Petition For Dissolution Of Marriage Page 9

STATE OF KENTUCKY

)

) SCT.

COUNTY OF

)

Subscribed and sworn to before me by ____________________________, on this the _______ day

of ______________, 2______.

Notary Public, _________________________

My commission expires: ________________________.

CERTIFICATE OF SERVICE

This is to certify that the foregoing _________________ Verified Disclosure Statement was θ mailed θ hand-

delivered to counsel for Respondent on this the _____ day of __________________, _______, and documents

requested and supporting the information set forth herein are currently available at the undersigned’s office or

are

in the undersigned’s possession and are available for inspection and copying at the requesting party’s expense.

PETITIONER

_________________

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