Complaint For Limited Divorce (Dom Rel 21)
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1
2
3Circuit Court for
Case No.
City or County
vs.
Name
Name
Street Address
Apt #
Street Address
Apt #
(
)
(
)
Area
Area
City
State
Telephone
City
State
Zip Code
Telephone
Zip Code
Code
Code
Plaintiff
Defendant
COMPLAINT FOR LIMITED DIVORCE
(DOM REL 21)
I,
, representing myself, state that:
My name
1.
The Defendant and I were married on
Month
Day
Year
in
in a
civil
religious ceremony.
City/County/State where Married
2.
Check all that apply:
I have lived in Maryland since:
Month/Year
My spouse has lived in Maryland since:
Month/Year
3.
Check all that apply: (See paragraph 13)
The grounds for divorce occurred in the State of Maryland.
The grounds for divorce occurred outside the State of Maryland and I or my spouse have been
a resident for at least one (1) year prior to the date of the filing of this Complaint.
4.
Check one:
We have no children together (skip paragraphs 5 and 6) or
My spouse and I are the parents of the following child(ren):
Name
Date of Birth
Name
Date of Birth
Name
Date of Birth
Name
Date of Birth
Name
Date of Birth
Name
Date of Birth
5.
I know of the following related cases concerning the child(ren) or parties (such as domestic
violence, paternity, divorce, custody, visitation, termination of parental rights, adoption or other
cases):
Court
Case No.
Kind of Case Year Filed
Results or Status (if you know)
Page 1 of 3
CC-DR 21 (Rev. 7/2010)
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