Fill and Sign the Pro Se District Court of Wyoming Form

Affidavit for Divorce (No Minor Children) July 2014 Page 1 of 6 STATE OF WYOMING ) IN THE DISTRICT COURT ) ss COUNTY OF ________________ ) _______________ JUDICIAL DISTRICT Plaintiff:____________________________, ) Civil Action Case No. ___________ (Print name of person filing) ) ) vs. ) ) Defendant:__________________________. ) (Spouse) (Print name) AFFIDAVIT FOR DIVORCE WITHOUT APPEARANCE OF PARTIES (Only use if the parties have reached an agreement and both have signed the Decree of Divorce or if either party defaulted and all default paperwork has been presented to the court and an Entry of Default issued.) STATE OF WYOMING ) ) ss. COUNTY OF _____________ ) _____________________________________, being first duly sworn, deposes and says: (Print Name) 1. I am the Plaintiff Defendant in the case. 2. Plaintiff resided in the State of Wyoming for more than 60 days immediately prior to filing the Complaint for Divorce in this case. 3. The Plaintiff Defendant and I were married to each other on the _____ day of ___________, ____________ in _____________, ______________ __. (Month) (Year) (City) (State) 4. Plaintiff is currently a resident of County, State of _____________. 5. Defendant is currently a resident of County, State of ______________. 6. Plaintiff and Defendant do not have any minor children. Affidavit for Divorce (No Minor Children) July 2014 Page 2 of 6 7. To the best of Plaintiff’s knowledge, Wife is not pregnant, OR Wife is pregnant (If pregnant, consult an attorney. Your divorce may not be able to be final until after the baby is born) and The baby is due on or about (date), (and, check one space below): The Plaintiff and Defendant are the biological parents of the child, OR Plaintiff is not the biological parent of the child, OR Defendant is not the biological parent of the child. 8. Irreconcilable differences exist in the marriage. 9. The Wife does not desire to have her former name restored ; OR her former name restored to: (list first, middle, and last name desired) 10. The Decree of Divorce equitably distributes the property and debt acq uired during our marriage. In support of this assertion I am submitting the following evidence: A. Debts (For Party Designation use: "P" = Plaintiff, "D " = Defendant, "J" = Join t) PRINT CLEARLY OR TYPE Party Paying Debt Creditor and Acct. # Name(s) on Account Date of Balance Balance Main Purchase(s) for Which Debt Was Incurred $ $ $ $ $ $ Add additional sheets, if necessary. Clearly identify any attached documents. Total Debt of Plaintiff: $ Total Debt of Defendant: $ Affidavit for Divorce (No Minor Children) July 2014 Page 3 of 6 B. Real Estate (For Party Designation use: "P" = Plaintiff, "D " = Defendant, "J" = Join t) PRINT CLEARLY OR TYPE Party Paying Debt Property Type Owned and Address (residence, condo, rental, etc.) Name(s) on Title Fai r Market Value Basis of Fair Market Value (i.e.,appraisal, estimate, purchase price) 1st Mortgage 2 nd Mortgage Add additional sheets, if necessary. Clearly identify any attached documents. Total Debt of Plaintiff: $ Total Debt of Defendant: $ C. Motor Vehicles (For Party Designation use: "P" = Plaintiff, "D " = Defendant, "J" = Joint) PRINT CLEARLY OR TYPE Party Keeping Vehicle Year, Make, Model and VIN Name(s) on Title Name of Creditor Fair Market Value Amount of Debt Add additional sheets, if necessary. Clearly identify any attached documents. Total Debt of Plaintiff: $ Total Debt of Defendant: $ D. Cash on Hand, Bank, Checking, or Saving Accounts, CD’s ( For party designation use: "P" = Plaintiff, "D" =Defendant or "J" = Joint) PRINT CLEARLY OR TYPE Party Keeping Property Type of Account Name of Bank Account No. (Last 4 Digits Only) Date of Balance Balance Affidavit for Divorce (No Minor Children) July 2014 Page 4 of 6 Add additional sheets, if necessary. Clearly identify any attached documents. Amount to Plaintiff: $ Amount to Defendant: $ E. Furniture and Household Goods ("Value" equals what you could sell it for in its current condition, such as at auction, not what you paid for it or cost of replacement.) PRINT CLEARLY OR TYPE Description of Items - Household furnishings and personal belongings (clothes, jewelry, etc.) Value of Plaintiff’s Possessions Value of Defendant’s Possessions 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. TOTAL: $ $ Add additional sheets, if necessary. Clearly identify any attached documents. F. Miscellaneous/Other Assets or Interests (not listed abov e) List all other assets, including life insurance, stocks, bonds, retirement benefits, income tax refunds owing, money owed to you, livestock, guns, etc. as distributed in the Decree. PRINT CLEARLY OR TYPE (For party designation use: "P" = Plaintiff, "D" =Defendant or "J" = Joint) Party Keeping Property Description Account, serial or ot her identifying number, if any - Last 4 Digits Only Value Affidavit for Divorce (No Minor Children) July 2014 Page 5 of 6 Add additional sheets, if necessary. Clearly identify any attached documents. Amount to Plaintiff: $ Amount to Defendant: $ 11. Please list why the distribution of property and debts listed above is “equitable.” The Wyoming Supreme Court has held that a just and equitable distribution does not necessarily mean “equal.” I request the court grant me a divorce. OATH I affirm that this Affidavit (including attached sheets, if relevant) contains a complete disclosure, to the best of my information and belief, of all items of property in which my spouse and I have any current interest or expect to receive in the future based upon the work or events that took place during the marriage, and all liabilities for which I am aware that either of u s could be held personally responsible. I also affirm that the representations made herein concerning my income and expenses, and that of my spouse, are accurate to the best of my knowledge. I am aware that should the information provided herein prove to be fraudulent or contain material misstatements or omissions, whether inadvertent or intentional, or be found to be inaccurate, the court shall have continuing jurisdiction to enter such orders as it considers necessary in equity and law to determine the rights and duties with regard to that property right or obligation. I am also aware the court may punish as perjury any materially false statements knowingly made with intent to defraud or mislead. Signature Printed Name: Address: Phone Number: Affidavit for Divorce (No Minor Children) July 2014 Page 6 of 6 Subscribed and sworn to before me by ____________________________ on this _____ day of ____________________, 20____. Witness my hand and official seal. ______________________________ Notarial Officer / Court Clerk My Commission Expires: C E R T I F I C A T E O F S E R V I C E I certify that on (date) the original of this document w as filed with the Clerk of District Court; and, a true and accurate copy of this document was served on the other party by Hand Delivery OR Faxed to this number OR by placing it in the United States mail, postage pre-paid, and addressed to the following: (Print Defendant/Defendant’s Attorney’s Name and Address) TO: ______________________________________ ______________________________________ ______________________________________ Your signature Print name