Application For Divorce Kit Page 3

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Part D
Marriage and separation
12. Date and place of marriage on your
Date
/
/
marriage certificate
(day / month / year)
Town/city
Pages E & F – Divorce Kit
Country
13. Full names of both parties as they appear
Husband
on the marriage certificate
Wife
Date
/
/
14. Date of separation
(day / month / year)
Page F – Divorce Kit
Husband
Yes
No
15a. At the date of separation, did you regard
Wife
Yes
No
the marriage as over?
Page F – Divorce Kit
Husband
Date
/
/
15b. If you answered no to question 15(a), on
Wife
Date
/
/
what date did you regard the marriage as
over?
(day / month / year)
Yes
No
16a. Since the date of separation, have you and
your spouse lived together in the same
home but not as husband and wife?
From
/
/
16b. If you answered yes to question 16(a), give
to
/
/
dates of each period you and your spouse
lived together in the same home after
From
/
/
separation.
(day / month / year)
to
/
/
If relying on any period outlined here as part of the
12 months separation, go to Page F – Divorce Kit.
Yes
No
17a. Since the date of separation, have you and
your spouse lived together as husband and
wife?
From
/
/
17b. If you answered yes to question 17(a), give
to
/
/
dates of each period you and your spouse
lived together as husband and wife.
From
/
/
(day / month / year)
to
/
/
If relying on any period outlined here as part of the
12 months separation, go to Page G – Divorce Kit.
Yes
No
18. Do you think it is likely that you and your
spouse will live together again as husband
and wife?
If yes, go to Page G – Divorce Kit.
Yes
No
19. At the date of filing this application, is it
less than two years since you married?
If yes, go to Page G – Divorce Kit.
7
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