Case No.____________________________________
REQUESTS TO THE COURT:
A.
DISSOLUTION (DIVORCE):
Dissolve our marriage and return each party to the status of a single person;
B.
NAMES:
Restore
Petitioner
Respondent to her or his former name of:
_____________________________________
WARNING: If you are not the person who is requesting to have your former name restored, the court
must have a written request from the party who wants his or her name restored to change the name.
C.
PATERNITY and CHILDREN’S NAMES:
The
Petitioner or
Respondent is declared to
be the father of the minor children named below, born before the marriage and (optional) change the
legal name of those children to the name listed on the right, below :
Current Legal Name
(OPTIONAL) Change the name of the child to:
New Name
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
D.
LEGAL DECISION MAKING AND VISITATION:
Award legal decision making and visitation
of the children under the age of 18 years and common to the parties, whether by birth or adoption, as
follows: (Check either the sole legal decision making box or the joint legal decision making box. If you
check the sole legal decision making box, check only one box related to visitation.)
C.1.
SOLE LEGAL DECISION MAKING of the minor child(ren) awarded to
Petitioner
OR
Respondent, subject to visitation as follows:
Reasonable Visitation rights to the parent not having legal decision making, as will
be described in the Parenting Plan attached to the Divorce Decree.
Supervised Visitation between the children and the
Petitioner OR
Respondent is in the best interest of the children because: (Explain the reasons or
need for supervised visitation. Use extra paper if necessary.)
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Name of the person who will supervise:_____________________________________
Requested restrictions on visitation: (explain here)
____________________________________________________________________
The cost of supervised parent/child access will be paid by
the parent being
supervised;
the parent having legal decision making;
shared equally by the
parties.
No Visitation rights to the parent not having legal decision making is in the best
interests of the child(ren) because: (Explain the reasons for no visitation. Use extra
paper if necessary):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Page 6 of 8
Revised: 7/22/2015