Petition For Dissolution Of Marriage Page 7
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15III. CHILD CUSTODY JURISDICTION INFORMATION
A. The following are children under age 19 born of the marriage or adopted by the petitioners:
Child’s Name
Place of Birth
Birthdate
Sex
Marital Status
School Grade
Present Address (since
/
/
)
Who Has Custody Relationship
Prior Residences for
City & State
Person child lived with
Relationship
past 5 years (dates)
(Name & Current Address)
to
to
to
Child’s Name
Place of Birth
Birthdate
Sex
Marital Status
School Grade
Present Address (since
/
/
)
Who Has Custody Relationship
Prior Residences for
City & State
Person child lived with
Relationship
past 5 years (dates)
(Name & Current Address)
to
to
to
Child’s Name
Place of Birth
Birthdate
Sex
Marital Status
School Grade
Present Address (since
/
/
)
Who Has Custody Relationship
Prior Residences for
City & State
Person child lived with
Relationship
past 5 years (dates)
(Name & Current Address)
to
to
to
Husband’s Signature
Wife’s Signature
Page 7 of 15
AS 25.30.380
DR-105 (4/09)(cs)
AS 25.24.200-.260
PETITION FOR DISSOLUTION OF MARRIAGE (WITH CHILDREN)
Civil Rule 90.1(a), f(2)(A)(B), (i)(1)
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