Petition For Divorce Page 2

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Case Name:
Case Number:
PETITION FOR DIVORCE
6. List the places where the minor child/ren of the parties has/have lived in the last five (5) years and the
names of the people they lived with at that time, if you know. Start with where the child lives now and work
backward in time.
Dates
Town/City, State
Parent(s)/Caretaker
Current Address/Contact
Which
From/To
Address of Parent/Caretaker
Child/ren
If more space is needed, attach Extra Page (Form NHJB-2656-FPS).
I have attached Form NHJB-2656-FPS because additional space was needed.
7. Are there any person(s), not a party to this proceeding, who have physical custody of the child/ren or who
claim to have custody, physical custody or parenting time rights?
Yes
No
If yes, list name(s) and address(es) of person(s):
8. Check one of the following:
I have not participated in any court case(s) concerning the custody, visitation, parenting time or
placement of the child/ren in this or any other state.
OR
I have participated in court case(s) concerning the custody, visitation, parenting time or placement of
the child/ren in this or any other state. I have participated in the following:
Name of Court
State
Case No.
Date of Court Order
9. Are there any actions for enforcement, or proceedings relating to domestic violence, domestic relations,
protective orders, marriage dissolution, paternity, legitimation, custody, parental rights and responsibilities,
termination of parental rights, adoption, juvenile, or other proceedings in any court in any state affecting any
children named in this petition or parents of those children?
Yes
No
If yes, complete the following:
Name of Court
State
Case No.
Type of Court Case
Top of 1st Page
NHJB-2057-FS (12/01/2010)
Page 2 of 4

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