Your Phone Number *
Email *
ATLAS No. - if applicable
Your Height *
Job Title
Your Employer's Phone Number
Phone Number of Respondent *
Email of Respondent *
Respondent's Height *
Spouse's Job Title
Respondent Employer's Phone Number
City and State or Country where you were married *
Domestic Violence has occurred but it was committed by both parties or it is otherwise still in the best interests of the minor child(ren) to grant joint or sole legal decision-making (joint or sole legal custody) to a parent who has committed domestic violence because:
If you answered yes to the pregnancy, enter due date and whether you and the respondent are the parents of the unborn child.
If you answered yes to the community property, enter how you would like to divide it below:
If you answered yes to the community property, list household furniture and appliances as well as their value.
If you answered yes to the community property, list household furnishings as well as their value.
If you answered yes to the community property, list other items as well as their value.
If you answered yes to the community property, list pension/retirement fund/profit sharing/stock plan/401k, as well as its value.
If you answered yes to the community property, list motor vehicles, including their make, year, model, VIN, lien holder, and current value.
Separate Property (List the property and the value of the property, and list who should get the property)
The legal decision-making (legal custody) and parenting time arrangement I am requesting appropriately protects the minor child(ren). Explain how this arrangement appropriately protects the minor child(ren).
Restore Name: I took the name of my spouse at the time of marriage and I want to restore my last name to the name I used before this marriage or to my maiden name. My complete married name is:
Restore Name: I want my name restored to: (List complete maiden or legal name before this marriage):
Children at your primary residence
Children at Respondent's primary residence
Supervised or no parenting time is in the best interests of the child(ren) because:
To complete the child support worksheet you will need to provide: • Your monthly gross income and that of the other parent. • The monthly cost of medical insurance for the minor children who are the subject of this action. • Monthly childcare amounts paid to others. • The number of days the minor child(ren) spend with the non-primary residential (custodial) parent. • Monthly obligations of yourself and the other parent for child support or court-ordered spousal maintenance/ support *
Tax Exemptions: The parties will claim the children as income tax dependency exemptions on federal and state income tax returns as follows:
Other Orders that you are requesting: