Verified Petition For Dissolution Of Marriage Page 2
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1
2Petitioner wishes the Court to divide the following debts / personal property:
a.
_________________________________________________________________
b.
_________________________________________________________________
c.
_________________________________________________________________
d.
_________________________________________________________________
7.
__________________________________________________ is not pregnant.
8.
Neither party is a member of the military.
9.
This marriage has suffered an irretrievable breakdown and should be dissolved.
10.
Change of name:
Wife would like her former name of ______________________________ restored to her.
Wife does not want to change her name.
I affirm under the penalties of perjury that the foregoing representations are true.
____________________________________
Signature
_____________________________________
Print or Type Name
_____________________________________
Street Address
_____________________________________
City, State and Zip Code
_____________________________________
Phone Number
Form #PS-31152-3
Approved by State Court Administration 02/10
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