State Of North Carolina Certificate Of Absolute Divorce Or Annulment
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1N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES
N.C. VITAL RECORDS
STATE OF NORTH CAROLINA
CERTIFICATE OF ABSOLUTE DIVORCE OR ANNULMENT
File Number: _____________________________
County: __________________________________
P L A IN T IF F
Husband
FIRST
MIDDLE
LAST
1.
Wife
RESIDENCE – STATE
COUNTY
2a.
2b.
D EF E ND AN T
Husband
FIRST
MIDDLE
LAST
3.
Wife
RESIDENCE – STATE
COUNTY
4a.
4b.
M AR RI AG E
DATE OF THIS MARRIAGE
PLACE OF THIS MARRIAGE
5.
6.
NUMBER OF MINOR CHILDREN
DATE OF SEPARATION
7.
8.
C ER T I F IC AT I O N
I hereby certify that the above information as abstracted from court documents is true and correct. The
divorce
annulment was rendered in the above
entitled matter on the ________________ day of _____________________________________________________.
____________________________________
Signature __________________________________________________________________
Date
Clerk of Superior Court
Assistant CSC
Deputy CSC
DHHS 2089 (Revised 07/13)
N.C. Vital Records (Review 07/16)
After printing form, please cut on dashed line
to create a form with the dimensions of 8.5 inches by 7 inches.
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