Request for Entry of Decree and Declaration of Jurisdictional Facts (For Use by Attorney only) LCR 8 -- Revised 9/2005 Page 1 of 2 SUPERIOR COURT OF WASHINGTON COUNTY OF ISLAND SAN JUAN In Re the Marriage of: No. , Petitioner, REQUEST FOR ENTRY OF DECREE and AND DECLARATION OF JURISDICTIONAL FACTS (For Use by Attorney Only) , Respondent. REQUEST: The petitioner requests immediate entry of Findings of Fact, Conclusions of Law and Decree of Dissolution of Marriage, Decree of Legal Separation, or Declaration of Invalidity without a final hearing, and states: RESIDENCE: I was a resident of the state of Washington when the petition was filed. TIME LIMITS: More than 90 days have elapsed since the later of , 20, the date on which the Petition was filed, and , 20, the date on which the respondent signed an acceptance of service and the respondent has either signed the final documents or waived notice and the final documents provide for only that relief requested in the petition. Or the summons and petition were personally served upon the respondent, or the summons was first published pursuant to an order for service by publication, or the summons and petition were mailed pursuant to an order for service by mail. MARRIAGE & SEPARATION: The parties were married on , ,(date) at , (city and state) and separated on , 20. The marriage is irretrievably broken, or The husband and wife wish to be legally separated, or The marriage of the parties is invalid. American LegalNet, Inc. www.FormsWorkFlow.com Request for Entry of Decree and Declaration of Jurisdictional Facts (For Use by Attorney only) LCR 8 -- Revised 9/2005 Page 2 of 2 PREGNANCY: The wife is not pregnant, or The wife is pregnant. The father of the unborn child is the husband, not the husband, undetermined. DEPENDENT CHILDREN & All dependent children of the marriage are identified and the Child Support Worksheets are accurate. PARENTING CLASS: Both mother and father have completed the mandatory court-approved parent education seminar and the certificates of completion are attached. The parent education seminar has been waived by the court. PROPERTY & DEBTS: All property and all debts of the parties are fairly and completely divided in the Decree. MEDIATION: The parties have complied with mandatory mediation and a certification of completion by the mediator is attached. Mediation has been waived by the court. IF DEFAULT: If entry of the Decree is sought after default of the Respondent, the final documents provide for only that relief requested in the petition. PERJURY DECLARATION: I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Dated this date at , Washington Signature of Petitioner Presented by: Approved, notice of presentation waived: Signature of Petitioner222s Attorney Signature of Respondent222s Attorney Signature of Respondent American LegalNet, Inc. www.FormsWorkFlow.com