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Re: the Marriage of Plaintiff _____________________________________ Court ____________________________ v. Defendant __________________________________ Docket No. ________________________ The plaintiff,_____________________________, respectfully declares the following: Plaintiff currently resides at the following address: _________________________________________________________________________ _____ _________________________________________________________________________ _____ Plaintiff has been a resident of the State of___________________for a period of_______months. Defendant currently resides at the following address: _________________________________________________________________________ _____ _________________________________________________________________________ _____ _________________________________________________________________________ _____ _________________________________________________________________________ _____ Plaintiff and Defendant were married on the______day of______________, 20____, and at the place of ________________________________________________ (city) (county) (state). A copy of the marriage license is attached hereto. Plaintiff seeks a divorce from Defendant based on the following: _________________________________________________________________________ _____ _________________________________________________________________________

_____ _________________________________________________________________________ _____ _________________________________________________________________________ _____ (NOTE: Most States recognize one or more of the following grounds as sufficient for granting a no-fault divorce: Irretrievable breakdown of the marriage, Incompatibility or living separate and apart without cohabitation for one or two years, Irreconcilable differences that have caused the irremediable breakdown of the marriage. This is only a sample. Check with court clerks for the OFFICIAL DIVORCE FORMS required in your jurisdiction. It varies for each State.) There have been no previous actions for divorce or annulment between Plaintiff and Defendant except: _________________________________________________________________________ _____ _________________________________________________________________________ _____ _________________________________________________________________________ _____ _________________________________________________________________________ _____ The marriage between Plaintiff and Defendant is irretrievably broken and efforts at reconciliation have not been successful. Plaintiff and Defendant____have (copy attached)____have not entered into a Settlement Agreement. Other declarations: _________________________________________________________________________ _____ _________________________________________________________________________ _____ _________________________________________________________________________ _____ _________________________________________________________________________ _____ Wherefore, Plaintiff requests judgment dissolving the marriage between the parties and such further relief as Plaintiff may have requested herein. Verification I, being of full age and mind, hereby certify that I am the Plaintiff in the foregoing Complaint for Divorce, that all declarations are true to the best of my knowledge and belief, and I have filed this Complaint in good faith and have not colluded with anyone in relation to it. I am aware that perjury and willful false statements will subject me to punishment under the law. ___________________________ Plaintiff’s Signature

_____/____/_______ Date Address:______________________________________________ Telephone:_________________ NOTARY Subscribed and sworn to before me on this_______day of____________________, 20____. Notary's Seal __________________________ Notary's Signature

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