Fill and Sign the Notice Entry Form

_______________________________ 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.: _________________ Notice of Entry of Decree TO THE ABOVE-NAMED RESPONDENT: Notice is hereby given that on the ______ day of ______________________, 20___, the Court entered a Final Decree of Dissolution in the above-entitled action. A true and correct conformed copy of the Final Decree of Dissolution is attached to this Notice and served upon you. DATED this ______ day of _______________ , 20___. ____________________________________ Petitioner Pro Se ____________________________________ Print Name Notice of Entry of Decree, Page 1 of 2 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04 Proof of Service STATE OF MONTANA ) ): ss COUNTY OF _________________ ) _____________________________, being first duly sworn, deposes and says as follows: A true and correct copy of the foregoing Notice of Entry of Decree was served the ____ day of _______________, 20___, by mailing said copy, postage paid, to: _____________________________ Respondent _____________________________ _____________________________ Address DATED this ____ day of _______________, 20___. _______________________________ Petitioner’s Signature SIGNED AND SWORN to before me on the ____ day of _______________, 20___. Signature: Name (printed) : _______________________________ (Seal) Notary Public for the State of Montana Residing at My Commission Expires Notice of Entry of Decree, Page 2 of 2 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 04/01/04