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State of ____________________, and ever since that day have been, and are now, husband and wife.
(State in which marriage took place)
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III.
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Wife _________________ pregnant at this time.
(is or is not)
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If wife is pregnant at this time, answer the following questions. If wife
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is not pregnant, print "N/A" in the spaces.
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Husband (is or is not)_____________the father of the unborn child. The unborn child is
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due to be born on: (date of expected birth)__________________________________.
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IV.
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That there are no minor children born to, or adopted, through this union.
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V.
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Division of Assets
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Initial ONLY ONE of the statements below. Print "N/A" in the spaces you
do not use. Be sure to address all retirement accounts, bank accounts and
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vehicles. When listing accounts, use the last four digits of the account.
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Include the VIN numbers when listing vehicles.
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1. ________ All of the community assets and property have been previously divided and
each is to keep the property they have in their possession at this time.
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2. ________ There is no community property to be divided.
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3. ________ The community property should be divided as follows: (Include retirement and
pension benefits.)
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WIFE SHALL RECEIVE THE FOLLOWING:
___________________________________
_____________________________________
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___________________________________
_____________________________________
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___________________________________
_____________________________________
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___________________________________
_____________________________________
___________________________________
_____________________________________
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