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RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 1 of 10 Superior Court of Washington, County of In re the domestic partnership of: Petitioner (person who started this case) : And Respondent (other domestic partner) : No. Petition for Legal Separation (Registered Domestic Partnership) (PTLGSP) Petition f or Legal Separation (Registered Domestic Partnership) Use this form only if your domestic partnership was registered with a state (not a city or county). Do not use this form if you are married or have a state registered domestic partnership that conver ted into a marriage by law on June 30, 2014. Use the Petition for Legal Separation (Marriage), form FL Divorce 203, instead. 1. Information about the parties Petitioner lives in (county): (state): Respondent lives in (county): (state): 2. Inf ormation about the domestic partnership (check all that apply): We registered our domestic partnership in the State of: on (date): . At that time, we lived in (city and state): . [ ] We currently live in the same household. [ ] We began living in s eparate households on (date): . 3. Request for legal separation I ask the court for a legal separation and to find that our domestic partnership community ended on (check one): [ ] the date this Petition is filed. [ ] (date): , which is when (check all that apply): [ ] one of us moved to a separate household . [ ] we separated our assets and debts. RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 2 of 10 [ ] we agreed the domestic partnership community ended. [ ] other (specify): 4. Jurisdiction over the partners The court has jurisdiction over the domestic partnership because at least one of the partners lives in Washington State, or is stationed in this state as a member of the armed forces. [ ] The court has personal jurisdiction over the Respondent because (check all that apply): [ ] The Res pondent lives in Washington State. [ ] The Petitioner and Respondent lived in Washington State while they were registered domestic partners, and the Petitioner still lives in this state or is stationed in this state as a member of the armed forces. [ ] The Petitioner and Respondent may have conceived a child together in this state. [ ] Other (specify): [ ] The court does not have personal jurisdiction over the Respondent. (This may limit the court’s ability to divide property and debts, award money, se t child support or maintenance, or approve a restraining order or protection order.) 5. Is one of the partners pregnant? (Check one): [ ] No [ ] Yes If Yes , who is pregnant? [ ] Petitioner [ ] Respondent Note: The law considers the other pa rtner to be the parent of any child born during the registered domestic partnership or within 300 days after it ends. If the other partner is not the parent, either partner may file a Petition to Disprove Parentage of Presumed Parent (form FL Parentage 35 5) in court. In most cases, the deadline to file the Petition to Disprove is before the child turns four. (See RCW 26.26.116, 26.26.500 – 26.26.625.) If everyone agrees, both partners and the child’s biological father can sign an Acknowledgment (and De nial) of Paternity . Those forms must be notarized and filed with the Washington State Registrar of Vital Statistics to be valid. 6. Children of the domestic partnership [ ] My domestic partner and I have no children together who are still dependent. (Skip to 7.) [ ] My domestic partner and I have the following children together who are still dependent (only list children you and your partner have together, not children from other relationships): Child’s name Age Child’s name Age 1. 4. 2. 5. 3. 6. a. Children’s home/s During the past 5 years have any of the children lived:  on an Indian reservation, RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 3 of 10  outside Washington state,  in a foreign country, or  with anyone who is not a party to this case? [ ] No. (Skip to b.) [ ] Yes. (Fill out below to show where each child has lived during the last 5 years.) Dates Children Lived with In which state, Indian reservation, or foreign country From: To: [ ] All children [ ] (Name/s): [ ] Petitioner [ ] Respondent [ ] Other (name): From: To: [ ] All children [ ] (Name/s): [ ] Petitioner [ ] Respondent [ ] Other (name): From: To: [ ] All children [ ] (Name/s): [ ] Petitioner [ ] Respondent [ ] Other (name): From: To: [ ] All children [ ] (Name/s): [ ] Petitioner [ ] Respondent [ ] Other (name): From: To: [ ] All children [ ] (Name/s): [ ] Petitioner [ ] Respondent [ ] Other (name): b. Other people with a legal right to spend time with a child Do you know of anyo ne besides you and your partner who has (or claims to have) a legal right to spend time with any of the children? (Check one): [ ] No. (Skip to c.) [ ] Yes. (Fill out below.) Name of person Children this person may have the right to spend time w ith [ ] All children [ ] (Name/s): [ ] All children [ ] (Name/s): c. Other court cases involving a child Do you know of any court cases involving any of the children? (Check one): [ ] No. (Skip to 7.) [ ] Yes. (Fill out below.) Kind of case (Family Law, Criminal, Protection Order, Juvenile, Dependency, Other) County and State Case number and year Children [ ] All children [ ] (Name/s): RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 4 of 10 Kind of case (Family Law, Criminal, Protection Order, Juvenile, Dependency, Other) County and State Case number and year Children [ ] All children [ ] (Name/s): [ ] All children [ ] (Name/s): [ ] All chi ldren [ ] (Name/s): 7. Jurisdiction over the children (RCW 26.27.201 – .221, .231, .261 , .271) [ ] Does not apply. My domestic partner and I have no children together who are still dependent. [ ] The court can approve a Parenting Plan for the childre n my domestic partner and I have together because (check all that apply; if a box applies to all of the children, you may write “the children” instead of listing names): [ ] Exclusive, continuing jurisdiction – A Washington court has already made a custod y order or parenting plan for the children, and the court still has authority to make other orders for (children’s names): . [ ] Home state jurisdiction – Washington is the children’s home state because (check all that apply): [ ] (Children’s names): lived in Washington with a parent or someone acting as a parent for at least the 6 months just before this case was filed, or if the children are less than 6 months old, they have lived in Washington with a parent or someone acting as a parent since birt h. [ ] There were times the children were not in Washington in the 6 months just before this case was filed (or since birth if they are less than 6 months old), but those were temporary absences. [ ] (Children’s names): do not live in Washington right now, but Washington was the children’s home state some time in the 6 months just before this case was filed, and a p arent or someone acting as a parent of the children still lives in Washington. [ ] (Children’s names): do not have another home state. [ ] No home state or home state declined – No court of any other state (or tribe) has the jurisdiction to make decisions for (children’s names): , or a court in the children’s home state (or tribe) decided it is better to have this case in Washington and:  The children and a parent or someone acting as a parent have ties to Washington beyond just living here; and  There is a lot of information (substantial evidence) about the children’s care, protection, education and relationships in this state. RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 5 of 10 [ ] Other st ate declined – The courts in other states (or tribes) that might be (children’s names): ’s home state have refused to take this case because it is better to have this case in Washington . [ ] Temporary emergency jurisdiction – The court can make decisions for (children’s names): because the children are in this state now and were abandoned here or need emergency protection because the children (or the children’s parent, brother or sister) were abused or threatened with abuse. ( Check one): [ ] A custody case involving the children was filed in the children’s home state (name of state or tribe): . Washington should take temporary emergency jurisdiction over the children until the Petitioner can get a court order from the children’s home state (or tribe) . [ ] There is no valid custody order or open custody case in the children’s home state (name of state or tribe): . If no case is filed in the children’s home state (or tribe) by the time the children have been in Washington for 6 months, (date): , Was hington should have final jurisdiction over the children. [ ] Other reason (specify): [ ] The court cannot approve a Parenting Plan because the court does not have jurisdiction over the children. 8. Parenting Plan [ ] My domestic partner and I hav e no children together who are still dependent. [ ] I ask the court to order a Parenting Plan for the children my partner and I have together. I will file and serve my proposed Parenting Plan (form FL All Family 140) (check one): [ ] at the same time as this Petition . [ ] later. [ ] The court cannot approve a Parenting Plan because the court does not have jurisdiction over the children. 9. Child Support [ ] My domestic partner and I have no children together who are still dependent. [ ] Court O rder – I ask the court to order child support (including medical support) according to state law for the children my partner and I have together . (You may ask for a court order of child support even if there is already an administrative order. The court order will replace the administrative order to the extent the court order is different.) [ ] I ask the court to order my partner to pay his/her proportionate share of (check all that apply): [ ] day care expenses [ ] long -distance transportation expen ses [ ] education expenses [ ] post -secondary (college or vocational school) support [ ] other child -related expenses (specify): RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 6 of 10 [ ] I ask the court to order that we have the right to claim the children as dependents for purposes of personal tax exe mptions and associated tax credits on our tax forms (describe): Important! Although the personal tax exemptions are currently suspended through tax year 2025, other tax benefits may flow from claiming a child as dependent. [ ] Administrative Order – There is no need for the court to make a child support order. The DSHS Division of Child Support (DCS) has already established an administrative child support order for the children my partner and I have together in DCS case number/s: . I am not asking the court to make a different child support order. DCS child support orders do not cover tax issues or post -secondary (college or vocational school) support. Because these issues are not in the administrative order, I ask the court to order (check all th at apply): [ ] we have the right to claim the children as dependents for purposes of personal tax exemptions and associated tax credits on our tax forms as follows (describe): [ ] my partner to pay his/her proportionate share of post -secondary (col lege or vocational school) support. 10. Children from other relationships [ ] Neither domestic partner has children from other relationships who are still dependent. [ ] I have the following dependent children who are not from this relationship (lis t name/s and age/s): . [ ] My domestic partner has the following dependent children who are not from this relationship (list name/s and age/s): . 11. Written Agreements Have you and your partner signed a prenuptial agreement, separation contract or com munity property agreement? (Check one): [ ] No. (Skip to 12 .) [ ] Yes. (Fill out below.) Type of written agreement: Date of written agreement: Should the court enforce this agreement? (Check one): [ ] Yes [ ] No If No, why not? 12. Real Property (land or home) [ ] Neither partner owns any real property. RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 7 of 10 [ ] I ask the court to divide the real property according to the written agreement described in 11 above. [ ] I ask the court to divide the real property fairly (equitably), a s explained below: Real Property Address Tax Parcel Number Who should own this property? [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] I ask the court to divide the real property fairl y (equitably) as the court decides. [ ] The court does not have jurisdiction to divide the real property. [ ] Other (specify): 13. Personal Property (possessions, assets or business interests of any kind) [ ] We have already divided the property f airly. I ask the court to order that each partner will keep any personal property that s/he now has or controls. [ ] I ask the court to divide the personal property according to the written agreement described in 11 above. [ ] I ask the court to divide the personal property fairly (equitably), as explained below: List property (include vehicles, pensions/retirement, insurance, bank accounts, furniture, businesses, etc. Do not list more than the last four digits of any account number.) : Who should own this property? [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Res pondent [ ] Petitioner [ ] Respondent [ ] I ask the court to divide the personal property fairly (equitably) as the court decides. RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 8 of 10 [ ] The court does not have jurisdiction to divide the personal property. [ ] Other: 14. Debts [ ] I am not a ware of any debts. [ ] I ask the court to order each partner to be responsible for debts s/he incurred (made) after the date of separation. [ ] I ask the court to divide the debts according to the written agreement described in 11 above. [ ] I ask the court to make the following orders about debts (check all that apply): [ ] Each partner is responsible for the debts that are now only in his/her own name. [ ] Divide the debts fairly (equitably), as explained below: Debt Amount Creditor (person or c ompany owed this debt) Who should pay this debt? [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Petitioner [ ] Respondent [ ] Divide the debts fairly (equitably) as the court decides. [ ] The court does not have jurisdiction to divide the debts. [ ] Other: 15. Maintenance (Alimony) [ ] Maintenance is not needed. [ ] Maintenance is needed. The [ ] Petitioner [ ] Respondent has the ability to pay and should pay support: [ ] as decided by the court. [ ] $ every month until (date or event): . [ ] according to the written a greement described in 11 above. RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 9 of 10 [ ] other: 16. Fees and Costs [ ] No request. [ ] Order my partner to pay my lawyer’s fees, other professional fees, and costs for this case. 17. Protection Order Do you want the court to issue an Order for Protect ion as part of the final orders in this case? [ ] No. I do not want an Order for Protection . [ ] Yes. (You must file a Petition for Order for Protection, form DV -1.015 for domestic violence, or form UHST -02.0200 for harassment. You may file your Pet ition for Order for Protection using the same case number assigned to this case.) Important! If you need protection now , ask the court clerk about getting a Temporary Order for Protection. [ ] There already is an Order for Protection between my partne r and me . (Describe): Court that issued the order: Case number: Expiration date: 18. Restraining Order Do you want the court to issue a Restraining Order as part of the final orders in this case? [ ] No. (Skip to 19 .) [ ] Yes. Check the type of orders you want: [ ] Do not disturb – Order the Respondent not to disturb my peace or the peace of any child listed in 6. [ ] Stay away – Order the Respondent not to go onto the grounds of or enter my home, workplace, or school, and the daycare or sc hool of any child listed in 6. [ ] Also, not knowingly to go or stay within feet of my home, workplace, or school, or the daycare or school of any child listed in 6. [ ] Do not hurt or threaten – Order the Respondent:  Not to assault, harass, stalk o r molest me or any child listed in 6; and  Not to use, try to use, or threaten to use physical force against me or the children that would reasonably be expected to cause bodily injury. Warning! If the court makes this order, the court must consider if w eapons restrictions are required by state law; federal law may also prohibit the Restrained Person from possessing firearms or ammunition. [ ] Prohibit weapons and order surrender – Order the Respondent:  Not to access, possess , or obtain any firearms, other dangerous weapons, or concealed pistol license s until the Order ends, and RCW 26.09.020 Mandatory Form (07/ 2019 ) FL Divorce 204 Petition for Legal Separation (Registered Domestic Partnership ) p. 10 of 10  To immediately surrender any firearms, other dangerous weapons, and any concealed pistol license s that he/she possesses t o (check one): [ ] the police chief or sheriff. [ ] his/her lawyer. [ ] other person (name): . [ ] Other restraining orders: Important! If you want a restraining order now , you must file a Motion for Temporary Family Law Order and Restraining Order (FL Divorce 223) or a Motion for Immediate R estraining Order (Ex Parte) (FL Divorce 221). 19. Name Change [ ] No request. [ ] Change the Petitioner’s name to: first middle last 20. Other requests, if any Petitioner fills out below: I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form are true. Signed at (city and state): Date: Petitioner signs here Print name Petitioner’s lawyer (if any) fills out below: Petitioner’s lawyer signs here Print name and W SBA No. Date [ ] Respondent fills out below if he/she agrees to join this Petition: I, (name): , agree to join this Petition . I understand that if I fill out and sign below, the court may approve the requests listed in this Petition unless I file and s erve a Response before the court signs final orders. (Check one): [ ] I do not need to be notified about the court’s hearings or decisions in this case. [ ] I ask the Petitioner to notify me about any hearings in this case. (List an address where you agree to accept legal documents. This may be a lawyer’s address or any other address.) address city state zip (If this address changes before the case ends, you must notify all parties and the court in writing. You may use the Notice of Address Change f orm (FL All Family 120). You must also update your Confidential Information Form ( FL All Family 001) if this case involves parentage or child support .) Respondent signs here Print name Date