Georgia Court Forms Page 7
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7d) Visitation with the minor children;
e) Child Support;
f)
Medical, Dental and Hospitalization insurance for the children;
g) Life Insurance for the benefit of the minor children;
h) Alimony;
i)
An award of the marital property listed in paragraph (14c);
j)
Respondent to pay the joint debts listed in paragraph (I5b);
k) That all issues of child support, health insurance for the minor children, life insurance for
the minor children, alimony, division of property and debts be held in abeyance until such
time as this court has personal jurisdiction over my spouse;
l)
A change back to my former name
m) A restraining order to restrain and enjoin the Respondent from harassing, molesting or
threatening me in any way whatsoever;
n) A total divorce, a vinculo matrimonii, from Respondent;
o) Respondent be served with a copy of my Complaint for Divorce;
p) That the Separation Agreement attached to this petition be made the Order of this Court;
and
q) Any other appropriate relief.
This the
day of
, 2
.
[Date]
[Month]
[Year]
Respectfully submitted,
PRO SE
(Sign your name here)
Petitioner’s name
:
(print or type)
Petitioner’s address:
Petitioner’s telephone number:
Page 7 of 7
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