Fill and Sign the Fm 004 Rev0616divorce with Children Approved6716docx Form

FM-004, Rev. 06/16 Page 1 of 2 STATE OF MAINE DISTRICT COURT Location Docket No. Plaintiff COMPLAINT FOR DIVORCE v. (with children) Title to Real Estate Is Involved Defendant 19-A M.R.S. § 901, 1652, 1653, 1851 M.R. Civ. P. 10(a) 1. Plaintiff was lawfully married to defendant in (town) , (county) , (state) , on (mo/date/yr.) 2. Plaintiff now resides in (town) , (county) , (state) . If either party wishes to keep his/her address confidential, that party may complete an Affidavit for Confidential Address (FM-057). This form is available at the Clerk’s Office or at courts.maine.gov. 3. Defendant now resides in (town) , (county) , (state) , OR Residence of the Defendant is unknown and Plaintiff has used reasonable efforts and cannot locate Defendant. 4. The court has jurisdiction because (check all of the statements that apply): A. Plaintiff resided in Maine in good faith for six months before filing this complaint; B. Plaintiff is a resident of Maine and the parties were married in Maine; C. Plaintiff is a resident of Maine and the parties resided in Maine when the grounds for divorce arose; and/or D. Defendant is a resident of Maine. 5. Neither Plaintiff nor Defendant has filed for divorce or annulment from the other before this complaint, OR A complaint for divorce or annulment was filed before in (court name, town and state of court) Docket No. . That case: Was dismissed on (date) . Is still pending. 6. The parties have personal property, AND Either or both parties has an interest in real estate, (file and exchange form FM-056) Neither party has an interest in real estate. 7. Plaintiff lists the following grounds for divorce: Irreconcilable marital differences exist between the parties. Other . 8. Plaintiff and defendant are the legal parents of the following child(ren), 19-A M.R.S. § 1844 (2) (A): Name Date of Birth Present Address List below where and with whom the child(ren) have lived within the past 5 years. Name and present address of Dates child(ren) lived Town and State where child(ren) person child(ren) lived with with that person lived with that person FM-004, Rev. 06/16 Page 2 of 2 9. Plaintiff has not been involved in any way in, and has no information about, another court case in Maine or in any other state concerning the custody of the child(ren) except as follows: Protection from Abuse, (provide docket number): Probate matter, (provide docket number): ___________________________________________________ Other (describe what kind of other case) 10. No one other than the parties has physical custody of the child(ren), or claims to have custody or visitation rights with respect to the child(ren), except as follows: 11. (Check all boxes that apply) No public assistance benefits have ever been received for the child(ren). OR Public assistance benefits have been, are now, or will be received for the child(ren). AND Plaintiff has sent a copy of this complaint to the Department of Health and Human Services at the following address: Support Enforcement Division, Central Office Supervisor, State House Station 11, Augusta, ME 04333-0011. (A copy must be sent when the child(ren) have been, are now or will be receiving public assistance benefits.) The Department of Health and Human Services has issued a child support order regarding the child(ren). (If such an order has issued, a copy of the order must be attached to this Complaint). The Department of Health and Human Services has been contacted to set up, review, change or enforce a child support order regarding the child(ren). 12. PLAINTIFF REQUESTS that a divorce be granted and that the court; (Check all boxes that apply) Determine parental rights and responsibilities regarding the minor child(ren), including child support (file and exchange form FM-050); Set apart the non-marital property to each party and divide the marital property; Order that spousal support be paid to Plaintiff by Defendant (file and exchange form FM-043); Award reasonable attorney's fees to Plaintiff's attorney (file and exchange form FM-043); and Change Plaintiff's name to: . Date: (Plaintiff's signature) Plaintiff Attorney: Plaintiff: Address: Address: Telephone: Telephone: STATE OF MAINE County Personally appeared the above named Plaintiff, , and made Oath that the foregoing statements are true. Before me, Date: Attorney at Law / Notary Public / Deputy Clerk Defendant has 20 days after being served with this complaint (being given a copy), to file an answer with the Court and must provide copies of all filings to other party.