Vital Records (Divorce) Form. This is a Pennsylvania form and can be use in Montgomery Local County.
Tags: Vital Records (Divorce), Pennsylvania Local County, Montgomery
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. 105.157 REV. .6/02. . . . . . COMMONWEALTH OF PENNSYLVANIA Index No. DEPARTMENT OF HEALTH : VITAL RECORDS COUNTY RECORD OF OR (CHECK ONE) DIVORCE Plaintiff(s) -against- HUSBAND 1. Name (First) (Middle) 3. RESIDENCE Street or R.D. City, Boro. Or Twp. 5. NUMBER OF THIS MARRIAGE 6. RACE WHITE (Last) : Calendar No. NUMBER STATE FILE ANNULMENT : STATE FILE DATE JUDICIAL SUBPOENA : : 2. Date of Birth County State : (Month) 4. PLACE OF BIRTH (Day) (Year) (State or Foreign Country) 7. USUAL OCCUPATION Defendant(s) : ...................................................... BLACK OTHER (Specify) WIFE 8. MAIDEN Name 10. RESIDENCE (First) Street or R.D. (Middle) (Last) City, Boro. Or Twp. County 9. Date of Birth State (Month) (Day) (Year) 11. PLACE OF BIRTH (State or Foreign Country) THE PEOPLE OF THE STATE OF NEW YORK 12. NUMBER OF THIS MARRIAGE TO 15. PLACE OF THIS MARRIAGE 13. RACE WHITE (County) 14. USUAL OCCUPATION BLACK (State or Foreign County) 17A. NUMBER OF 17B. NUMBER OF 18. PLAINTIFF CHILDREN THIS DEPENDENT CHILDREN HUSBAND WIFE MARRIAGE UNDER 18 20. NUMBER OF CHILDREN TO CUSTODY OF HUSBAND WIFE SPLIT CUSTODY OTHER (Specify) GREETINGS: 22. DATE OF DECREE (Month) OTHER (Specify) (Day) (Year) 16. DATE OF THIS MARRIAGE OTHER (Specify) (Month) (Day) (Year) 19. DECREE GRANTED TO HUSBAND WIFE OTHER (Specify) 21. LEGAL GROUNDS FOR DIVORCE OR ANNULMENT 23. DATE REPORT SENT TO VITAL RECORDS (Month) (Day) (Year) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the TRANSCRIBING at the Court 24. SIGNATURE OF Honorable CLERK located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com