Page 1 of 2 STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION Unit Docket No. Plaintiff Date Of Birth Defendant Date Of Birth V. NOTICE OF APPEARANCE, ANSWER TO THE COMPLAINT AND COUNTERCLAIM I intend to represent myself and hereby enter my appearance with the Court. No attorney will represent me in this case unless an attorney or I notify the Court otherwise. I understand that IT IS MY RESPONSIBILITY TO: 1.Notify the Court in writing if I change my address or phone number;AND2.Send copies of any papers I file with the Court to the other party in this case. All Court papers may be mailed to me by first class mail at the address listed below. Name: Date of Birth: Street Address: City/State/Zip: Mailing Address (if different from Street Address): City/State/Zip: Email Address: Daytime Phone: Evening Phone: ANSWER TO COMPLAINT FOR ANNULMENT I am the Defendant in this case. This is my answer to the facts in the Plaintiff222s Complaint: (Please refer to the Plaintiff222s Complaint and check whether you agree or disagree with the facts in each paragraph of the Complaint.) 1.Residencea.My Residence:Agree Disagreeb.Plaintiff222s Residence:Agree Disagree2.Date and Place of Marriage:Agree Disagree3.Grounds for Annulment:Agree Disagree4.Minor Children of the Parties:Agree Disagree N/A5.Facts Related to UCCJEA Jurisdiction:Agree Disagree N/A6.Property, Assets and Debts: I have listed all of the property, assets and debts that myspouse and I own either jointly or solely that are known to me, in the Financial Affidavit thatI am filing with this Answer. (form 400-00813B)7.Public Assistance:Agree Disagree Don222t know8.Earlier Actions for Divorce, Legal Separation,Dissolution, or Annulment:Agree Disagree9.Relief from Abuse or protective order proceedings:Agree Disagree10.Military Status:Agree Disagree American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 If you disagree with any of the facts in Plaintiff222s Complaint, please write the paragraph number below and state the facts you believe to be true: COUNTERCLAIM Based on the facts stated above, I ask that the Family Court grant me: (check each box that applies) Decree of Parental Rights and ResponsibilitiesLegalParental Rights and Responsibilities:Shared Jointly Plaintiff Given Solely to: yselfPhysical Parental Rights and Responsibilities: Shared JointlyGiven Solely to:MyselfPlaintiffParent Child Contact forMyselfPlaintiffChild Support, Medical Support and/or Maintenance Supplement.Division of Property (divide our marital property, assets and debts).Spousal Maintenance (Alimony).Court costs.Attorney fees.Name change: I would like to resume my former name of . I hereby swear or affirm that the information above is true to the best of my knowledge and belief. Dated Signature Defendant Signed and sworn to or affirmed before me: Date Signature of Notary Public Expiration Date American LegalNet, Inc. www.FormsWorkFlow.com