Petition For Legal Separation Without Children

Person Filing: Street Address: City, State, Zip: Phone Number: Representing Self SUPERIOR COURT OF ARIZONA, COUNTY OF COCONINO In re the marriage of Case Number (leave blank): DO Petitioner (Me) PETITION FOR LEGAL SEPARATION WITHOUT CHILDREN Respondent (My spouse) I STATE THE FOLLOWING UNDER OATH: My Name: Street Address: City, State, Zip: Birthdate: Phone Number: Job title: Number of months/years in a row to date I have lived in Arizona: If not living in Arizona now, I [ ] lived [ ] did not live in Arizona at some point during our marriage. My Spouse's Name: Street Address: City, State, Zip: Birthdate: Phone Number: Job title: Number of months/years in a row to date my spouse has lived in Arizona: If not living in Arizona now, my spouse [ ] lived [ ] did not live in Arizona at some point during our marriage. The Marriage: Date of Marriage: City and state or country where we were married: Our marriage is irretrievably broken or I and/or my spouse desire to live separate and apart. The conciliation provisions have been met or do not apply. We do not have a covenant marriage. My spouse does not object to a decree of legal separation. Military Service: My spouse is not in military service. Residency: I and/or my spouse will live in Arizona, or I will be stationed in Arizona while a member of the Armed Forces, on the date I file this Petition. Page 1 of 4 Revised March 2012 Coconino County Law Library and Self-Help Center Forms American LegalNet, Inc. www.FormsWorkFlow.com Minor Children: We have no biological or adopted children together, and the wife is not pregnant by the husband. I ASK THE COURT TO ORDER THE FOLLOWING: Legal Separation: Order that my spouse and I are legally separated. Spousal Support: Neither party is entitled to spousal support. Award [ ] me OR [ ] my spouse $ per month in spousal support from the other party beginning the first day of the month after the Decree is signed because he/she: [] Lacks sufficient property to provide for his or her reasonable needs [] Is unable to support himself or herself through appropriate employment [] Is the custodian of at least one child whose age or condition is such that the person should not be required to seek employment outside the home [] Lacks earning ability in the labor market adequate to support himself or herself [] Contributed to the educational opportunities of the other spouse [] Had a marriage of long duration and is now of an age that precludes the possibility of gaining employment adequate to support himself or herself Order that payments be made by the first day of each month thereafter and continue until the receiving party is remarried or deceased or until . Order that payments be made through the Support Payment Clearinghouse by automatic wage assignment. If there are temporary spousal maintenance orders, order a judgment for arrearages when the judge signs the Decree. Property And Debts: WARNING: If you own any property or owe any debts, or if your spouse does, you must list them. See the Instructions in this packet for details. Order our community property and debts divided and our separate property and debts confirmed as follows. Value Community Property: Real Estate: Address: Legal Description: Address: Legal Description: Me My spouse [] [] $ [] [] $ [] [] Page 2 of 4 Revised March 2012 Coconino County Law Library and Self-Help Center Forms American LegalNet, Inc. www.FormsWorkFlow.com Value Bank Accounts: Enter the name on the account and the account description (for example, "savings"). $ $ $ $ Motor Vehicles: Make: Model: Lienholder: Last Four Digits of VIN: Make: Model: Lienholder: Last Four Digits of VIN: Employment Benefits: Examples: 401K, retirement accounts, pensions. Enter name on the account and the fund name. $ Me My spouse [] [] [] [] [] [] [] [] [] [] $ [] [] $ $ $ $ [] [] [] [] [] [] [] [] Other Community Property: [] My spouse and I have already divided all remaining property, and I ask the court to confirm that division, except as follows. Value Me My spouse Household Furniture and Appliances: $ [] [] $ [] [] $ [] [] $ [] [] Other: $ [] [] $ [] [] $ [] [] $ [] [] Community Debts: Enter the name on the account, creditor, and description (for example, "credit card"). $ $ $ $ Page 3 of 4 Revised March 2012 [] [] [] [] [] [] [] [] Coconino County Law Library and Self-Help Center Forms American LegalNet, Inc. www.FormsWorkFlow.com Value Separate Property: $ $ $ $ Separate Debts: $ $ $ $ I Request the Following Other Orders: Me [] [] [] [] My spouse [] [] [] [] [] [] [] [] [] [] [] [] I request any other orders that the court deems appropriate. OATH AND VERIFICATION: I have read this Petition. It is true and complete to the best of my knowledge. Sign in front of a notary, or in front of the Court Clerk when you start your case. The person signing must bring photo ID. Notaries are at most banks or listed in the Yellow Pages. Notaries usually charge a fee. My Signature: State of Arizona County of Subscribed and sworn before me this date: Seal: ) ) ) by: Notary Public: Notary Expiration Date: Page 4 of 4 Revised March 2012 Coconino County Law Library and Self-Help Center Forms American LegalNet, Inc. www.FormsWorkFlow.com