_______________________________ Name _____________________________________ Address _____________________________________ City State Zip Code _____________________________________ Phone Number PETITIONER PRO SE MONTANA _______________ JUDICIAL DISTRICT COURT _____________________ COUNTY In re the Marriage of: Cause No.: _________________ ________________________, Petitioner, Petition for Dissolution and ________________________, Respondent. The Petitioner respectfully submits the following: 1. Information about Petitioner a. Name: b. Age: c. Address: City: Date of Birth: State: d. Length of Residence in County: e. Length of Residence in Montana, if applicable: f. County: Occupation: Petition for Dissolution, Page 1 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com 2. Information about Respondent a. Name: b. Age: c. Address: Date of Birth: City: State: d. Length of Residence in Montana, if applicable: f. 3. Length of Residence in County: e. County: Occupation: Date and Place of Marriage Choose One: [] The parties were married on (date): registered in the County of [] . The marriage was , State of . The parties were married at common law. The parties assumed a marital relationship by mutual consent and agreement and confirmed their marriage by cohabitation and public repute. 4. Separation Choose One: [] [] 5. The parties separated on (date): . The parties are not yet separated. Jurisdiction a. The jurisdictional requirements of M.C.A. § 40-4-104 exist. b. Choose One: [] The marriage is irretrievably broken in that there is serious marital discord which adversely affects the attitude of one of the parties towards the marriage, and there is no reasonable prospect of reconciliation. [] The marriage is irretrievably broken in that the parties have lived separate and apart for a period of more than one hundred eighty (180) days preceding Petition for Dissolution, Page 2 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com the commencement of these proceedings, and there is no reasonable prospect of reconciliation. c. The conciliation provisions of the Montana Conciliation law and M.C.A. § 40-4-107 do not apply. 6. No Children of the Marriage Choose One: [] There were no children born of the marriage. [] There were children of the marriage, but none are now minors. [] There were children born of the marriage, but this Court has no jurisdiction over them. 7. Pregnancy Choose One: [] The wife is not pregnant. [] The wife is pregnant. However, the husband is not the father, and the child is not at issue in this proceeding. 8. Preliminary Disclosure The Petitioner is complying with the preliminary disclosure requirements of M.C.A. §40-4252 and will serve a Declaration of Disclosure of Assets, Debts, Income and Expenses upon the Respondent at the time of service of this Petition. 9. Real Property Choose One: [] The parties do not own any real property. or [] a. The [ ] Petitioner/[ ] Respondent/[ ] both parties is/are the owner(s) of record of real property located at Petition for Dissolution, Page 3 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com . The legal description of the property is . b. This real property should be distributed as follows. Choose One: [] The [ ] Petitioner/[ ] Respondent should be awarded ownership of this real property. or [] Describe the proposed distribution of the real property: . If needed, attach additional sheets as Exhibit _____. 10. Vehicles Choose One: [] The parties do not own any vehicles. or [] The parties own the following vehicle(s). It is equitable that the vehicle(s) be distributed as follows (Please include the year, make, and model for each vehicle listed.): To Petitioner: Vehicle: VIN#: Vehicle: VIN#: Vehicle: VIN#: To Respondent: Vehicle: VIN#: Vehicle: VIN#: Vehicle: VIN#: Petition for Dissolution, Page 4 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com If needed, attach additional sheets as Exhibit _____. 11. Personal Property Choose One: [] The parties have already divided their personal property. It is equitable that each party retain the property currently in his or her possession. or [] The parties have not divided their personal property. It is equitable that the property be divided as follows: To Petitioner: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________________ To Respondent: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ __________________________________________________________________ If needed, attach additional sheets as Exhibit _____. 12. Debts Choose One: [] There are no debts of the marriage. [] The parties have accumulated debts during the course of their marriage. It is equitable that each party retain responsibility for the debts currently in his or her name. Petition for Dissolution, Page 5 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com or [] The parties have accumulated debts during the course of their marriage. It is equitable that responsibility for the debts be divided as follows: To Petitioner: Description of Debt Creditor Current Balance Amount to Petitioner Any and all other debts in Petitioner’s name only; any and all other debts incurred solely by the Petitioner since the parties’ separation. To Respondent: Description of Debt Creditor Current Balance Amount to Respondent Petition for Dissolution, Page 6 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com Description of Debt Creditor Current Balance Amount to Respondent Any and all other debts in Respondent’s name only; any and all other debts incurred solely by the Respondent since the parties’ separation; and any and all other debts not disclosed by the Respondent to the Petitioner. If needed, attach additional sheets as Exhibit _____. 13. Wife’s Former Name Choose One: [] The wife would like to be restored to her former name of _________________________________________________________________. [] The wife does not want to be restored to her former name. [] The husband does not know whether the wife would like to be restored to her former name. 14. Other Provisions . Petition for Dissolution, Page 7 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com WHEREFORE, the Petitioner requests as follows: 1. That this Court enter a Decree of Dissolution of Marriage dissolving the marital status between the parties; 2 That each party be granted real and personal property as requested above; 3. That each party be granted ownership of the vehicles as requested above; 4. That each party be ordered to pay debts as requested above; 5. That the wife be restored to use of her former name, if requested above; 6. Other Provisions: _________________________________________________________ ; and 7. For such other and further relief as the Court deems just and proper. DATED this _______ day of ____________________, 20___. _____________________________________ Petitioner Pro Se _____________________________________ Print Name Petition for Dissolution, Page 8 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com STATE OF MONTANA ) ) ss. COUNTY OF _________________ ) _______________________________, being first duly sworn on oath, says that he/she is the Petitioner in the above-entitled proceeding; that he/she has read the foregoing Petition and knows the contents thereof; and that the matter, facts and things stated therein are true to the best of his/her knowledge and belief. _____________________________________ Petitioner Pro Se SUBSCRIBED AND SWORN to before me this _____ day of ________________, 20____. (SEAL) _____________________________________ Name (printed): ________________________ Notary Public for the State of Montana. Residing at ____________________________ My Commission Expires__________________ Petition for Dissolution, Page 9 of 9 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 American LegalNet, Inc. www.FormsWorkflow.com