Fillable Printable Dissolution of Marriage - Connecticut

Dissolution of Marriage - Connecticut

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JOINT PETITION -

NONADVERSARIAL DIVORCE

(DISSOLUTION OF MARRIAGE)

JD-FM-242 Rev. 10-15

P.A. 15-7

("X" all that apply)

NADJPET

STATE OF CONNECTICUT

SUPERIOR COURT

JUDICIAL BRANCH

www.jud.ct.gov

petition or before the divorce will become final.

planning to live here permanently.

At least one petitioner has lived in Connecticut for at least 12 months immediately before the filing of this divorce joint

At least one petitioner lived in Connecticut at the time of the marriage, moved away, and then returned to Connecticut,

The marriage broke down after at least one petitioner moved to Connecticut.

Location of marriage (Town and State or Country)

Date of marriage

Judicial District of

At (Town)

Docket number

Name of Petitioner A (Last, First, Middle Initial)

Name of Petitioner B (Last, First, Middle Initial)

Birth name of Petitioner A (If different from above) Birth name of Petitioner B (If different from above)

ADA NOTICE

The Judicial Branch of the State of Connecticut

complies with the Americans with Disabilities

Act (ADA). If you need a reasonable

accommodation in accordance with the ADA,

contact a court clerk or an ADA contact person

listed at www.jud.ct.gov/ADA.

Instructions:

Complete this form and have it notarized. Attach: (1) a Financial Affidavit (form JD-FM-6-SHORT or

JD-FM-6-LONG) from each petitioner, (2) Notice of Automatic Orders (form JD-FM-158), and (3) a completed

Appearance (form JD-CL-12) from each petitioner. If you have a settlement agreement (form JD-FM-243) that

you are asking the court to include in the divorce decree, you must also file that agreement with this joint

petition. After you file this form and before the court orders a divorce decree, if either petitioner wants to stop

this nonadversarial process, a petitioner must file with the clerk a Notice of Revocation (form JD-FM-245).

Case Type:

Major F Minor 05

Address of Petitioner A (Number, street, town, state, and zip code)

Address of Petitioner B (Number, street, town, state, and zip code)

Phone number of Petitioner B

Phone number of Petitioner A

As of the time of filing of the joint petition in this action, the petitioners attest that the following conditions exist:

1. The marriage has broken down irretrievably;

2. The duration of the marriage does not exceed 8 years;

3. Neither petitioner is pregnant;

4. No children were born to or adopted by the petitioners prior to, or during, the marriage;

5. Neither petitioner has any interest or title in real property;

6. The total combined fair market value of all property owned by either petitioner, excluding all encumbrances, is less than

$35,000;

7. Neither petitioner has a defined benefit pension plan;

8. Neither petitioner has a pending petition for relief under the United States Bankruptcy Code;

9. Neither petitioner is applying for or receiving benefits pursuant to Title XIX of the Social Security Act;

10. No other action for dissolution of marriage, civil union, legal separation or annulment is pending in this state or in a foreign

jurisdiction; and

11. A restraining order, issued pursuant to section 46b-15 of the Connecticut General Statutes, or a protective order, issued

pursuant to section 46b-38c of the Connecticut General Statutes, between the petitioners is not in effect.

Note: After the filing of the joint petition and before the court enters a divorce decree, if a change occurs to any of the

conditions listed above, one or both of the petitioners shall notify the court immediately of the changed condition.

*NADJPET*

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JD-FM-242 Rev. 10-15 Page 2 of 2

On this the _____ day of______________, 20____, before me,

______________________________ , the undersigned officer,

personally appeared_________________________________,

known to me (or satisfactorily proven) to be the person whose

name is subscribed to the within instrument and acknowledged

that he/she executed the same for the purposes therein

contained, and swore under oath or affirmed and declared that

the information stated on this Joint Petition is complete, true,

and accurate.

listed above has received from the State of Connecticut:

If yes, you must send a copy of this joint petition and any other documents filed with this joint petition to the Assistant

Attorney General, 55 Elm Street, Hartford, CT 06106, and file the Certification of Notice (JD-FM-175) with the court clerk.

The Court is asked to order a divorce (dissolution of marriage) and: ("X" all that apply)

Signature of Petitioner B

("X" all that apply)

Petitioner A; Petitioner B;

financial support ("X" one)

Yes No Do not know

HUSKY Health Insurance ("X" one)

Yes No Do not know

The settlement agreement filed with this joint petition be incorporated by reference into the divorce decree

A name change to the birth or former name for Petitioner A to

Print name of Petitioner B

Date signed

Certification and Attestation

Petitioner B; Petitioner A;

("X" all that apply)

listed above has received financial support from a city or town

in Connecticut

("X" one)

Do not knowNoYes

(State, City, or Town:

)

If yes, send a copy of this joint petition and any other documents filed with this joint petition to the City Clerk of the town

providing assistance and file the Certification of Notice (JD-FM-175) with the court clerk.

(decree of dissolution).

A name change to the birth or former name for Petitioner B to

Both petitioners attest that:

1. They agree to proceed by consent and waive service of process;

2. Neither petitioner is acting under duress or coercion;

3. Each petitioner is waiving any right to a trial, alimony, spousal support or an appeal;

and

4. The terms of any separation agreement filed with this joint petition are fair and equitable.

Date signed

Print name of Petitioner A

Signature of Petitioner A

I attest that the statements in this petition are true to

the best of my knowledge and belief

I attest that the statements in this petition are true to

the best of my knowledge and belief

Petitioner A

Petitioner B

State of Connecticut, County of

ss.

State of Connecticut, County of

ss.

Signature of Clerk, Commissioner of Superior Court, or Notary Public

Date Commission Expires: Date Commission Expires:

Signature of Clerk, Commissioner of Superior Court, or Notary Public

In witness whereof I hereunto set my hand. In witness whereof I hereunto set my hand.

On this the _____ day of______________, 20____, before me,

______________________________ , the undersigned officer,

personally appeared_________________________________,

known to me (or satisfactorily proven) to be the person whose

name is subscribed to the within instrument and acknowledged

that he/she executed the same for the purposes therein

contained, and swore under oath or affirmed and declared that

the information stated on this Joint Petition is complete, true,

and accurate.

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