Divorce Complaint Page 2
Download a blank fillable Divorce Complaint in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Divorce Complaint with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
211.
If there is a court order regarding custody or support for any child listed above, name the child(ren) below and specify
the person or agency awarded custody or ordered to pay support:
Child's name
Name of person or agency awarded custody
Name of person ordered to pay support
Child's name
Name of person or agency awarded custody
Name of person ordered to pay support
Child's name
Name of person or agency awarded custody
Name of person ordered to pay support
12.
The ("X" all that apply)
plaintiff
defendant
or any of the child(ren) listed above have received from the
State of Connecticut:
financial support ("X" one)
Yes
No
Do not know
HUSKY Health Insurance ("X" one)
Yes
No
Do not know
If yes, you must send a copy of the Summons, Complaint, Notice of Automatic Court Orders and any other documents
filed with this Complaint to the Assistant Attorney General, 55 Elm Street, Hartford, CT 06106, and file the Certification
of Notice (JD-FM-175) with the court clerk.
.
13.
The ("X" all that apply)
plaintiff
defendant is pregnant with a child due to be born on
(date)
unknown
The other parent of this unborn child is the
plaintiff or
defendant
not the plaintiff
not the defendant.
14.
The ("X" all that apply)
plaintiff
defendant or any of the child(ren) listed above has received financial support
from a city or town in Connecticut. ("X" one)
Yes (State city or town:
)
If yes, send a copy of the Summons, Complaint, Notice of Automatic Court Orders and
No
Do not know.
any other documents filed with this Complaint to the City Clerk of the town providing assistance and file the
Certification of Notice (JD-FM-175) with the court clerk.
The Court is asked to order: ("X" all that apply)
Regarding Parental Decisionmaking Responsibility:
A divorce (dissolution of marriage).
Sole custody.
A fair division of property and debts.
Joint legal custody.
Alimony.
A parenting responsibility plan which includes a plan for the
Child Support.
parental decisionmaking regarding the minor child(ren).
AND
An order regarding the post-majority
Regarding Physical Custody:
educational support of the child(ren).
Primary residence with:
Name change to:
Visitation.
A parenting responsibility plan which includes a plan for the
schedule of physical care of the minor child(ren).
And anything else the Court deems fair.
Signature
Print name of person signing
Date signed
Address
Juris number (If applicable)
Telephone (Area code first)
• If this is a Complaint, attach a copy of the Automatic Court Orders before serving a copy
on the Defendant.
• If this is an Amended Complaint or a Cross Complaint, you must mail or deliver a copy to
anyone who has filed an appearance and you must complete the certification below.
I certify that I mailed or delivered a copy to all counsel and self-represented parties of record on:
Date copies mailed or delivered
Signed (Attorney or self-represented party)
Name of each party copy was mailed or delivered to*
Address at which copy was mailed or delivered*
*If necessary, attach additional sheet with name of each party and the address at which the copy was mailed or delivered to.
JD-FM-159 (Back) Rev. 11-09
PRINT
RESET
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal