Petition for Dissolution of Marriage and Civil Union

The Petition for the Dissolution of Marriage form has to be submitted to initiate a divorce process in the State of Illinois. The form has to be submitted to the county court clerk’s office near your place of residence.

Extracted Text for Proper Search

IN THE CI	
RC	
UIT 	
CO	
URT O	
F
 T	
H
E	
     J	
U
DI	
CIAL CI	
RC	
UIT 	

                        , 	
ILLINOIS 	

 	

  	
) 	

  	
) 	

 	
 ) 	

Peti	
ti
oner  	
) 	

v
s
. 	
 ) 	
Gen	
.
 No. 	
 	
 	
 	
 	
 	
 	

  	
) 	

  	
) 	

 	
 ) 	

Respondent  	
) 	

 	

PETITION FOR DISSOLUT	
I
ON OF MARRIAGE 	

 

I
,
 
 	
       	
, the Petitioner, represen	
ting myself, state that: 	

  	
 	
 	
Name	
 	
 

Part A. J	
u
risdicti	
on 	

(One 	
party must 	
be 	
a resident o	
f
 the 	
St	
ate of Illinois 	
for at l	
e
ast	
 90 	
days prior either 	
to the 	

filing o	
f
 th	
is Petition 	
or to the entry of 	
the Judgment	
 for Dis	
s
olution of M	
a
rri	
age). 	

 

1.  Petitioner 	

a.	
 I am 	
 	
 	
 years of age. 	

b.	
 
I
 
p
r
e
s
e
n
t
l
y
 
r
e
s
i
d
e
 
a
t
 
 
          	
. 	

City/County and State	
 	

c.
 
My 	
occupation 	
is 	
that 	
of: 	
 	
         	
. 	

 

2.  Res	
p
on	
dent 	

a.	
 T
h
e Resp	
ondent	
 i
s
  	
 	
 years of age. 	

b.	
 The	
 Resp	
ondent presently 	
resides 	
at 	
 	
       	
.  	

City/County and State	
 	

c.
 The Respondent’s occupation 	
i
s
 
t
h
a
t
 
o
f
:
 
 	
       	
. 	

 

3.  Marri	
age 	

a.	
 The Respondent and 	
I were married on 	
 	
  ____________________________	
. 	

 
 	
        (	
mmddyyyy) 	

b.	
 The	
 marriage took place in	
 
 
      	
 
and the m	
a
rriage 	
is
  	

       C	
i
t
y
/
C
o
u
n
t
y
 
a
n
d
 
S
t
a
t
e
 	

registered in that 	
state	
 and 	
county.  	

 

4.	
  
Resid	
e
ncy 	
(Chec	
k
 all th	
at 	
apply): 	

S
 
a.	
 I 	
have	
 l
i
v
ed i	
n
 Illinoi	
s si	
nce 	
 	
 	
 	
 	
 	
 	
 	
. 	

 
 	
       	
Month/Yea	
r
 	

S
 
b.	
 My	
 spou	
se h	
a
s liv	
ed in	
 Ill	
i
n
o
is
 sin	
c
e 
 	
 	
 	
 	
 	
 	
. 	

 
 	
       	
Month/Yea	
r
 	

5.  Othe	
r Procee	
din	
g
s 
(Ch	
e
ck one)	
 	

S
 
a
. 
No pet	
i
ti
on for di	
ssol	
u
ti
on of 	
marri	
age between 	
the 	
part	
ies is pe	
n
d
in
g in	
 any	
 ot	
h
e
r 
coun	
t
y
 or st	
at
e.
 	

S
 
b
.
 
Th	
ere is an	
ot	
h
e
r pet	
i
t
i
on	
 f
o
r dissolu	
t
i
on	
 of	
 marriage bet	
w
een	
 th	
e 
part	
ies is pen	
d
in
g in	
:
 	

 	
      	
  	

  	
 	
    	
City/Count	
y and 	
State	
 

Page	
 1 of 4   	
 	
 	
 	
 	
174-	
CSR	
2
00  (	
R
e
v
 09/	
04)

Part B. C	hildre	n/ Related Cases 	
1.	 Childr	en (Check all 	that ap	ply	): 	
(A c	ompleted	 Decl	ar	ation 	Under Uni	form 	Child 	Cust	ody Jurisdi	ction Enfor	cement Ac	t  	
     (UCCJE	A) 	for	m	 must be 	att	ached t	o thi	s petiti	on	.) 	
S a.	 We 	ha	ve no c	hildren toget	her. 	or	 	
S b. 	That	 I 	S am	 / S am	 no	t currentl	y pregn	ant.	 or	 	
S c. 	That m	y spouse 	S is 	/ S is n	ot curren	tly pregnant	.  	
 	(If no chil	d(ren), ski	p to Part B	, par	agr	aph 4	). 	 
 
S d.	 The fol	lowi	ng chi	ld(ren) 	were 	born to or	 adopte	d by 	myself and 	my spouse 	and me d	uring the  	
   	   	  marri	age: 	
Name	 	Dat	e of	 Birt	h 	(mmddyyyy) 	Curre	ntly L	iving Wi	th 	
 	 	 	
 	 	 	
 	 	 	
 	 	 	
 	 	 	
 	 	 	
(Attach	 addi	tiona	l pa	ge	s as nee	ded)	 	
2.	  It is in	 th	e best	 int	erest	s of	 the ch	ild(	ren	) th	at (ch	eck o	ne): 	
S a.	 Tempo	rary and 	permanent sole custod	y o	f  	 	 	 	 	 	 	 	 	
 	        	Name of	 Ch	ild(ren	) 	
be awarded to the 	S Petition	er  S Re	sp	ond	ent	. 	
S b.	 Tempo	rary and 	permanent joint custody 	of 	 	 	 	 	 	 	 	 	
 	        	Name of	 Ch	ild(ren	) 	
be awarded	 to the parti	es with 	S Petition	er  S Re	sp	ond	ent	 as t	he residen	tial paren	t.  	
 
3.	  It is in	 th	e best	 int	erest	s of	 the ch	ild(	ren	) th	at the Court	 prov	ide for v	isit	ation	 as f	ollow	s (check on	e)	: 	
S a.	 De	ny	  S Re	strict	 visitation because:  	        	
 	              	        . 	
S  b. Gran	t visitation as follows:   	         	
 	              	        . 	
4.	  I 	kno	w of the following related cases pe	nding or cl	osed concerni	ng t	he parti	es or chi	ld(ren) (s	uc	h a	s  	
domesti	c vi	olence, paterni	ty, di	vo	rce, cus	tod	y, 	visitati	on	 or juveni	le co	urt cases	, support, etc.): 	
 
Cou	nty/	State 	Cas	e Num	ber 	Kind o	f Case 	Year Filed 	Pendin	g or	 Clos	ed 	
 	 	 	 	 	
 	 	 	 	 	
 	 	 	 	 	
(Attach	 addi	tiona	l pa	ge	s as nee	ded)	 	 	
Part C. Support 
(Affi	davit 	of Income 	and 	Expen	ses must be file	d in t	he court 	at	 the ti	me o	f any h	eari	ng on 	
 support 	and maint	enance.	) (Check al	l th	at appl	y) 	
1.	 	S a. 	The Respondent 	S is  S is n	ot employed. 	
S b.	 The R	espondent 	S is  S is n	ot abl	e to c	ontri	bute to	 the 	suppor	t of 	S our min	or chil	d(re	n) 	
            	        S and my	self	. 	
 	
Page	 2 of 4   	 	 	 	 	174-	CSR	200  (	Rev 09/	04)

2. 	 I 	S am	 / 	S am	 not	 (chec	k on	e)	 seeki	ng mai	ntenanc	e (suppor	t) for mysel	f because: 	
               	 	
               	 	
               	        . 	
Part D. Property 
(You do n	ot have to 	complet	e Part D 	if 	you ar	e 	not askin	g the court to make deci	sions abo	ut 	
your  pro	perty.) 	(Atta	ch ad	ditional 	pages	 as n	eeded) 	
1.	  My 	spou	se and/or I	 have t	he fol	lowi	ng mari	tal	 property and 	debts 	(check al	l th	at appl	y): 	
S Real Estate/House(s):  	          	 	
 	      	Stre	et Addr	ess 	
S Pension(s):  	            	 	
 	      	Name	 of Co	mpany 	
S Bank 	acc	ount	(s) 	and investment	(s):	  	        	 	
 	      	Name 	of Fi	na	nci	al Insti	tution 	
S Motor Vehicle(s):  	           	 	
 	      	Year,	 Ma	ke	 and M	ode	l  	
S Debts (a	ttach l	ist) 	
S Other:               	 	
2.	  S I cl	aim the 	fol	lowi	ng proper	ty as	 my 	no	n-mari	tal property because the pro	perty was acquired  	
S pri	or to our marriage	  S by	 g	ift  S by in	herit	ance	  S oth	er:  	    	 	
               	 	
                	        . 	
3.	  S I acknowl	edge t	he fol	lowi	ng property as	 my spo	use	’s non-marital property because the property as  	
acquired 	S prior to ou	r marri	age	  S by gift	  S by i	nhe	ritance	  S ot	her	.:  	 	 	 	 	
               	 	
               	        . 	
Part E. Grounds for Dissol	utio	n o	f Marriage	 	
1.	  My grou	nds 	for Di	ss	oluti	on of m	y marri	age are: 	(Ch	eck all th	at 	apply) 	
S a.	 Irr	econcilabl	e Di	fferenc	es (	sep	arated 	in exce	ss 	of 	2 year	s)	 	
From on or 	about __ 	 	 	, my 	spouse	 and I	 have	 lived separate and a	part from 	 	
  	   	mmddyyyy 	
each other 	for a continuous period in excess	 of 	2 years and irreconcil	abl	e di	fferences have 	
caused the irretrievab	le breakdown of the marriage. 	Efforts	 at reconci	liati	on have 	failed or fut	ure 	
attempts 
at recon	cilia	tion	 w	ould be impract	icable an	d not	 in	 th	e best	 in	terest	s of th	e f	amil	y. 	
S b. Irrec	oncil	able 	Differ	ences (separ	at	ed in	 e	xces	s of 6 m	onths w	ith 2	 year wa	iver) 	
From on or 	about 	  	 	, my 	spouse	 and I	 have	 lived separate and a	part from  	
  	 	 	mmddyyyy	 	
each other 	for a continuous period in excess	 of 	6 mont	hs a	nd we ha	ve si	gned wri	tten 	wai	vers of 	
the 2 	year 	period of separation.  Ir	reconcila	ble di	fferences	 have 	ca	used	 the ir	retrievable 	
breakdown 	of the marriage.  	Effo	rts at recon	ciliation have 	fai	led or fut	ure attempt	s at  	
recon	ciliat	ion would be impract	icabl	e an	d not in t	he best	 in	terest	s of	 the f	amily	.  	
S c. Physi	cal or 	Men	tal Cr	uelt	y 	
That 	witho	ut cause or provocation on my 	part	, my spo	use 	during the 	marriage ha	s been  	
guilty of extreme and repeated 	S physic	al	 an	d/or S mental cru	elty. 	
 	
Page	 3 of 4   	 	 	 	 	174-	CSR	200  (	Rev 09/	04)

Distribution: (3 Copies)   U Original to Circuit Clerk      U Petitioner      U Respondent 
  Page 4 of 4            174-CSR200  (Rev 09/04) 	
S d.  Other Grounds per 750 ILCS 5/401 (Please specify)  	
               	 	
               	 	
 
Part F. Parties' Agreements 
1.	  S  	The parties have  reached agreement(s)  on the following issues: 
S  custody , S  visitation , S child support  or S maintenance  (support for a spouse)  
State the specific arrangements: 
              	 	
              	 	
              	 	
              	 	
              	 	
              	. 	
(Attach additional pages as needed) 	
 
Part G. Relief Requested 
1.  FOR THESE REASONS,  I request that judgment be ente red that provides as follows: 
     (Check all that apply)  	
S a. That the marriage be dissolved.	 	
S 	b. That sole custody of the  minor child(ren) be awarded to  S Petitioner   S  Respondent . 	
S c. That joint legal custody of the minor child(ren) be awarded with  S Petitioner   S  Respondent   
  to be the residential custodian. 	
S d. That visitation with the minor child(ren) be 	S granted   	S restricted   	S barred   	S reserved . 	
S e. That child support be awarded.  
S f. That a fair division of the property or its va lue acquired during the marriage be divided in just  
  proportions. 	
S g. That maintenance to the Petitioner be 	S granted  	S waived  	S reserved 	
S h. That maintenance to the Respondent be 	S granted  	S barred  	S reserved  	
S i. That a change back to my former name:             	 be granted.	 	
          Full Former Name	  	
S j. That any other approp riate relief be awarded. 	
 
 Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure,* the 
undersigned certifies that the statements set fo rth in this instrument are true and correct. 
 
     	         	 	Date        Signature  	
              	 	
          Printed Name 	
     * - Any person who makes a false stat ement, material to the issue or point in question, which he does 
not believe to be true, in any docume nt certified by such person in accordance with 735 ILCS 5/1-109 shall 
be guilty of a Class 3 felony punishable by two (2) to  five (5) years imprisonment and/or a $10,000.00 fine.