1 Code: 4050 Name:_________________________ 2 Address:_______________________ ______________________________ 3 Telephone:_____________________ 4 Name:_________________________ Address:_______________________ 5 ______________________________ Telephone:_____________________ 6 Acting In Proper Person 7 IN THE FAMILY DIVISION 8 OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA 9 IN AND FOR THE COUNTY OF WASHOE 10 __________________________________, 11 Plaintiff/Petitioner, Case No. ___________________ 12 vs Dept. No. __________________13 __________________________________, 14 Defendant/Petitioner/Respondent. 15 ________________________________________/ 16 STIPULATION MODIFYING DIVORCE ORDERS 17 IT IS HEREBY STIPULATED AND AGREED, by and between ________________________ (Plaintiff/Petitioners18 _____________________ and _____________________________________ , the parties in this matter,19 name) (Defendant/Petitioner/Respondents name) 20 that the orders now existing, which were entered on _______________________________________ (Date the order was entered that you are modifying)21 in this matter, be modified, or changed, as follows: 22 23 Be very specific and detailed as to how you want the order changed. For each part of the order or decree that you want to change, first, identify the part of the document to be changed, and24 second, state the change you are agreeing to. If the change is a new addition to the order or25 decree, state the fact that it is to be added to the order or decree. (See instructions for examples of proper wording) 26 27 __________________________________________________________________________________ 28 ________________________________________________________________________________ Ct. 1/00 1 >>>> 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 (If more room is needed, you may attach additional paper. Be sure each page is clearly28 identified as a continuance of the Stipulation and each page is initialed by both parties) Ct. 1/00 2>>>> 3 1 All other provisions, except those modified, shall remain as stated in the prior order(s). 2 The parties hereby certify that they are not represented by counsel in this matter and, if they have 3 been previously represented by counsel in this matter, that counsel has formally withdrawn from this 4 case 5 by having filed with the Court either a formal Withdrawal of Counsel or a Substitution of Counsel, 6 stating the party now represents themselves. 7 Dated:_________________________________ Dated:_________________________________ 8 9 ______________________________________ _______________________________________ (Print Name) (Print Name) 10 ______________________________________ _______________________________________ 11 (Signature) (Signature) 12 13 SUBSCRIBED and SWORN to before me SUBSCRIBED and SWORN to before me14 this ________day of ________________, ______.this________day of ________________,15 ______ 16 17 _______________________________________________________________________________ 18 NOTARY PUBLIC NOTARY PUBLIC19 20 21 22 23 24 25 26 27 28 Ct. 1/00 3