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_______________________________
Name
_____________________________________
Address
_____________________________________
City State Zip Code
_____________________________________
Phone Number
PETITIONER PRO SE
MONTANA _______________ JUDICIAL DISTRICT COURT
_____________________ COUNTY
In re the Marriage of:
________________________,
Petitioner,
and
________________________,
Respondent. Cause No.: _________________
Petition for Dissolution
The Petitioner respectfully submits the following:
1. Information about Petitioner
a. Name:
b. Age: Date of Birth:
c. Address:
City: State: County:
d. Length of Residence in County:
e. Length of Residence in Montana, if applicable:
f. Occupation:
Petition for Dissolution, Page 1 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
2. Information about Respondent
a. Name:
b. Age: Date of Birth:
c. Address:
City: State: County:
d. Length of Residence in County:
e. Length of Residence in Montana, if applicable:
f. Occupation:
3. Date and Place of Marriage
Choose One:
[ ] The parties were married on ( date ): . The marriage
was registered in the County of , State of
.
[ ] The parties were married at common law. The parties assumed a marital
relationship by mutual consent and agreement and confirmed their marriage by
cohabitation and public repute.
4. Separation
Choose One:
[ ] The parties separated on ( date ):
.
[ ] The parties are not yet separated.
5. Jurisdiction
a. The jurisdictional requirements of M.C.A. § 40-4-104 exist.
b. Choose One:
[ ] The marriage is irretrievably broken in that there is serious marital discord
which adversely affects the attitude of one of the parties towards the
marriage, and there is no reasonable prospect of reconciliation.
Petition for Dissolution, Page 2 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
[ ] The marriage is irretrievably broken in that the parties have lived separate
and apart for a period of more than one hundred eighty (180) days
preceding the commencement of these proceedings, and there is no
reasonable prospect of reconciliation.
c. The conciliation provisions of the Montana Conciliation law and M.C.A. § 40-4-
107 do not apply.
6. No Children of the Marriage
Choose One:
[ ] There were no children born of the marriage.
[ ] There were children of the marriage, but none are now minors.
[ ] There were children born of the marriage, but this Court has no jurisdiction over
them.
7. Pregnancy
Choose One:
[ ] The wife is not pregnant.
[ ] The wife is pregnant. However, the husband is not the father, and the child is not
at issue in this proceeding.
8. Preliminary Disclosure
The Petitioner is complying with the preliminary disclosure requirements of M.C.A. §40-
4-252 and will serve a Declaration of Disclosure of Assets, Debts, Income and Expenses
upon the Respondent at the time of service of this Petition.
9. Real Property
Choose One:
[ ] The parties do not own any real property.
or
[ ] a. The [ ] Petitioner/[ ] Respondent/[ ] both parties is/are the owner(s)
of record of real property located at
Petition for Dissolution, Page 3 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
. The legal description of the property is
.
b. This real property should be distributed as follows. Choose One:
[ ] The [ ] Petitioner/[ ] Respondent should be awarded ownership of
this real property.
or
[ ] Describe the proposed distribution of the real property :
.
If needed, attach additional sheets as Exhibit _____.
10. Vehicles
Choose One:
[ ] The parties do not own any vehicles.
or
[ ] The parties own the following vehicle(s). It is equitable that the vehicle(s) be
distributed as follows ( Please include the year, make, and model for each vehicle
listed. ):
To Petitioner:
Vehicle: VIN#:
Vehicle: VIN#:
Vehicle: VIN#:
To Respondent:
Vehicle: VIN#:
Vehicle: VIN#:
Vehicle: VIN#:
If needed, attach additional sheets as Exhibit _____.
11. Personal Property
Choose One:
[ ] The parties have already divided their personal property. It is equitable that each
party retain the property currently in his or her possession.
Petition for Dissolution, Page 4 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
or
[ ] The parties have not divided their personal property. It is equitable that the
property be divided as follows:
To Petitioner :
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
To Respondent :
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
If needed, attach additional sheets as Exhibit _____.
12. Debts
Choose One:
[ ] There are no debts of the marriage.
[ ] The parties have accumulated debts during the course of their marriage. It is
equitable that each party retain responsibility for the debts currently in his or her
name.
or
[ ] The parties have accumulated debts during the course of their marriage. It is
equitable that responsibility for the debts be divided as follows:
To Petitioner:
Description of Debt Creditor Current Balance Amount to Petitioner
Petition for Dissolution, Page 5 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
Description of Debt Creditor Current Balance Amount to Petitioner
Any and all other debts in Petitioner’s name only; any and all other debts incurred solely by the
Petitioner since the parties’ separation.
To Respondent:
Description of Debt Creditor Current Balance Amount to Respondent
Any and all other debts in Respondent’s name only; any and all other debts incurred solely by
the Respondent since the parties’ separation; and any and all other debts not disclosed by the
Respondent to the Petitioner.
Petition for Dissolution, Page 6 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
If needed, attach additional sheets as Exhibit _____.
13. Wife’s Former Name
Choose One:
[ ] The wife would like to be restored to her former name of
_________________________________________________________________.
[ ] The wife does not want to be restored to her former name.
[ ] The husband does not know whether the wife would like to be restored to her
former name.
14. Other Provisions
.
WHEREFORE, the Petitioner requests as follows:
1. That this Court enter a Decree of Dissolution of Marriage dissolving the marital status
between the parties;
2 That each party be granted real and personal property as requested above;
3. That each party be granted ownership of the vehicles as requested above;
4. That each party be ordered to pay debts as requested above;
5. That the wife be restored to use of her former name, if requested above;
6. Other Provisions: _________________________________________________________
;
and
7. For such other and further relief as the Court deems just and proper.
DATED this _______ day of ____________________, 20___.
_____________________________________
Petitioner Pro Se
_____________________________________
Petition for Dissolution, Page 7 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
Print Name
Petition for Dissolution, Page 8 of 9
Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04
STATE OF MONTANA )
) ss.
COUNTY OF _________________ )
_______________________________, being first duly sworn on oath, says that
he/she is the Petitioner in the above-entitled proceeding; that he/she has read the foregoing
Petition and knows the contents thereof; and that the matter, facts and things stated therein are
true to the best of his/her knowledge and belief.
_____________________________________
Petitioner Pro Se
SUBSCRIBED AND SWORN to before me this _____ day of ________________,
20____.
_____________________________________
Name (printed) : ________________________
(SEAL) Notary Public for the State of Montana.
Residing at ____________________________
My Commission Expires__________________
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