DR-103 Page 1 of 2 Rev. 4/18 COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION CLERMONT COUNTY, OHIO Your Name /Petitioner Case Number : Street Address City, State and Zip Code and Spouse222s Name /Petitioner Street Address City, State and Zip Code PETIT ION FOR DISSOLUTION WITH C HILDREN (our ame) and The Petitioners, (pouse222s ame) say as follows: 1. (our ame) (pouse222s ame)Both parties is/are currently a resident/s of the State of Ohio and has/have been a resident/s of the State of Ohio for at least six months immediately preceding the filing of this petition. 2. (pouse222s ame) Both County for at least 90 days (our ame) parties has/have been a resident/s of immediately before filing this petition. 3.The Petitioners were married to one another on (date of marriage) in (city or county and state). American LegalNet, Inc. www.FormsWorkFlow.com DR-103 Page 2 of 2 Rev. 4.Check all that apply: Child/ren are expected from this marriage. Child/ren are expected from this marriage and the approximate due date is . The Petitioners are the parents of (number) child/ren born from or adopted during this marriage or relationship. Of the child/ren (number) is/are emancipated adult/s and not under any disability. The following (number) child/ren is/are minor child/ren and/or mentally or physically disabled and incapable of support or maintaining themselves (name and date of birth of each child) Name of Child Date of Birth I am not the parent of the following child/ren who was/were born during the marriage (name and date of birth of each child): 5.There is a custody and/or child support order in effect through Court. Name of Child Date of Order 6.The Petitioners have entered into a Separation Agreement. 7.The Petitioners have entered into a Shared Parenting Plan. 8. (Name) requests to be restored to the former name of . The Petitioners ask the Court for a Decree of Dissolution dissolving their marriage pursuant to the terms of their Separation Agreement and a Decree of Shared Parenting pursuant to their terms of the Shared Parenting Plan (if shared parenting is agreed to). Email Address Email Address Phone Number Phone Number Your Signature Spouse222s Signature American LegalNet, Inc. www.FormsWorkFlow.com