Free Joint Petition for Civil Union Dissolution - Nebraska


File Size: 15.4 kB
Pages: 2
Date: April 10, 2009
File Format: PDF
State: Nebraska
Category: Divorce
Author: MHP
Word Count: 573 Words, 3,670 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courts.state.nh.us/forms/nhjb-2450-fs.pdf

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Preview Joint Petition for Civil Union Dissolution
THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH
http://www.courts.state.nh.us

Court Name: Case Name: Case Number:
(if known)

JOINT PETITION FOR CIVIL UNION DISSOLUTION
1. Petitioner Name Date of Birth Residence Address Mailing Address (if different) Telephone Number (Home) 2. Respondent Name Date of Birth Residence Address Mailing Address (if different) Telephone Number (Home) 3. City and State of Civil Union Date of Civil Union 4. 5. Length of time parties have been residents of New Hampshire (P) (R) (Work) E-mail Address (optional) (Work) E-mail Address (optional)

List minor children born to, or adopted by, the parties either before or during the civil union: Name Date of Birth Name Date of Birth

6.

Please check one of the following regarding public assistance. No public assistance (TANF) is now being or has within the last 6 months been provided, nor is medical assistance (Medicaid) presently being provided, for any minor child of the parties. The N. H. Department of Health and Human Services is providing or has provided within the last 6 months public assistance (TANF) and/or medical assistance (Medicaid) for a minor child or children of the parties. If you check this box, you must mail copies of this petition and the Personal Data Sheet (NHJB-2077-FS) to DHHS at: New Hampshire Department of Health and Human Services Division of Child Support Services - Legal Unit 129 Pleasant Street Concord, NH 03301 To the knowledge of the parties, is either party pregnant? Do the parties own real estate jointly? Does the petitioner own real estate individually? Does the respondent own real estate individually?
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7. 8.

Yes Yes Yes Yes

No No No No

NHJB-2450-FS (04/09/2009)

Case Name: Case Number: JOINT PETITION FOR CIVIL UNION DISSOLUTION

9.

The cause for dissolution is: (Check one or both) Irreconcilable differences have developed that have caused the irremediable breakdown of the civil union. Other:

10. Are there any pending adoption, juvenile, domestic violence, domestic relations, paternity, legitimation, custody, parental rights and responsibilities, or other proceedings in any court in any state affecting any child(ren) named in this petition or parents of those children? Yes No If yes, specify 11. Requests for court orders: A. TEMPORARY. The parties respectfully request that the Court issue temporary orders on any of the following issues. (Check all that apply). A temporary order is in effect until the dissolution is granted. Child support Alimony Parenting Plan Use of family home Use of personal property and payment of debt Other:

B. FINAL. The parties respectfully request that the Court grant a civil union dissolution, equitably divide personal property, real estate, debts and obligations of the parties, and issue a final order approving or establishing the following (Check all that apply): A parenting plan which describes the parties' parental rights and responsibilities relating to minor children; Child support obligations for any minor children; Alimony; Any other relief which may be appropriate; Other:

Signature of Attorney for Petitioner Printed Name, Address and Phone Number of Attorney

Petitioner's Signature

Date Bar #

State of This instrument was acknowledged before me on My Commission Expires Affix Seal, if any

, County of by
Signature of Notarial Officer / Title

Signature of Attorney for Respondent Printed Name, Address and Phone Number of Attorney

Respondent's Signature

Date Bar #

State of This instrument was acknowledged before me on My Commission Expires Affix Seal, if any
NHJB-2450-FS (04/09/2009)

, County of by
Signature of Notarial Officer / Title

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