400 - 00836NoChildren Complaint for Divorce /Legal Separation/ Dissolution No Children (01/2018) Page 1 of 4 STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION Unit Docket No. Plaintiff Name Defendant Name v . Plaintiff Information: Name: Date of Birth: Street Address: City/State/Zip: Mailing Address (if different from Street Address) : City/State/Zip: Email Address: Daytime Phone: Even ing Phone: A ttorney Name: Attorney Phone: Defendant Information: Name: Date of Birth: Street Address: City/State/Zip: Mailing Address (if different from Street Address) : City/State/Zip: Email Address: Daytime Phone: Even ing Phone: A ttorney Name: Attorney Phone: SUMMONS THIS SUMMONS IS DIRECTED TO: Name of Defendant 1. PLAINTIFF IS SEEKING A Name of Plaintiff DIVORCE LEGAL SEPARATION CIVIL UNION DISSOLUTION The C omplaint begins on the next page. Do not throw these papers away. They are official papers that affect your rights. 2. TO PROTECT YOUR RIGHTS, YOU SHOULD REPLY WITHIN 2 1 DAYS. Your written response is called an Answer. You can get an official court form for an Answer to a Divorce Complaint at any Vermont F amily C ourt or on the Judiciary web site at http://www.vermontjudiciary.org. 3. YOU MUST RESPOND TO EACH CLAIM. In your Answer you must state whether you agree or disagree with each paragraph of the C omplaint. If you believe the Plaintiff should not be giv en everything asked for in the C omplaint, you should say so in your Answer. 4. IF YOU DO NOT FILE AN ANSWER OR FILE AN APPEARANCE, THE COURT IS NOT REQUIRED TO NOTIFY YOU OF HEARINGS. If you do not attend the court hearings, the Plaintiff may receive everything requested in the C omplaint. You will not get a chance to tell your side o f the story. 5. YOU MUST GIVE OR SEND A COPY OF YOUR ANSWER TO THE PLAINTIFF. If the Plaintiff has an attorney, you must give or sen d a copy of your answer to the P attorney. American LegalNet, Inc. www.FormsWorkFlow.com 400 - 00836NoChildren Complaint for Divorce /Legal Separation/ Dissolution No Children (01/2018) Page 2 of 4 6. YOU MUST GIVE OR SEND YOUR ORIGINAL ANSWER TO THE COURT at this addres s: 7. LEGAL ASSISTANCE: You may wish to get help from a lawyer. Even if you cannot get legal help, you must still give the C ourt a written Answer to protect your rights. Dated Signature of Court Clerk American LegalNet, Inc. www.FormsWorkFlow.com 400 - 00836NoChildren Complaint for Divorce /Legal Separation/ Dissolution No Children (01/2018) Page 3 of 4 COMPLAINT FOR DIVORCE/LEGAL SEPARATION/DISSOLUTION FACTS The Plaintiff states that the following facts are true: 1. Residence: (A) I am now a resident of , . County State I have resided in Vermont for 6 full months. (B) Defendant is now a resident of , . County State Defendant has resid ed in Vermont for 6 full months, since . Month/Date/Year 2. Marriage: We were married at , City State on and are still married. M onth /Date / Y ear Civil Union: Our civil union took place at , City State on and it has never been dissolved . 3. Grounds for Divorce/Legal Separation/Dissolution: The reason I am asking for a D ivorce L egal S eparation Dissolution Is that: Six Month Separation: We have or will have lived separate and apart for more than six (6) consecutive months and it is not reasonably probable that we can resume our relationship. The Defendant and I separated on : . M onth / D ate/ Y ear this field is required Other: (Please explain) 4. Property, Assets and Debts: I have listed all of the property, assets and debts that my spouse and I own either together or separately that are known to me, in the Financial Affidavit that I am filing with this Complaint (form 400 - 00813 B ) . 5. Public Assistance: I receive assistance from the Division of Economic Services (DES) (examples: Food Stamps, Reach Up). The Defendant receives public assistance from the Division of Economic Services (DES). 6. Earlier actions for divorce, legal separation, dissolution , annulment: I have not filed for divorce, legal separation, dissolution or annulment in any court against the Defendant, as far as I know, the Defendant has not filed for divorce, legal separation, dissolution or annulment against me. I have filed OR the Defendant has filed for divorce, legal separation, dissolution or annulment before the date of the filing of this petition. ( If you check this box, you must fill in the information below. Use an additional page if necessary.) Type of Action Who Fi led Where Filed Year Filed (Court, County, State) Please attach a copy of any Court Order issued in a case listed above. American LegalNet, Inc. www.FormsWorkFlow.com 400 - 00836NoChildren Complaint for Divorce /Legal Separation/ Dissolution No Children (01/2018) Page 4 of 4 7. Relief from abuse or protective order proceedings: I have not filed a complaint for relief from abuse or a request for a protective order against the Defendant AND, as far as I know, the Defendant has not filed such an action against me. I have filed a complaint for relief from abuse or a request for a protective order against the Defendant OR the Defendant has filed a complaint for relief from abuse or a request for a protective o rder against me. ( If you check this box, you must complete the information below. Use an additional page if necessary.) Type of Action Who Filed Where Filed Year Filed (Court, County, State) Please attach a copy of any Court Order issued in a case listed above. 8. Military Service: The Defendant is in the military service. The Defendant is not in the military service. I am in the military service. I am not in the military service. REQUEST FOR RELIEF 1. I ask that the Family Court grant me: ( check each box that applies ) Decree of Divorce Decree of Legal Separation Decree of Dissolution 2. Division of Property (divide our property, assets and debts). 3. Spousal Maintenance (Alimony). 4. Court costs. 5. Attorney fees. 6. Name change: I would like to resume my former name of: I have attached a written agreement signed by my spouse and myself. I ask that the C ourt issue an order that includes the provisions of our written agreement. ( In order to qualify for the reduced filing fee, the attached agreement must cover all the issues that the P laintiff seeks to have the C ourt resolve.) I hereby swear or affirm that the information above is true to the best of my knowledge and belief. Dated Signature of Plaintiff Printed Name Signed and sworn to or affirmed before me: Date Signature of Notary Public Expiration Date American LegalNet, Inc. www.FormsWorkFlow.com