Notice And Acknowledgment To Child Support Enforcement Division
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1
2_______________________________
Name
_____________________________________
Address
_____________________________________
City
State
Zip Code
____________________________________
Phone Number
WIFE, PETITIONER PRO SE
_______________________________
Name
_____________________________________
Address
_____________________________________
City
State
Zip Code
____________________________________
Phone Number
HUSBAND, PETITIONER PRO SE
MONTANA _______________ JUDICIAL DISTRICT COURT
_____________________ COUNTY
In re the Marriage of:
Cause No.: _________________
________________________,
Petitioner,
and
Notice and Acknowledgment to Child
Support Enforcement Division
________________________,
Petitioner.
COMES NOW, the Petitioners and give notice to the State of Montana, Department of Public
Health and Human Services, Child Support Enforcement Division, in accordance with M.C.A. § 40-5-
202(5), that they have filed a Joint Petition for Dissolution of Marriage in the above-entitled action,
and that one of the issues in this legal action is child support. A copy of the Petition is attached
hereto. In accordance with M.R.Civ.P. 4D(2)(h), the Petitioners also give notice to the Attorney
General of the State of Montana.
DATED this ______ day of ____________________, 20___.
____________________________________
___________________________________
Wife, Petitioner Pro Se
Husband, Petitioner Pro Se
Notice to CSED, Page 1 of 2
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02
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