Form 12.901(a), Petition for Simplified Dissolution of Marriage Instructions
This form contains 45 fields organized into 11 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Court | ||
| Name of circuit court | Text |
Enter the name of the circuit court where the case is filed.
|
| enter county name | Text |
Enter the county name associated with the court jurisdiction.
|
| Case Number | Text |
Provide the case number assigned to this petition.
|
| Division | Text |
Indicate the division within the court handling the case.
|
| Eligibility | ||
| Check if applicable | CheckBox |
Check this box if the corresponding eligibility condition applies as outlined in the form instructions.
|
| Check if applicable | CheckBox |
Check this box if the corresponding eligibility condition applies as outlined in the form instructions.
|
| Check if applicable | CheckBox |
Check this box if the corresponding eligibility condition applies as outlined in the form instructions.
|
| Check if applicable | CheckBox |
Check this box if the applicable condition described in the form is met.
|
| Husband | ||
| Name of Husband | Text |
Enter the husband’s commonly used name for identification purposes.
|
| Husband full legal name | Text |
Provide the husband’s full legal name as it appears on official documents.
|
| Husband Info | ||
| Name of Husband | Text |
Enter the full legal name of the husband.
|
| Address | Text |
Enter the street address of the husband.
|
| City, State, Zip | Text |
Enter the city, state, and zip code associated with the husband's address.
|
| Telephone Number | Text |
Enter the husband's telephone number.
|
| Fax Number | Text |
Enter the husband's fax number, if available.
|
| E-mail Address(es | Text |
Enter the husband's email address(es).
|
| Husband Residence | ||
| County where husband lives | Text |
Enter the county where the husband currently resides.
|
| State where husband lives | Text |
Enter the state where the husband currently resides.
|
| date husband moved to county, state | Date |
Provide the date when the husband moved to his current county and state.
|
| Marriage | ||
| City of Marriage | Text |
Specify the city in which the marriage took place.
|
| Date of marriage | Date |
Provide the date on which the marriage occurred.
|
| Name of state of marriage | Text |
Enter the name of the state where the marriage was performed.
|
| or in Country of Marriage | Text |
Specify the country of marriage if it occurred outside the United States.
|
| Nonlawyer Assistance | ||
| IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] Check if form was prepared for the husband | CheckBox |
Check this box if a nonlawyer prepared the form for the husband.
|
| Check if form was prepared for the wife | CheckBox |
Check this box if a nonlawyer prepared the form for the wife.
|
| name of nonlawyer who assisted | Text |
Enter the full name of the nonlawyer who assisted in filling out the form.
|
| name of business | Text |
Enter the name of the business associated with the nonlawyer assistance, if applicable.
|
| address | Text |
Enter the address of the nonlawyer or business that provided assistance.
|
| telephone number | Text |
Enter the telephone number of the nonlawyer or assisting business.
|
| state | Text |
Enter the state where the nonlawyer or assisting business is located.
|
| city | Text |
Enter the city where the nonlawyer or assisting business is located.
|
| Signature | ||
| Date of husband's signature | Date |
Enter the date when the husband signed the petition under penalty of perjury.
|
| Wife | ||
| Name of Wife | Text |
Enter the wife’s commonly used name for identification purposes.
|
| Wife full legal name | Text |
Provide the wife’s full legal name as it appears on official documents.
|
| Wife former name - full legal name | Text |
Provide the wife’s former full legal name if she has previously used another name.
|
| Wife Info | ||
| Date of wife's signature | Date |
Enter the date when the wife signed the form.
|
| Name of Wife | Text |
Enter the full legal name of the wife.
|
| Address | Text |
Enter the street address of the wife.
|
| City, State, Zip | Text |
Enter the city, state, and zip code associated with the wife's address.
|
| Telephone Number | Text |
Enter the wife's telephone number.
|
| Fax Number | Text |
Enter the wife's fax number, if available.
|
| E-mail Address(es | Text |
Enter the wife's email address(es).
|
| Wife Residence | ||
| County where wife lives | Text |
Enter the county where the wife currently resides.
|
| State where wife lives | Text |
Enter the state where the wife currently resides.
|
| Wife has lived there since date | Date |
Enter the date since which the wife has been residing at her current location.
|