Fillable Printable Petition for Divorce - West Virginia
Fillable Printable Petition for Divorce - West Virginia
Petition for Divorce - West Virginia
SCA-FC-101: Petition For Divorce
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 1 of 7
IN THE FAMILY COURT OF
COUNTY, WEST VIRGINIA
Civil Action No.
(Completed by Circuit Clerk's Office.)
IN RE:
The Marriage / Children Of:
Petitioner (First/Middle/Last)
,
and
Respondent (First/Middle/Last)
.
PETITION FOR DIVORCE
I,
, the Petitioner, upon oath, state that the following facts
and allegations are true to the best of my personal knowledge and belief; and if I have provided information
given to me by others, I believe that information to be true.
Check the boxes and fill in the blanks for all items that apply to your case.
YES
NO
Are you currently a party to a domestic violence proceeding?
1.
Petitioner has been a resident of West Virginia for more than one year prior to filing this divorce case.
Respondent has been a resident of West Virginia for more than one year prior to the filing of this
divorce case.
Petitioner and Respondent were married in West Virginia, and at least one of them resides in West
Virginia at this time.
2.
This action is being brought in
County, West Virginia because:
This is the county where the Petitioner and Respondent last lived together as spouses.
This is the county where the Respondent now resides.
This is the county where the Petitioner now resides, and the Respondent is not a resident of West
Virginia.
Other reasons: (Explain)
.
SCA-FC-101: Petition For Divorce
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 2 of 7
3.
Petitioner currently resides in
County, West Virginia.
4.
Respondent currently resides: (Check only one of the following three items.)
In
County, West Virginia.
At an address unknown to the Petitioner.
Out of state, where the last known address was
.
5.
Petitioner and Respondent were married in
County, in the state of
, on the
day of
,
.
6.
Petitioner and Respondent last lived together as spouses in
County, in the state
of
at the address of
.
Petitioner and Respondent separated on the
day of
,
, and
that separation has been continuous and uninterrupted since that date.
7.
YES NO
a. Is either party to this case under the age of eighteen?
YES NO
b. Is either party to this case currently serving on active duty with the military services of
the United States?
YES NO
c. Is either party to this case legally incompetent?
YES
NO
d. Is either party to this case currently incarcerated?
8.
Petitioner and Respondent are the parents of:
No children were born during this marriage, and no children are expected.
The children whose names and dates of birth are:
Name Date of Birth
/
/
/ /
/ /
/ /
Name Date of Birth
/
/
/ /
/ /
/ /
In the rest of this Petition, "the children" always means the children whose names you just listed.
A child is currently expected, and the estimated date of delivery is
/ /
.
SCA-FC-101: Petition For Divorce
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 3 of 7
9.
The children currently live with:
Petitioner Respondent
.
Another person, or persons, whose name(s) and address(es) are:
.
10.
During the last five years, if any of the children have lived at addresses other than their current address, use
the following space to list where they lived, and for how long. If there is not enough room in the following
space, use an additional sheet of paper.
I have attached additional sheet(s).
Child's Name Address Date of Residence
11.
Who provides health insurance for the children?
Petitioner
Respondent
Medicaid
WV CHIP
Another person, whose name and address is
.
The children DO NOT have health insurance coverage.
The West Virginia Children's Health Insurance Program (WV CHIP) can help parents obtain
free or low cost health care for their children. For more information, call 1-877-982-2447, or ask
the Family Court staff about WV CHIP.
12. Answer all of the following questions.
YES
NO
a. Has the Petitioner been a party or witness in any other proceeding, in any state,
concerning the allocation of custodial responsibility for the children?
YES
NO
b. Is the Petitioner aware of any other proceeding, past or present, in any state,
concerning allocation of custodial responsibility for the children?
YES NO
c. Is the Petitioner aware of any person other than the parties to this case who has
physical custody of or claims any custodial right concerning the children?
SCA-FC-101: Petition For Divorce
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 4 of 7
13.
Check all of the following items that apply.
The children have resided in West Virginia for at least 6 months immediately preceding the filing of
this case, or from birth if less than six months old.
The Petitioner believes it is in the best interest of the children for a West Virginia court to assume
jurisdiction of this case, because one or both parents have a significant connection to West Virginia,
and West Virginia is the location of a substantial number of witnesses and/or other sources of
evidence relating to the children's care and upbringing.
The children are now present in West Virginia, and have been abandoned here.
The children are now present in West Virginia, and the Petitioner believes it is necessary for a West
Virginia court to assume jurisdiction of this case on an emergency basis to protect the children, because
the children have been subjected to or threatened with mistreatment or abuse, or have otherwise been
neglected, or are depending on persons other than their parents.
The Petitioner believes no other state has jurisdiction over this case, and it would be in the children's
best interest for a West Virginia court to assume jurisdiction.
Another state has declined to assume jurisdiction over this case on the ground West Virginia is the best
place to decide matters relating to the allocation of custodial responsibility for the children, and for this
reason, the Petitioner believes it would be in the children's best interest for a West Virginia court to
assume jurisdiction.
14.
Check all of the following items that apply to your case.
Prior to the separation, both parents performed a reasonable share of the caretaking and parenting
functions for the children. For this reason, the Petitioner believes it is appropriate for the parents to
continue to share the authority for making significant decisions relating to the children's care and
upbringing. The Petitioner also believes custodial responsibility for the children should be allocated in
proportion to the time each parent spent in caretaking and parenting functions before the separation.
Prior to the separation, the Petitioner performed most, if not all of the caretaking and parenting
functions for the children. For this reason, the Petitioner believes it is appropriate for the Petitioner to
have sole authority for making significant decisions relating to the children's care and upbringing. The
Petitioner also believes custodial responsibility for the children should be allocated between the parties
in proportion to the time each parent spent performing caretaking duties prior to the parties' separation.
15.
Check all of the following items that apply to your case.
The Respondent has:
Abused, neglected, or abandoned one or more of the children.
Sexually assaulted or abused one or more of the children.
Engaged in acts of domestic violence.
Repeatedly interfered with Petitioner's access to or contact with the children.
Repeatedly made false reports or accusations of domestic violence or child abuse.
SCA-FC-101: Petition For Divorce
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 5 of 7
15.
(continued) Check all of the following items that apply to your case.
For these reasons, the Petitioner believes:
It is in the children's best interest that the authority for making significant decisions relating to the
children's care and upbringing be allocated to the Petitioner alone.
The court should impose limits on the Respondent's custodial responsibility for, and contact with, the
children.
The Respondent should not be allocated any custodial responsibility, or permitted any contact with the
children unless the court specifically finds such custodial responsibility or contact will not endanger the
children, or the Petitioner.
16.
Petitioner is in need of spousal support.
17.
Petitioner is in need of support for the minor children.
18.
Over the course of the marriage, the Petitioner and Respondent have accumulated marital property
and/or debts which the Court will have to divide.
19.
Petitioner wishes to resume using the name
.
20.
Irreconcilable differences have arisen between the parties.
21.
The parties have lived separate and apart without cohabitation for one year or more.
22.
The Respondent has inflicted cruel and inhuman treatment upon the Petitioner which has destroyed or
tended to destroy the mental or physical well-being of the Petitioner, and which renders continued
cohabitation with the Respondent unsafe and unendurable.
23.
Other grounds for divorce:
(Consult the Code of West Virginia for information regarding the grounds for divorce.)
.
THEREFORE, the Petitioner asks the Court to grant a divorce, and to grant such other relief as the Court
considers proper, including the matters specifically stated below:
Approve the Proposed Parenting Plan filed by the Petitioner.
Order the Respondent to pay support for the minor children.
Order the Respondent to maintain health insurance coverage on the children, if reasonably available,
and to assist with reasonable health care expenses not covered by insurance or by a government
medical card.
Order the Respondent to pay spousal support.
Make a fair and equitable division of marital property.
Award the
Petitioner / Respondent
the exclusive use and possession of the marital home
located at
.
SCA-FC-101: Petition For Divorce
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 6 of 7
Award the
Petitioner/
Respondent
the exclusive use and possession of the following motor
vehicles:
.
Award the
Petitioner/
Respondent
the exclusive use and possession of the furniture, furnishings
and appliances located in the marital home.
Award the Petitioner the exclusive use, possession, and ownership of the following marital property:
Description of Property Estimated Value
$
$
$
$
$
Order that the Petitioner be held solely responsible for the following debts:
Description of Debt Amount Owed
$
$
$
$
$
Order that the Respondent be held solely responsible for the following debts:
Description of Debt Amount Owed
$
$
$
$
$
Prohibit the Respondent from conveying or otherwise disposing of any marital property prior to the
time the Court divides the property.
Grant Petitioner the right to resume using the name
.
Prohibit the Respondent from annoying, abusing, threatening, or interfering with the personal liberty
and safety of the Petitioner.
SCA-FC-101: Petition For Divorce
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 7 of 7
Grant this other relief:
_________________________________________
Petitioner's Signature
___________________________________
Date
You must sign the following Verification before a Notary Public or Deputy Circuit Clerk.
VERIFICATION
I, _________________________________________, after making an oath or affirmation to tell the truth,
say that the facts I have stated in this Petition are true to the best of my personal knowledge and belief; and if I
have provided information given to me by others, I believe that information to be true.
_________________________________________
Signature
___________________________________
Date
This Verification was sworn to or affirmed before me on the ________ day of ___________________ 20____.
My commission expires: __________________________________________.
_________________________________________
Notary Public / Other Official
