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.
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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.
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