PLAINTIFF (UDA) 1F-P-333
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STATE OF HAWAI‘I
FAMILY COURT
________ CIRCUIT
AFFIDAVIT OF PLAINTIFF
(FOR UNCONTESTED DIVORCE)
PAGE TWO
CASE NUMBER
FC-D NO.
5. Jurisdiction: (Check all that apply)
5a. u Plaintiff had been domiciled or physically present on the Island of O‘ahu for a continuous period of at least
3 months prior to the filing of the Complaint for Divorce.
5b. u Plaintiff had been domiciled or physically present in the State of Hawai‘i for a continuous period of at least
6 months prior to the filing of the Complaint for Divorce.
5c. u Defendant had been domiciled or physically present in the State of Hawai‘i for a continuous period of at
least 6 months prior to the filing of the Complaint for Divorce.
6. Defendant resides in (city, state) _______________________________ , _______________________________ .
(City)
(State)
7. The parties were married on _______________________________ .
(Mo/Day/Yr)
8. The parties last lived together in (city, state) ___________________________ , ________________________ on
(City)
(State)
_____________________________________ .
(Mo/Day/Yr)
9. Plaintiff believes that the marriage is irretrievably broken because:
__________________________________________________________________________________________
__________________________________________________________________________________________
10. Financial statements:
10a. Plaintiff signed Income and Expense and Asset and Debt Statements on _______________________. To the
(Mo/Day/Yr)
best of Plaintiff’s knowledge there have been no substantial changes in Plaintiff’s financial circumstances
since that date.
10b. u Defendant signed Income and Expense and Asset and Debt Statements on _______________________.
(Mo/Day/Yr)
Plaintiff recognizes Defendant’s signature on said documents.
10c. u Defendant’s Income and Expense Statement and Asset and Debt Statement are not filed because:
_______________________________________________________________________________________
_______________________________________________________________________________________
11. Plaintiff has carefully reviewed the proposed decree and agrees to the alimony, division of property and other
provisions as provided in the proposed decree.
12. Plaintiff signed the proposed decree. u Plaintiff recognizes Defendant’s signature on the decree.
13. Wife wishes to resume the use of her u birth surname u former married name and be known as:
__________________________________________________________________________________________ .
14. Husband wishes to resume the use of his u birth surname u former married name and be known as:
__________________________________________________________________________________________ .
15. Language Comprehension:
15a. u Plaintiff fully understands the English language.
15b. u Although Plaintiff does not fully comprehend written English, this document has been explained to him/
her by ____________________ and based on that explanation Plaintiff understands this document.
16. Plaintiff requests that the court grant this divorce and enter the decree without his/her appearance in court.
17. Plaintiff has read this document and signs it voluntarily and without coercion and duress and not because he/she
was told to sign it.
12/98
Page 2 of 4
AFFIDAVIT OF PLAINTIFF (UDA) 1F-P-333
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STATE OF HAWAI‘I
FAMILY COURT
_________ CIRCUIT
AFFIDAVIT OF PLAINTIFF
(FOR UNCONTESTED DIVORCE)
PAGE THREE
CASE NUMBER
FC-D NO.
18. Pregnancy:
18a. u Wife is not pregnant.
18b. u Wife is pregnant and her expected date of delivery is _______________. Husband u is u is not the father
(Mo/Day/Yr)
of said child.
19. Child(ren):
19a. u Plaintiff and Defendant have no children together.
19b. u The parties have ______ children together. The complete name and birthdate of each are listed as follows
from the oldest to the youngest child (including adult child(ren)):
Name
Date of Birth
__________________________________________________________________________________________
(Mo/Day/Yr)
__________________________________________________________________________________________
(Mo/Day/Yr)
__________________________________________________________________________________________
(Mo/Day/Yr)
__________________________________________________________________________________________
(Mo/Day/Yr)
__________________________________________________________________________________________
(Mo/Day/Yr)
__________________________________________________________________________________________
(Mo/Day/Yr)
19c. u There is/are child(ren) conceived during the marriage fathered by someone other than husband. Their
name(s) and date of birth is/are listed as follows:
Name
Date of Birth
Judgment of Paternity entered
u Yes
_____________________________________________________________
(Mo/Day/Yr)
u Yes
_____________________________________________________________
(Mo/Day/Yr)
u No
u No
20. Prior or Pending Custody Proceedings:
20a. u I have not participated in any capacity in any law suit or proceeding in any state concerning custody of any
of the minor children of the Plaintiff and Defendant together. I have no information of any pending custody
proceeding or of any person not a party to this proceeding who has physical custody or claims to have
custody or visitation rights concerning any minor children of the Plaintiiff and Defendant together.
20b. u Prior court case involving the subject children:
Case Name: __________________________________________________________________________
Case Number: ________________________________________________________________________
Location of Court:_____________________________________________________________________
Date Filed: (Mo/Day/Yr)
__________________________________________________________________________
Date Concluded: (Mo/Day/Yr)
______________________________________________________________________
Type of Case: ________________________________________________________________________
20c. u Other court case involving the subject children which is still pending:
Case Name: __________________________________________________________________________
Case Number: ________________________________________________________________________
Location of Court:_____________________________________________________________________
Date Filed: (Mo/Day/Yr)
__________________________________________________________________________
Date Concluded: (Mo/Day/Yr)
______________________________________________________________________
Type of Case: ________________________________________________________________________
12/98
Page 3 of 4
AFFIDAVIT OF PLAINTIFF (UDA) 1F-P-333
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STATE OF HAWAI‘I
FAMILY COURT
_________ CIRCUIT
AFFIDAVIT OF PLAINTIFF
(FOR UNCONTESTED DIVORCE)
PAGE FOUR
CASE NUMBER
FC-D
NO.
21. u Plaintiff agrees to the custody arrangement and child support amounts as provided in the proposed divorce
decree.
22. Child Support:
22a. u Plaintiff believes that the information provided in the completed Child Support Guildelines Worksheet is
accurate, to the best of the Plaintiff’s knowledge and proposed child support is consistent with the Child
Support Guidelines Worksheet.
22b. u Proposed child support varies from the Child Support Guidelines Worksheet because of the following
exceptional circumstances: ______________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
23. Kids First:
(Mo/Day/Yr)
23a. u I attended the Kids First II Program (Wednesday Night) on ____________________________________ .
23b. u I was excused by Judge _______________________________ from attending the Kids First II Program.
24. u Other: __________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Plaintiff declares that he/she understands that his/her signature under oath before a notary public is his/her solemn statement that he/she read this
Affidavit and knows and understands the contents and that these statements are true, correct and complete to the best of his/her knowledge and belief.
PLAINTIFF’S SIGNATURE
SUBSCRIBED AND SWORN TO
BEFORE ME THIS DATE:
NOTARY PUBLIC’S SIGNATURE
IN___________________, Hawai‘i
STATE OF HAWAI‘I
12/98
Page 4 of 4
MY COMMISSION EXPIRES:
AFFIDAVIT OF PLAINTIFF (UDA) 1F-P-333
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