1 Code: 1030 2 Name: ____________________________________ Address:____________________________________ _____________________________________ Telephone No._______________________________ Appearing in Proper Person 3 4 5 6 IN THE FAMILY DIVISION 7 OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA 8 IN AND FOR THE COUNTY OF WASHOE 9 10 11 ________________________________________ Plaintiff, vs. Case No. ________________________ Dept. No.________________________ 12 13 ________________________________________ Defendant. ____________________________________________/ 14 AFFIDAVIT IN SUPPORT OF DEFAULT DIVORCE WITH CHILDREN 15 16 STATE OF NEVADA 17 COUNTY OF WASHOE ) ) ss. ) 18 19 20 ________________________________________, being first duly sworn under penalties of (Your Name) perjury, deposes and says: 21 1. I am the Plaintiff in this matter. 22 2. I am a resident of the State of Nevada, County of ____________________________, (County in which you live) 23 24 and I have lived in said County and State in excess of six weeks prior to the filing of the Complaint 25 in this matter on ___________________________________ and I intend to remain in Nevada and (Date Complaint was filed with the Court) 26 27 to make the State of Nevada my home for an indefinite period of time. 28 /// Revised 2005 1 American LegalNet, Inc. www.FormsWorkflow.com 1 SERVICE OF THE COMPLAINT 2 3. The Complaint and Summons were served on Defendant by: 3 Initial ONLY ONE of the following paragraphs and print N/A in the other space not initialed.. 4 5 6 7 __________ Defendant was personally served with the documents on _______________________ (Date of service on Defendant) and proof of service has been filed with the Clerk of the Court. 8 OR 9 __________ Defendant was served by publication of the Summons in the newspaper and a Proof 10 of Publication has been filed with the Court. 11 Complaint was mailed to Defendant by certified mail to Defendant’s last-known 12 address. 13 A copy of the Summons and MARRIAGE INFORMATION 14 4. Defendant and I were married on ________________________________________, (Date of marriage) 15 16 in ___________________________________________________, and still are husband and wife. (Place of marriage) 17 18 5. We are incompatible in marriage and there is no hope of reconciliation. 19 CHILDREN’S INFORMATION 6. 20 There are _________________ minor children born to or adopted through this union. (number of minor children) 21 NAME 22 AGE DATE OF BIRTH 23 ____________________________________________ _________ ____________________ 24 ____________________________________________ _________ ____________________ 25 ____________________________________________ _________ ____________________ 26 ____________________________________________ _________ ____________________ 27 ____________________________________________ _________ ____________________ 28 /// Revised 2005 2 American LegalNet, Inc. www.FormsWorkflow.com 1 Initial EITHER 7 or 8 and print N/A in the space not initialed. 2 3 7. __________ It is in the child(ren)’s best interests that this Court affirm the custody 4 designation and visitation schedule as set out in the Complaint. 5 OR 6 8. __________ The Court does not have jurisdiction to enter custody and visitation 7 orders regarding the children. 8 9 Initial EITHER 9 or 10 and print N/A in the space not initialed. 10 11 9. __________ 12 It is in the children’s best interests that this Court affirm the issues of child support and health insurance as set out in the Complaint. 13 OR 14 10. 15 __________ This Court does not have jurisdiction to enter child support orders in this matter. 16 17 COMMUNITY ASSETS 18 Initial EITHER 11, 12 or 13 and print N/A in the other 2 spaces not initialed. 19 20 11. __________ All of the community assets and property have been previously 21 divided and each should keep the property in his or her possession at 22 this time. 23 OR 24 12. __________ There is no community property to be divided. 25 OR 13. 26 Complaint. 27 28 __________ The community property should be divided as set out in the /// Revised 2005 3 American LegalNet, Inc. www.FormsWorkflow.com 1 COMMUNITY DEBTS 2 Initial EITHER 14, 15 or 16 and print N/A in the other 2 spaces not initialed. 3 4 14. __________ All of the community debts have been previously divided and each 5 should keep those debts assigned to him or her and hold the other 6 harmless from those debts. 7 8 OR 15. __________ 9 10 There are no community debts to be divided. OR 16. __________ The community debts should be divided as set out in the Complain. 11 12 13 14 RESTORATION OF WIFE’S NAME If Wife is filing this Default, she initial ONLY ONE of the following paragraphs and print N/A in the other spaces. If Husband is filing this Default, he must print N/A in all the spaces. 15 Initial EITHER 17, 18 or 19 and print N/A in the other 2 spaces not initialed. 16 17 17. __________ 18 19 OR 18. 20 __________ Wife wishes to return to her former full name of _________________ (Print full name) _______________________________________________________. 21 22 Wife does not wish to return to her former name. OR 19. __________ Wife never changed her name and, therefore, does not request restoration of a former name. 23 SPOUSAL SUPPORT 24 20. The issue of spousal support as set out in the Complaint should be affirmed. 25 26 27 DEFAULT INFORMATION 21. A Default was taken against Defendant on _________________________________. (Date Default was entered by Filing Clerk) 28 Revised 2005 4 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 22. I request that a Decree of Divorce issue and that the Court grant any further relief deemed just and proper in this situation. DATED this _____ day of _________________________, 20______. 4 5 ____________________________________________ (Signature) 6 7 ____________________________________________ (Print Your Name) 8 ___________________________________________ (Address) 9 10 ____________________________________________ (City, State, Zip) 11 ____________________________________________ (Telephone Number) 12 13 SUBSCRIBED and SWORN to before me 14 this _______ day of ______________________, 20______. 15 16 __________________________________________ NOTARY PUBLIC 17 18 19 20 21 22 23 24 25 26 27 28 Revised 2005 5 American LegalNet, Inc. www.FormsWorkflow.com