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Code No. ____________________
Name: ____________________________
Address: __________________________
__________________________________
Telephone Number: __________________
Acting In Proper Person
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IN THE ____________ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
IN AND FOR THE COUNTY OF ____________
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______________________________
(Your name)
Plaintiff,
vs
Case No. _____________________
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Dept. No. _____________________
______________________________
(The other party’s name)
Defendant.
____________________________________/
COMPLAINT FOR DIVORCE
(With Children)
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Plaintiff, ______________________________, in proper person, and for a cause of action
(Your name)
alleges as follows:
I.
The Plaintiff is a resident of the State of Nevada, County of ____________, and for
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a period of more than six weeks immediately preceding the commencement of this action, has resided
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in, been physically present in, and is a resident of the State of Nevada, and intends to continue to
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make the State of Nevada her/his __________ home for an indefinite period of time.
The Defendant is a resident of the State of _______________, County of _______________.
(State and County of Defendant’s residence)
II.
The parties were married on ________________________, in _______________________,
(Date of marriage)
(City or County of Marriage)
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State of ____________________, and ever since that day have been, and are now, husband and wife.
(State in which marriage took place)
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III.
Wife _________________ pregnant at this time.
(is or is not)
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If wife is pregnant at this time, answer the following questions. If wife
is not pregnant, print "N/A" in the spaces.
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Husband (is or is not)_____________the father of the unborn child. The unborn child is
due to be born on: (date of expected birth)__________________________________.
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IV.
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In the following paragraph, list all children born of this union, whether born prior to marriage
or during the marriage and also include any children who were adopted during the time of the
marriage.
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That there are _____________ minor children born to, or adopted, through this union.
(Number of minor children)
NAME
AGE
DATE OF BIRTH
______________________________________
_____________
___________________
______________________________________
_____________
___________________
______________________________________
_____________
___________________
______________________________________
_____________
___________________
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______________________________________
_____________
___________________
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______________________________________
_____________
___________________
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V.
Children’s Residence
In the following paragraph, print each child’s name and indicate in what State each
child presently resides and how long the child has resided in that state.
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The state of residence of the children is as follows:
Name
State Of Residence
____________________
_____________________
Length Of Time Child Has
Lived In That State
_________________________
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____________________
_____________________
_________________________
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____________________
_____________________
__________________________
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____________________
_____________________
__________________________
____________________
______________________
__________________________
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If the children have not been physically present in the State of Nevada for the past six months,
STOP HERE. There may be a jurisdictional issue regarding the authority of the court to enter
orders concerning custody and visitation of the children and you should seek legal assistance
on this matter before going any further.
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VI.
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Legal Custody Of The Children
WARNING: Your choice of custody terms will have a direct effect on your legal rights to your
children. Be sure you are familiar with the legal definitions of the different kinds of custody
before you choose how custody will be stated in these documents.
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Sole legal custody is granted only in extreme or unusual circumstances.
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Initial only ONE of the following statements and print “not applicable” in the other space.
WARNING: If you select “SOLE CUSTODY” you must describe facts that demonstrate the
other parent is not fit to have joint legal custody and you may be required to appear in court to
justify your choice of sole legal custody.
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_________ mother and father are fit and proper persons to share joint legal custody of the minor
Initial
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child(ren) ________________________________________________________________________
(names of child(ren)
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OR,
_________ __________________________ is a fit and proper person to have sole legal custody of
Initial
(mother or father)
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the minor child(ren) ________________________________________________________________
(names of child(ren)
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and the other parent is not fit to have joint legal custody because: ____________________________
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VII.
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Physical Custody of the Children
There are THREE different choices in the following paragraph: (a) joint physical
custody; or (b) primary physical custody; or (c) sole physical custody. Choose only
ONE. Initial the ONE choice. In the space not initialed, print “N/A”.
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(a)
Joint Physical Custody
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____________ mother and father are fit and proper persons to be awarded joint physical custody of
Initials
the minor child(ren) _______________________________________________________________
(Names of children)
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with visitation and exchange as set out in Paragraph VIII.
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(b)
Primary Physical Custody
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____________ ________________________is a fit and proper person to have the primary
Initials
(Name of custodial parent)
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physical custody of the minor child(ren),_____________________________________________
(Names of the children)
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with visitation by the non-custodial parent as set forth in the following schedule.
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(c)
Sole Physical Custody
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____________ ________________________ is a fit and proper person to have the sole physical
Initials
(Name of custodial parent)
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custody of the minor child(ren), _____________________________________________________
(Names of children)
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with visitation by the non-custodial parent as set forth in the following schedule.
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VIII.
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WEEKLY/MONTHLY AND SUMMER EXCHANGE AND VISITATION
Visitation must be set out in specific detail, including a full weekly or monthly schedule with the
days the exchanges will take place, the times of the exchanges, and who will provide
transportation. Also include specific details regarding holiday sharing and summer vacation
periods. Without very specific visitation, a Decree will not be granted. Terms such as
"reasonable visitation" and "visitation at reasonable times and places" will not be accepted.
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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HOLIDAY VISITATION
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(You may add or subtract any holidays on the following list. If you choose not to exchange the
child/ren on a specific holiday, print “N/A” in the spaces for that holiday. If no changes for the
holidays are to be made in the regular visitation schedule, state that clearly in the next paragraph
and print “N/A” on the lines provided for the individual holidays.)
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The major holidays will be handled in the following manner:
(Name each specific holiday, such as Thanksgiving, Christmas, Easter, Passover, Hanukkah and
include exactly when the holiday visitation shall begin and who will provide the transportation to
and from the visiting parent )
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________________________________________________________________________________
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________________________________________________________________________________
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_______________________________________________________________________________
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_______________________________________________________________________________
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_______________________________________________________________________________
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________________________________________________________________________________
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________________________________________________________________________________
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________________________________________________________________________________
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________________________________________________________________________________
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________________________________________________________________________________
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________________________________________________________________________________
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________________________________________________________________________________
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Should a holiday fall on a three day weekend and it is the other parent’s weekend to have the
child(ren), the three day holiday will be handled as follows:
_____________________________________________________________________________
_____________________________________________________________________________
________________________________________________________________________________
_______________________________________________________________________________
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________________________________________________________________________________
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_______________________________________________________________________________
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_______________________________________________________________________________
On each of the following holidays, visitation shall commence at_____________ __m.
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on the day of the holiday and end at __________________ ___m.
____________________________ will provide the transportation for the initial exchange
(Visiting Parent or Custodial Parent)
and _____________________________will provide the transportation for the return exchange.
(Visiting Parent or Custodial Parent)
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New Year’s Day will be alternated with_____________________________ having
(Father or Mother)
the child in the year _________ and each ______________year thereafter.
(odd or even)
Martin Luther King’s Birthday will be alternated with____________________ having the
(Father or Mother)
child in the year _________ and each ______________year thereafter.
(odd or even)
President’s Day will be alternated with____________________________ having the
(Father or Mother)
child in the year _________ and each ______________year thereafter.
(odd or even)
Memorial Day will be alternated with_____________________________ having the
(Father or Mother)
child in the year _________ and each ______________year thereafter.
(odd or even)
Fourth of July will be alternated with_____________________________ having the
(Father or Mother)
child in the year _________ and each ______________year thereafter.
(odd or even)
Labor Day will be alternated with _______________________having the child in
(Father or Mother)
the year _________ and each ______________year thereafter.
(odd or even)
Nevada Day will be alternated with_________________________ having the child in
(Father or Mother)
the year _________ and each ______________year thereafter.
(odd or even)
Halloween will be alternated with_________________________ having the child in
(Father or Mother)
the year _________ and each ______________year thereafter.
(odd or even)
Veteran’s Day will be alternated with______________________ having the child in
(Father or Mother)
the year _________ and each ______________year thereafter.
(odd or even)
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Child’s birthday will be alternated with ____________________having the child in
(Father or Mother)
the year _________ and each ______________year thereafter.
(odd or even)
________Mother shall have the child on Mother’s Day and Father shall have the child on
(Yes or No)
Father’s Day.
IX.
CHILD SUPPORT
The child support MUST be based on the formula as set out in the Nevada
Revised Statutes. You may not just state an arbitrary amount and you may not
state “no child support to be paid”.
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_______________ shall pay child support in the amount of $_________________________
(Father or Mother)
per month, per child, for a total monthly child support obligation of $_______________________
(Total monthly child support payment)
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per month. The child support shall be paid on or before the ________day of each month.
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This amount is based upon the following information:
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Husband’s gross monthly income is $________________________________.
(Amount earned per month before deductions)
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Wife’s gross monthly income is $___________________________________.
(Amount earned per month before deductions)
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Initial either line 25, or line 2, or line 6 on the next page. DO
NOT INITIAL ALL LINES. Print N/A on those lines you do
not initial.
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_________ _______________________ is the non-custodial parent and, the amount on lines
(Mother or Father)
12-14 above, is in compliance with NRS 125B.070 and is either ____________% of
(18%, 25%, 29%, 31%)
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_____________________ gross monthly income or the statutory minimum.
(Father's or Mother's)
OR
__________ Because Parents are joint physical custodians, the amount of child support on lines
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12-14 above, meets the statutory requirement.
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OR
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__________ The support obligation amount is not the amount required in the statutes. Under the
statutes, the child support obligation for ______________ would be $___________
(Mother or Father)
per month, per child. However, that amount should be different because: (Please
see NRS 125B.080 for the only reasons you can deviate from the statutory formula,
and list your reasons here)
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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_____________________________________________________________________________
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The child support obligation for each child ceases when the child reaches the age of 18 years of age
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if he/she is no longer enrolled in high school, otherwise, when he/she reaches the age of 19 years of
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age.
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A wage assignment for the child support ________________be immediately put in place.
(will or will not)
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If child support arrears from the date of separation are being requested, you must
fill in the following information. If you are not claiming child support arrears,
print “N/A” on the following lines. If you are claiming child support arrears
pursuant to NRS 125B.030, you may request up to four (4) years in arrears without a
prior court order.
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Plaintiff and Defendant separated on _____________________. Plaintiff requests child
(Date of Separation)
support in the amount of $___________ per month, per child, for a total of $______________
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per month from the date of the separation to the filing date of the Decree or other Order.
You must initial ONLY ONE of the following statements
regarding child support. On all other lines, print “N/A.”
1. ________ There is already a Child Support action through the District Attorney’s Office and
payment of the child support shall continue to be handled through that office.
2. ________ The children are receiving Welfare benefits and the Welfare Department has, or
will have, a child support case through the District Attorney’s Office and the
District Attorney’s Office shall continue to handle the child payments.
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3. ________ No formal child support obligation has ever previously been established and this
will be the SEVENTH Court Order for child support and the parent paying child
support
will pay the support directly to the receiving parent.
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4. ________ Although this is the SEVENTH Court Order for child support, the payments will
be
through the District Attorney’s Office and the parent who will be collecting child
support shall open the case with the District Attorney’s Office.
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X.
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Health Care
Provisions must be made for health care for the child(ren). If neither parent has health
insurance on the child(ren), that must be stated. If the children are on Medicaid or
Nevada Check-Up, that must be stated. Fill in all spaces, do not leave any spaces blank.
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The child(ren) presently (are or are not) _________covered by a health insurance policy.
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The child(ren) presently (are or are not)____________on Medicaid or Nevada Check-up.
______________________ shall maintain health insurance on the child(ren).
(Husband, Wife, both parents, or neither parent)
The parties shall each share, equally, any health expenses incurred on behalf of the child(ren)
that are not covered by insurance and each party shall be responsible for one half of the deductible
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and one half of the medical insurance premium if the child(ren) are covered by medical insurance.
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XI.
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Division of Assets
Initial ONLY ONE of the statements below. Print "N/A" in the spaces you do not use.
Be sure to address all retirement accounts, bank accounts and vehicles. When listing
accounts, use the last four digits of the account number, if known. Include the VIN
numbers when listing vehicles.
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1. ________ All of the community assets and property have been previously divided and
each is to keep the property they have in their possession at this time.
2. ________ There is no community property to be divided.
3. ________ The community property should be divided as follows: (Include retirement,
and pension benefits.)
WIFE SHALL RECEIVE THE FOLLOWING:
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
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HUSBAND SHALL RECEIVE THE FOLLOWING:
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
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___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
(If more room is needed, attach additional sheets but make sure the sheets are clearly identified as a
continuation of the division of assets. Write only on one side of the page of additional sheets and
each additional sheet must be initialed.)
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There may be additional community assets of the parties, the exact amounts and descriptions
12
of which are unknown to Plaintiff at this time. Plaintiff asks permission of this Court to amend this
13
Complaint to insert this information when it becomes known to Plaintiff, or at the time of trial.
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XII.
Division of Debts
Initial ONLY ONE of the three statements below. Print "N/A" in the
spaces you do not use. Be sure to list all credit cards with the last four
numbers of each account, if known.
1. ________ All of the community debts have been previously divided and each is to keep
those debts assigned to them and indemnify and hold the other party harmless
from those debts.
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2. ________ There are no community debts to be divided.
3. ________ The community debts should be divided as follows: (Be sure to list specific
debts with the last four numbers of the accounts, if available.)
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WIFE SHALL RECEIVE THE FOLLOWING DEBTS
AS HER SOLE AND SPEARATE DEBTS AND SHALL INDEMNIFY AND HOLD
HUSBAND HARMELSS FROM THESE DEBTS:
__________________________________
___________________________________
___________________________________
___________________________________
___________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
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___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_______________________________________
_____________________________________
_______________________________________
HUSBAND SHALL RECEIVE THE FOLLOWING DEBTS
AS HIS SOLE AND SEPARATE DEBTS AND SHALL INDEMNIFY AND HOLD WIFE
HARMELSS FROM THESE DEBTS:
__________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_____________________________________
___________________________________
_______________________________________
___________________________________
_____________________________________
___________________________________
_______________________________________
(If more room is needed, attach additional sheets but make sure the sheets are clearly identified
as a continuation of the division of debts. Write only on one side of the page on additional
sheets and each additional sheet must be initialed.)
There may be additional community debts of the parties, the exact amounts and
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descriptions of which are unknown to Plaintiff at this time. Plaintiff asks permission of this
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Court to amend this Complaint to insert this information when it becomes known to Plaintiff, or
25
at the time of trial.
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XIII.
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Spousal Support (Alimony)
Initial only ONE of the following statements. If you initial one of the statements that
makes a provision for spousal support, be sure to fill in all the spaces in that statement.
DO NOT LEAVE ANY SPACES BLANK IN THIS SECTION. PRINT “N/A” IN
ALL SPACES THAT ARE NOT APPLICABLE TO YOU.
Spousal Support will automatically cease upon the remarriage of the recipient or the
death of either party.
___________ Alimony is not appropriate in this case.
___________ Wife shall receive spousal support in the amount of $_____________________per
(Amount Wife to receive)
______________________, due and payable on the ___________________of each
(Week or month)
(Date amount due)
_______________________ for a period of ______________________________
(Week or month)
(Number of weeks, months or years)
The spousal support shall begin on ______________________________________
(Date spousal support to begin)
and end on _________________________________________.
(Date last spousal support payment will be made)
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___________ Husband shall receive spousal support in the amount of
$__________________per
(Amount to be received)
______________________, due and payable on the ___________________of each
(Week or month)
(Date amount due)
_______________________ for a period of ______________________________
(Week or month)
(Number of weeks, months or years)
The spousal support shall begin on ______________________________________
(Date spousal support to begin)
and end on _________________________________________.
(Date last spousal support payment will be made)
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XIV.
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Former Name
If wife is filing, wife should initial ONLY ONE of the following three statements
and print “N/A” in the spaces not filled in. If husband is filing, husband should
print “N/A” in all spaces
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_________ Wife does not wish to return to her former name.
_________ Wife wishes to return to her former name of _______________________________
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___________________________________________________ (Print full name).
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_________
Wife never changed her name and, therefore, does not request restoration of her
former name.
XV.
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The parties are incompatible in marriage and there is no hope for reconciliation, and/or
the parties have lived separate and apart for more than one year without cohabitation.
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WHEREFORE, Plaintiff prays for judgment against Defendant as follows:
1. That the bonds of matrimony heretofore and now existing between the Plaintiff and
11
Defendant be forever dissolved, and that each of the parties be restored to the status of
12
unmarried persons.
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2. That the Court grant Plaintiff the relief requested in this Complaint.
3. For other and further relief as the Court may deem just and proper in this action.
DATE:________________________________
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__________________________________
(Signature)
__________________________________
(Address)
__________________________________
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__________________________________
(Telephone number)
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VERIFICATION AND ACKNOWLEDGMENT
STATE OF NEVADA
3
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County of ____________
)
)ss
)
6
_____________________________________, being first duly sworn, under oath and the
(Your name)
penalties of perjury, deposes and says: I am the Plaintiff in the above entitled action, and competent
7
to testify as to the contents of the attached pleading of my own knowledge; that I have read the
8
foregoing Complaint For Divorce and know the contents thereof; that the same are true to the best of
5
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my own knowledge, save and except to those matters stated upon information and belief, and, as to
those matters, I believe the same to be true.
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____________________________________
(Signature)
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SUBSCRIBED and SWORN to before me
15
this _____day of ______________, _________.
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______________________________________
NOTARY PUBLIC
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STATE OF NEVADA
County of ____________
)
)ss
)
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On this _______________________, ________, personally appeared before me, the
undersigned, a Notary Public in and for the County of ____________, State of Nevada,
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___________________________________________________, personally known to me or proved
to me to be the person whose name is subscribed to the above instrument who acknowledged that
she/he executed the above instrument.
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___________________________________
NOTARY PUBLIC
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CC12
NAME
Firm Name
Bar No.
Address
City, State, Zip
Telephone
Attorney for
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IN THE ____________ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
8
IN AND FOR THE COUNTY OF ____________
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_________________,
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Plaintiff,
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vs.
_________________,
Defendant.
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)
)
)
)
)
)
)
)
)
)
CASE NO. _________
DEPT. NO. _________
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JOINT PRELIMINARY INJUNCTION
18
NOTICE: THIS INJUNCTION IS EFFECTIVE UPON THE PARTY REQUESTING IT
WHEN ISSUED AND AGAINST THE OTHER PARTY WHEN SERVED. THIS
INJUNCTION SHALL REMAIN IN EFFECT FROM THE TIME OF ITS ISSUANCE
UNTIL TRIAL OR UNTIL DISSOLVED OR MODIFIED BY THE COURT.
DISOBEDIENCE OF THIS INJUNCTION IS PUNISHABLE BY CONTEMPT.
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TO: Plaintiff and Defendant:
YOU, ANY OFFICERS, AGENTS, SERVANTS, EMPLOYEES OR A PERSON IN
ACTIVE CONCERT OR PARTICIPATION WITH YOU ARE HEREBY PROHIBITED
AND RESTRAINED FROM:
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1. Transferring, encumbering, concealing, selling or otherwise disposing of any of
your joint, common or community property except in the usual course of business or for the
necessities of life, without the written consent of the parties or the permission of the Court.
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2. Molesting, harassing, disturbing the peace of or committing an assault or battery upon
your spouse or your child or stepchild.
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3. Removing any child of the parties then residing in the State of Nevada with an intent
4
or effect to deprive the Court of jurisdiction as to said child without the prior written consent of
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the parties or the advance permission of the Court.
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Submitted by:
_________________________
Name
__________________________
Firm
__________________________
Address
__________________________
City, State, Zip
__________________________
Attorney for:
______________________________,
CLERK OF COURT
By:
Deputy Clerk
_________________
_________________
_________________
________
Date
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©Nevada Law Help Family-Form # 3.1
Revised 01/10/2006
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Code:____________________
Wife’s name:________________________
Address:___________________________
__________________________________
Telephone:_________________________
Husband’s name:______________________
Address:_____________________________
____________________________________
Telephone:___________________________
In Proper Person
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IN THE ____________ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
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IN AND FOR THE COUNTY OF ____________
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_________________,
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Plaintiff,
vs.
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_________________,
Defendant.
CASE NO. _________
DEPT. NO. _________
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AFFIDAVIT OF RESIDENT WITNESS
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STATE OF NEVADA
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County of ____________
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)
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I, ___________________________________________, do hereby swear under penalty
(Resident Witnesses’ name)
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of perjury that the assertions of this affidavit are true.
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1.
I am over the age of eighteen and competent to testify of my own knowledge to
the following.
2.
I have lived in the State of Nevada for _____________ years and presently live at
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___________________________________, City of _____________________, State of Nevada
(Street address of person making the Affidavit)
and I intend to live in the State of Nevada for the foreseeable future.
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© Nevada Law Help Family-Form # 7.1
Revised 01/10/2006
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3.
To my personal knowledge, __________________________________________,
(Name of person whose residency is being established)
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lives at____________________________________________________, State of Nevada and
has
(The address of the person whose residency is being established)
been physically living within the State of Nevada on a daily basis for at least six (6) weeks prior
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to the filing of this Complaint for Divorce on __________________________.
(Date Complaint for Divorce was filed)
4.
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lived in the State of Nevada Since_______________________________.
(State date you know the person has lived in Nevada)
5.
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To my personal knowledge, ____________________________has physically
(Name of person whose residency is being established)
I see the Petitioner on the average of ____________________times a week. The
(State how often you actually see the person in a week)
Petitioner is_____________________________________________________________.
(Fill in how you know the person, such as friend, relative, co-worker, etc.)
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6.
I know of my own personal knowledge that _________________________________
(Name of Resident Petitioner)
is a bona fide resident of the State of Nevada.
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DATED_________________________________.
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__________________________________
(Signature of person making this Affidavit)
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SUBSCRIBED AND SWORN to before me
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this _____ day of _________________,_________
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_________________________________________
NOTARY PUBLIC
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© Nevada Law Help Family-Form # 7.1
Revised 01/10/2006
