PFC IN THE COMMON PLEAS COURT OF MONTGOMERY COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS __________________________________ Plaintiff Name & Address __________________________________ __________________________________ and __________________________________ Defendant's Name & Address __________________________________ __________________________________ The undersigned petitioner respectfully represents that ______________________________of ___________________________________ and ______________________________of ___________________________________ are the parties to the above-entitled action; and alleges that a controversy between the said spouses which may, unless a reconciliation or amicable settlement is achieved, result in dissolution of the marriage or disruption of the household. The name and age of each minor child whose welfare may be affected by the controversy is as follows: NAME DOB: DOB: DOB: Wherefore, said petitioner requests the aid of the Court to effect a reconciliation or an amicable settlement of the controversy between the parties to preserve the marriage. ANY PENDING HEARING IS HEREBY STAYED UNTIL FURTHER ORDER OF THE COURT. ________________________________ Petitioner's Signature The State of Ohio, Montgomery County: SS. The petitioner herein named, being first duly sworn, says that the statements in the foregoing petition are true, as he/she verily believes. Sworn to before me and signed in my presence this __________ day of _______________________________. ________________________________ Notary Public My Commission Expires: cc-pet American LegalNet, Inc. www.FormsWorkFlow.com Case No: ___________________________ Conciliation Court Case No: ___________________________ Judge, _____________________________ PETITION FOR CONCILIATION YEARS OF AGE ________________________________