Fillable Printable Petition for Dissolution of Marriage - Illinois

Petition for Dissolution of Marriage - Illinois

IN THE CIRC UIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT

LAKE COUNTY, ILLINOIS

)

Petitioner )

vs. ) Gen. No.

)

Respondent )

PETITION FOR DISSOLUTION OF MARRIAGE

, the Petitioner, representing myself, state that:

Name

Part A. Jurisdiction

(One party must be a resident of the State of Illinois for at least 90 days prior either to the

filing of this Petition or to the entry of the Judgment for Dissolution of Marriage).

1. Petitioner

a. I am

years of age.

b. I presently reside at

City/County and State

c. My occupation is that of: .

2. Respondent

a. The Respondent is

years of age.

b. The Respondent presently resides at

City/County and State

c. The Respondent’s occupation is that of:

3. Marriage

a. The Respondent and I were married on

____________________________.

(mmddyyyy)

b. The marriage took place in and the marriage is

City/County and State

registered in that state and county.

Residency (Check all that apply):

S a. I have lived in Illinois since .

Month/Year

S b. My spouse h a s lived in Illin o is since .

Month/Year

5. Other Proceedings (Check one)

S a. No petition for dissolution of marriage between the parties is pen d ing in any ot her county or state.

S b. There is another petition f or dissolution of marriage between the parties is pen ding in:

City/County and State

Page 1 of 4 174-CSR200 (Rev 09/04)

Part B. Children/ Related Cases

1. Children ( Check all that ap ply ):

(A completed Declaration Under Uniform Child Custody Jurisdiction Enforcement Act

(UCCJEA) form must be attached to this petition.)

S a. We have no children together. or

S b. That I S am / S am not currently pregnant. or

S c. That my spouse S is / S is not currently pregnant.

(If no child(ren), skip to Part B, paragraph 4

)

S d. The following child(ren) were born to or adopted by myself and my spouse and me during the

marriage:

Name

Date of Birth

(mmddyyyy)

Currently Living With

(Attach additional pages as needed)

2. It is in the best int erests of the child(ren ) that (check one):

S a. Temporary and permanent sole custody of

Name of Ch ild(ren)

be awarded to the S Petitioner S Respondent.

S b. Temporary and permanent joint custody of

Name of Ch ild(ren)

be awarded to the parties with S Petitioner S Respondent as the resident ial parent.

3. It is in the best int erests of the child(ren) that the Court provide for visitation as follows (check one):

S a. Deny S Restrict visitation because:

S b. Grant visitation as follows:

4. I know of the following related cases pending or closed concerning the parties or child(ren) (such as

domestic violence, paternity, divorce, custody, visitation or juvenile court cases, support, etc.):

County/State Case Number Kind of Case Year Filed Pending or Closed

(Attach additional pages as needed)

Part C. Support

(Affidavit of Income and Expenses must be filed in the court at the time of any hearing on

support and maintenance.) (Check all that apply)

S a. The Respondent S is S is not employed.

S b. The Respondent S is S is not able to contribute to the support of S our minor child(ren)

S and myself.

Page 2 of 4 174-CSR200 (Rev 09/04)

2. I S am / S am not (check one) seeking maintenance (support) for myself because:

Part D. Property

(You do not have to complete Part D if you are not asking the court to make decisions about

your property.)

(Attach additional pages as needed)

1. My spouse and/or I have the following marital property and debts (check all that apply):

S Real Estate/House(s):

Street Address

S Pension(s):

Name of Company

S Bank account(s) and investment(s):

Name of Financial Institution

S Motor Vehicle(s):

Year, Make and Model

S Debts (attach list)

Other:

S I claim the following property as my non-marital property because the property was acquired

S prior to our marriage S by gift S by inheritance S other:

S I acknowledge the following property as my spouse’s non-marital property because the property as

acquired S prior to our marriage S by gift S by inheritance S other.:

Part E. Grounds for Dissolution of Marriage

1. My grounds for Dissolution of my marriage are: (Check all that apply)

S a. Irreconcilable Differences (separated in exce ss of 2 years)

From on or about __ , my spouse and I have lived separate and apart from

mmddyyyy

each other for a continuous period in excess of 2 years and irreconcilable differences have

caused the irretrievable breakdown of the marriage. Efforts at reconciliation have failed or future

attempts

at reconciliation would be impracticable and not in the best interests of the family .

S b. Irreconcilable Differences (separated in excess of 6 months with 2 year waiver)

From on or about

, my spouse and I have lived separate and apart from

mmddyyyy

each other for a continuous period in excess of 6 months and we have signed written waivers of

the 2 year period of separation. Irreconcilable differences have caused the irretrievab le

breakdown of the marriage. Efforts at reconciliation have failed or future attempts at

reconciliat ion would be impract icable and not in the best interests of the family.

S c. Physical or Mental Cruelt y

That without cause or provocation on my part, my spouse during the marriage has been

guilty of extreme and repeated S physical and/or S mental cruelty.

Page 3 of 4 174-CSR200 (Rev 09/04)

Distribution: (3 Co pies) U Original to Circuit Clerk U Petitioner U Respondent

Page 4 of 4 174-CSR200 (Rev 09/04)

S d. Other Grounds per 750 ILCS 5/401 (Please specify)

Part F. Parties' Agreements

1. S The parties have reached ag reement(s) on the f o llowing issues:

S custody, S visitation, S child support or S maintenance (support for a spouse)

State the specific arrangements:

(Attach additional pages as needed)

Part G. Relief Requested

1. FOR THESE REASONS, I request that judgment be entered that provides as follows:

(Chec k all that apply)

S a. That the marriage be dissolved.

S b. That sole custody of the minor child(ren) be awarded to S Petitioner S Respondent.

S c. That joint legal cust ody of the minor child(ren) be aw arded with S Petitioner S Respondent

to be the residential custodian.

S d. That visitation with the minor child(ren) be S granted S restricted S barred S reserved.

S e. That child support be awarded.

S f. That a fair division of the property or its value acquired during the marriage be divided in just

proportions.

S g. That maintenance to the Petitioner be S granted S waived S reserved

S h. That maintenance to the Respondent be S granted S barred S reserved

S i. That a change back to my former name: be granted.

Full Former Name

j. That any other appropriate relief be awarded.

Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure,* the

undersigned certifies that the statements set forth in this inst rument are true and correct.

Date Signature

Printed Name

* - Any person who makes a false statement, material to the issue or point in question, which he does

not believe to be true, in any document certified by such person in accordance with 735 ILCS 5/1-109 shall

be guilty of a Class 3 felony punishable by two (2) to five (5) years imprisonment and/or a $10,000.00 fine.