THIS FORM IS PROVIDED BY LOCAL RULE IN THE 32nd CIRCUIT AND IS COPIED FROM SAID LOCAL RULES FORM 68-E (DISSOLUTION JUDGMENT WITH CHILDREN) Note: This form is provided as a format for the various provisions which are required to be set forth in the judgment. Paragraphs are sequentially numbered even though some paragraphs are alternatives to be used based upon the facts in each case. CIRCUIT COURT OF ______________ COUNTY, MISSOURI ____________________________________ SSN: _______________________________ Petitioner, vs. _____________________________________ SSN: ________________________________ Respondent. ) ) ) ) ) ) ) ) ) ) ) Case No. ___________ JUDGMENT DISSOLVING MARRIAGE Petitioner appeared in person and by counsel, _____________. Respondent appeared not in person, nor by counsel, although duly served. OR not in person, nor by counsel, having filed an Entry of appearance. OR in person and by counsel, __________________. OR in person, pro se. The Court took up for hearing the Petition for Dissolution of Marriage, witnesses were sworn, evidence adduced and ( American LegalNet, Inc. www.FormsWorkflow.com petitioner OR the parties ) adduced the Court finds as follows: rested. On the evidence Petitioner has been a resident of the State of Missouri for more than ninety (90) days next preceding the filing of this action, currently living at ___________________. Respondent has been a resident of the State of Missouri for more than ninety (90) days next preceding the filing of this action, currently living at ________________. More than thirty (30) days have elapsed since the filing of this action. The parties’ social security numbers are as set forth in the caption. Petitioner and Respondent were married on _________, in ____________ County, _____________, and said marriage is registered there. Petitioner and Respondent separated on or about __________. There is no reasonable likelihood that the marriage of the parties can be preserved and, therefore, the marriage is irretrievably broken. There were ____ children born of the marriage, to-wit: ________________, DOB _____________, SSN: ____________ ________________, DOB _____________, SSN: ____________ There are no other lawsuits pending concerning the custody of the minor child___ and the Court has jurisdiction under the Uniform Child Custody Jurisdiction Act. ___________ is not now pregnant. _____________ has filed a Parenting Plan which the Court has reviewed and finds that it is in the best interests of the minor child_____ with custody to be awarded as follows: The parties should be granted joint legal and joint physical custody. OR The parties should be granted joint legal custody with having primary physical custody. OR ________ __________ should be granted legal and physical custody. Petitioner is employed full-time earning $______ per month. American LegalNet, Inc. www.FormsWorkflow.com Respondent is employed full-time earning $______ per month. ____________ has work-related child-care costs in the amount of $__________ per month. Neither parent has health insurance available for the minor child____ and that it is not economically possible for either parent to provide medical insurance coverage at this time. ___________ has medical insurance available for the minor child_____ through ______ place of employment at a cost of $____________ per month. OR The Court has reviewed all of the factors set forth in Section 454.603.2 RSMo and finds that the medical insurance available for the minor child ___ through ___ place of employment is best insurance available at this time. The Court has reviewed the Form 14 submitted by _______________ and finds that the presumed amount of child support is just and appropriate under the circumstances of this case. OR The Court has review the Form 14 submitted by _______________ and finds that the presumed amount of child support is unjust and inappropriate under the circumstances of this case because_________________________ (tax exemptions shared, etc). The parties own _____ real estate and have marital personal property and debts to be divided. OR The parties have items of marital property and/or marital debts which need to be divided and have entered into ( an oral agreement on the record OR a written agreement introduced into evidence ) as to the division of property and debts. OR The division of marital property and marital debts as set forth in the Property Settlement and Separation Agreement is found to be fair and not unconscionable. Neither party is entitled to maintenance from the other. OR ______________ is entitled to maintenance. ______________ requested that her name be changed. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED AS FOLLOWS: The marriage of ______________________ and ___________________ is dissolved. American LegalNet, Inc. www.FormsWorkflow.com The parties shall share joint legal custody of the minor children, ________________________, and __________ shall have the primary care, custody and control of the minor child, _____, subject to __________'s right to supervised visitation as set forth in the attached Parenting Plan, which is marked Judgment Exhibit _____ and incorporated herein by reference. OR The parties are awarded joint legal and joint physical custody of the minor child_____ as set forth in the attached Parenting Plan, which is marked Judgment Exhibit _____ and incorporated herein by reference. OR _________ shall have the legal and primary physical custody, care, and control of the minor child)______, _________________________________, subject to __________'s right to supervised visitation as set forth in the attached Parenting Plan, which is marked Judgment Exhibit _____ and incorporated herein by reference. The mailing address for the minor child______ shall be: ____________. Absent exigent circumstances as determined by a court with jurisdiction, you, as a party to this action, are ordered to notify, in writing by certified mail, return receipt requested, and at least sixty days prior to the proposed relocation, each party to this action of any proposed relocation of the principal residence of the child, including the following information: (1) The intended new residence, including the specific address and mailing address, if known, and if not known, the city; (2) The home telephone number of the new residence, if known; (3) The date of the intended move or proposed relocation; (4) A brief statement of the specific reasons for the proposed relocation of the child; and (5) A proposal for a revised schedule of custody or visitation with the child. Your obligation to provide this information to each party continues as long as you or any other party by virtue of this order is entitled to custody of a child covered by this order. Your failure to obey the order of this court regarding the proposed relocation may result in further litigation to enforce such order, including contempt of court. In addition, your failure to notify a party of a relocation of the child may be considered in a proceeding to modify custody or visitation with the child. Reasonable costs and attorney fees may be assessed against you if you fail to give the required notice. ___________ shall pay to the Family Support Center, (P.O. Box 109002, Jefferson City, MO 65110-9002 if an automatic wage American LegalNet, Inc. www.FormsWorkflow.com withholding OR P.O. Box 109001, Jefferson City, MO 65110-9001 if no automatic wage withholding) , as Trustee for __________, as and for child support for the ____ minor child, _______, the sum of ______________ ($____)per month with the first such payment due ______________, and a like amount on the ____ of each month thereafter. At such time as __________ is entitled to support for only ___ child, ______, on the date child support is payable, __________ shall pay the sum of ____________ ($______) per month, and at such time as __________ is entitled to support for only one child, on the date the child support is payable, __________ shall pay the sum of _____________ Dollars ($______) per month. This child support obligation shall continue in effect until the payor is no longer obligated to pay same or until subsequent order of the Court. An automatic wage withholding shall be initiated against the wages of __________ at his place of employment: (name and address). OR No automatic wage withholding shall be initiated because ___________. The medical insurance available for the minor child___ through ___________ place of employment is found to be the best coverage available at this time. _________________ shall cause said minor child___ to continue to be covered by medical, health and hospitalization insurance in the form now provided by _____ employer. In the event _____ loses said employment, ____ shall obtain a private policy of similar coverage. This order is in the nature of child support and is modifiable. OR Neither parent is ordered to provide medical insurance coverage for the minor children at this time. This order is in the nature of child support and is modifiable. Pursuant to '454.603.5 RSMo ___________ shall be liable for ____% of the medical or dental expenses for the minor child___ that are not covered by health benefit plan coverage because the Court finds that said plan does not cover all such expenses; each parent has the financial resources to contribute to said uncovered medical and dental expenses; and each parent has substantially complied with the terms of the health benefit coverage. Medical and dental expenses for the minor child___ are defined to be those expenses deductible for federal income tax purposes, including but not limited to: insurance deductibles, doctor's visits, dental visits, orthodontia, eye exams and glasses, and prescription drugs. American LegalNet, Inc. www.FormsWorkflow.com The parent incurring out-of-pocket medical expense on behalf of the minor child___ shall advise the other parent, in writing, in a timely manner of all medical expenses incurred and, within thirty (30) days of the receipt of any bill or insurance notice that all claims have been processed and paid (whichever is later), shall forward same to the other parent for payment of his or her share. Each parent shall pay his or her share of the unpaid medical expenses within sixty (60) days of the receipt of the final bill. ___________________ shall receive the federal and state income tax exemptions for _______________________. Neither of the parties shall pay maintenance and this order is not modifiable. OR ___________ shall pay to the Family Support Center, (P.O. Box 109002, Jefferson City, MO 65110-9002 if an automatic wage withholding or P.O. Box 109001, Jefferson City, MO 65110-9001 if no automatic wage withholding) , as Trustee for __________, as and for maintenance, the sum of ______________ ($____) per month with the first such payment due ______________, and a like amount on the ____ of each month thereafter. This maintenance order is OR is not modifiable. Petitioner is awarded the following real property: _________________. A copy of the legal description is attached hereto, marked Judgment Exhibit _____, and incorporated herein by reference. Petitioner shall assume the mortgage on said real estate and hold Respondent harmless therefrom. Respondent is awarded the following real property: ________________. A copy of the legal description is attached hereto, marked Judgment Exhibit _____, and incorporated herein by reference. Respondent shall assume the mortgage on said real estate and hold Petitioner harmless therefrom. Petitioner is awarded the personal property set over to Petitioner in the attached Property Settlement and Separation Agreement, which is marked, “Judgment Exhibit _______”, and incorporated herein by reference. Respondent is awarded the personal property set over to Respondent in the attached Property Settlement and Separation Agreement. American LegalNet, Inc. www.FormsWorkflow.com Petitioner shall pay the marital debts set over to Petitioner in the attached Property Settlement and Separation Agreement and hold Respondent harmless therefrom. Respondent shall pay the marital debts set over to Respondent in the attached Property Settlement and Separation Agreement and hold Petitioner harmless therefrom. OR Petitioner is awarded the following items of personal property: Respondent is awarded the following items of personal property: Petitioner shall pay the following marital debts and hold Respondent harmless therefrom: Respondent shall pay the following marital debts and hold Petitioner harmless therefrom: Each party is awarded all of pension benefits or retirement benefits in his or her name. OR _______________ is awarded _____________ of _______________ pension and retirement benefits at _________________________. The Court retains jurisdiction to enter a Qualified Domestic Relations Order satisfactory to the Trustee of said plan. Neither party is awarded maintenance and this order is not modifiable. Neither party is awarded attorney fees. OR __________ shall pay to ____________ the sum of $____________ as and for attorney fees in this case. (Petitioner) (Respondent)’s name is hereby changed from ____________ to ______. All other relief requested is denied. The Clerk shall forward a copy to counsel and unrepresented parties. Costs are assessed to _________. JUDGMENT ENTERED AND SO ORDERED: _____________________. __________________________________ American LegalNet, Inc. www.FormsWorkflow.com Judge American LegalNet, Inc. www.FormsWorkflow.com