Petition For Dissolution Of Marriage Page 3
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9STATE AT LARGE, KENTUCKY
AOC-238 Doc. Code DXPV
Rev. 1-11
Case No _________________
_________________ VERIFIED
Page 1 of 1
Commonwealth of Kentucky
DISCLOSURE STATEMENT
Court Circuit
Court of Justice
County _________________
FCRPP 2
Division Family
IN RE THE MARRIAGE OF:
_________________
PETITIONER
and
_________________
RESPONDENT
Petitioner submits under oath the following _________________ Verified Disclosure Statement pursuant to
FCRPP 2 which requires full and prompt disclosure of the following information:
NOTE: A RESPONSE OF “SEE ATTACHED” IS NOT APPROPRIATE FOR ANY PORTION OF THIS
STATEMENT. ATTACH DOCUMENTS REQUESTED HEREIN ONLY.
A.
BACKGROUND INFORMATION:
1.
Name: _________________
Maiden Name:
2.
Current Address:
_________________
3.
Date of Birth: _________________
State of Birth:
4.
Number of Prior Marriages:
How Each Terminated: _________________
_________________
5.
Minor Children From Prior Marriages: 0
Name
Date of Birth
Residing With
6.
Date of Marriage: _________________
Where License Obtained: _________________
7.
Date of Separation: _________________
8.
Children of This Marriage: 0
Name
Date of Birth
Residing With
9.
Have you attended a divorce education program? _________________ When: _________________
10.
Have children attended a children's divorce education program? ____ When: _____________
11.
Is there an Emergency Protective Order or a Domestic Violence Order in effect regarding these parties?
_________________
If so, ATTACH COPY OF ORDER (all pages).
12.
Is there a Petition pending filed by either party for an Emergency Protective Order?
If so, ATTACH COPY OF PETITION (all pages).
B. EMPLOYMENT INFORMATION:
1. Current Employer:
Address:
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