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Wyoming Divorce Package For Defendant With Children Form

This divorce forms package is approved by the Wyoming Courts. Use of this package is limited to Defendants of divorce cases involving minor children. [/pdf]Download

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Divorce with Children	 	
Revised 	October 2012	 	
Packet 	2	 	
 
 	
Divorce 	 	
(With Minor Children	) 	
 	
Forms and Procedures 	 	
 	
For Wyoming	 	
 	
DEFENDANT	 	
 	
2012	 	
 
 	
Published by	 	
Wyoming Supreme Court	 	
2301 Capitol Avenue	 	
Supreme Court Building	 	
Cheyenne, WY  82002

List of Forms	 	
Revised 	October 2012	 	
Page 	1 of 	1 	
LIST OF FORMS 	– PACKET 2 	 	
DEFENDANT DIVORCE WITH MINOR CHILDREN	 	
 
1.  	List of Forms	 	
2.  	Overview	- Divorce with Children	 	
3.  	Family Law Information and Instructions	 	
4.  	Checklist for Defendant	 	
5.  	Answer to Complaint for Divorce	 (with Children)	  	
6.  	Answer a	nd Counterclaim to Complaint for Divorce	 (with Children)	 	
7.  	Initial Disclosures	 	
8.  	Confidential Financial Affidavit	 	
9.  	Request for Setting	 	
10.	  	Order Setting Divorce Trial and Requiring Pretrial Statements	 	
11.	  	Pretrial Disclosures	 	
 
*All  underlined  form	s  are  required  in  a  divorce  with  children  action  where  the  parties 	
agree on all of the issues.  The rest of the documents required to be filed with the Clerk to 
complete  the  divorce  action  are  contained  in  the  Plaintiff’s  Packet.    It  is  recommended 
that  yo	u work with  the Plaintiff to  ensure all necessary  forms  are filled out correctly and 	
completely.  	You  will  also need to sign the 	Decree of Divorce	 that is  contained  in the 	
Plaintiff’s  Packet  before  your  divorce  can  be  completed  if  you  agree  on  all  of  the 
issues.	 	
**Other forms may be required by your Court.

Overvi	ew: Divorce (with Children)	 	
Revised 	October 2012	 	
Page 	1 of 	3 	
OVERVIEW	 	
 	
People  who  appear  for  themselves  without  an  attorney  are  considered  to  be  “self	-	
represented” and are also known as “pro se” litigants.  This packet is often referred to  as 
the 	“pro se divorce packet	.”  These packets work best when parties are abl	e to agree and 	
become  more  difficult  when  there  are  children,  disagreements  about  property,  financial 
interests,  violence,  harassment  or  coercion.  Many  areas  of  family  law  are  very  
complicated,  and  some  courts  in  the  State  of  Wyoming  require  certain  thing	s  that  others 	
courts  do  not.    Therefore,  it  is  not  possible  to  include  all  legal  solutions  available  to 
people in a divorce action in a single packet.  	Again	, this packet will be most 	useful	 for 	
people involved in 	an 	uncontested divorce	 (i.e., you both agr	ee on all matters)	.  There 	
are other types of actions available, including temporary orders on child custody, support, 
alimony and restraining orders that are not included in this packet and might be easier to 
obtain with an attorney.  These forms have bee	n created to  benefit the majority of people 	
who  represent  themselves  while  also  understanding  that  people  with  complex  or 
emergency  circumstances  may  continue  to  find  themselves  better  served  by  getting  an 
attorney.  We hope you find this packet and the r	esources that it contains helpful.   	 	
 
 
 	 	
 
 	
 	 	
 
 	
 
 	
 
 
 	This  information  packet  is  intended 	to  provide  general  information 	to  obtain  a 	
divorce. 	 	
 	There  is  no  guarantee  these  forms  are  still  accurate  and/or  current.    The 
information in this packet is not intend	ed to replace an attorney.  	 	
 	If  you  represent  yourself,  YOU  PROCEED  AT  YOUR  OWN  RISK.    You  must 
decide which forms apply to your situation.  	 	
 	DO NOT USE all forms, as some forms may not apply.  	 	
 	Fill out the 	necessary forms completely and correctly.  	 	
 	
Pri	nt  or  type  all  of  the  documents.	 DO  NOT  SIGN  YOUR  NAME  WHERE 	
THE JUDGE OR CLERK SHOULD SIGN.	 	
 
 
 	
DOMESTIC/FAMILY VIOLENCE:	   	
If you or your children have been a victim of family (domestic) violence, it is recommended that you find 
an  attorney  to  help  you.      There  may 	be  assistance  available  even  if  you  cannot  afford  an  attorney.  	
Contact  the  Wyoming  Coalition  Against  Domestic  Violence  &  Sexual  Assault  (1	-307	-755	-0992),  Legal 	
Aid of Wyoming ( 1	-877	-432	-9955) or the Wyoming State Bar (1	-307	-632	-9061) www.wyomingbar.org. 	 	
If  you  have  concerns  about  confidential  information  such  as  addresses  and/or  social  security  numbers, 
please  consult  an  attorney  and  do  not  attempt  to  do  this  on  your  own.  You  should  also  know  that 
Protection  Orders  and  Stalking  Orders  are  available  free 	of  charge  at  the  circuit  court  clerk’s  office.   	
Please  call  the  Wyoming  Coalition  Against  Domestic  Violence  &  Sexual  Assault  for  assistance  in 
obtaining domestic violence protection or stalking orders (1	-307	-755	-0992).   If you have ever obtained a 	
protec	tion order involving your spouse, you should include this information in the 	Complaint for Divorce	 	
or 	Counterclaim	 under the “Other Proceedings” section.

Overvi	ew: Divorce (with Children)	 	
Revised 	October 2012	 	
Page 	2 of 	3 
LAWS:    All  laws  and  rules  that  apply  to  attorneys  apply  to  you. 	 It  is  your 	
responsibility to properly prepare and file the necessary documents.  	The Judge wil	l not 	
sign orders 	that are incorrect or incomplete, nor will the Judge give you legal advice 	
or make corrections for you.	 	
 
You  should  read  Title  20  of  the  Wyoming  Statutes  (the  divorce  laws),  and  you 	
should  also  read  the  Wyoming  Rules  of  Civil  Procedure.    M	ost  of  the  District  Courts  in 	
the  State  of  Wyoming  have  a  courthouse  library  or  county  library  where  these  laws  and 
rules  can  be  read.    You  may  also  look  up  these  laws  and  rules  on  the  internet  at: 
www.courts.s	tate.wy.us	 and  clicking  on  “law  library	.”  Some  courts  have  special  forms 	
they  want  you  to  use  in  addition  to  the  forms  contained  in  this  packet.    Check  with  the 
clerk before you file your documents.	 	
 
Clerks May Not Help You Fill Out the Forms.  	Unless  yo	ur county has a court 	
facilitator,	 employees  in  the  Clerk  of  District  Court’s  office  and  in  the  Judge’s  office 	
cannot he	lp you or give you legal advice.  	   	
 
The  Judge  Cannot  Talk  to  You,  Answer  Your  Questions  or  Assist  You.   	Ex 	
parte	 communication is comm	unication with the Judge with only one party present.     If 	
you  have  something  you  need  to  tell  the  Judge,  you  must  ask  for  a 	hearing	 and  give 	
notice	 to  the  other  party  or  file  a  written  statement  in  the  Court  file  and  send  a  copy  of 	
the written statement	 to the other party.	 	
 
Situations  that  Need  an  Attorney.   	Federal  law  may  impact  the  division  of 	
retirement benefits, employer	-provided health insurance, or other benefits which arise out 	
of the employment of  either party	, and  your settlement  terms  may not 	be honored by the 	
employer or the plan administrator of the employee benefits plan if your divorce decree is 
not  properly  completed  or  if  a  “qualified  domestic  relations  order”  (QDRO)  is  required.  
In  addition,  in  the  division  of  retirement  benefits,  there	 may  be  tax  consequences  which 	
you  may  not  anticipate.    If  your  divorce  involves  issues  like  these,  see  an  attorney  to 
discuss tax consequences or the terms  of a QDRO, or, if dealing with  insurance issues, a 
“qualified medical child support order	.”   	
 
In a	ddition to the above situations, you should consult an attorney if:	 	
 	You are a vic	tim of domestic/family violence	  	
 	The other party hires an attorney	 	
 	You or the other party are contemplating filing bankruptcy	 	
 	You  or  the  other  party  expect  to  receive  money  be	cause  of  a  personal 	
injury	 	
 	You or the other party own a business	 	
 	You or the other party have significant assets or debts	 	
 	You or the other party own real estate	 	
 
Truthfulness.   	It  is  absolutely  essential  that  you  be  completely  honest  and 	
accurate in complet	ing all forms.  There are penalties for attempting to mislead the Court.

Overvi	ew: Divorce (with Children)	 	
Revised 	October 2012	 	
Page 	3 of 	3 	
You  should  read  Wyoming  Rules  of  Civil  Procedure,  Rule  11 	(representations  to  the 	
court)	 and Wyoming Statute § 6	-5-301 (perjury).	 	
 
Unauthorized  Practice  of  Law  Notice.   	The  purpose  o	f  this  packet  is  to  assist 	
those  persons  who  are  doing 	their  own	 divorce.    It  may  be  an  unauthorized  practice  of 	
law  for  a  person  who  is  not  a  licensed  attorney  to  assist  others  in  obtaining  a  divorce.  
Such practice could subject a guilty party to punishm	ent for contempt of court.	 	
 
You are reminded that if you choose to continue without an attorney, you are 	
expected to know what to do and how to do it.  	The Wyoming Supreme Court has said: 	
“A 	pro se	 litigant (one without an attorney) will be granted no grea	ter right than any other 	
litigant  and  he  must  expect  and  receive…the  same  treatment  as  if  represented  by  an 
attorney…”   	In  other  words,  if  you  do  not  have  an  attorney  you  will  be  held  to  the 	
same standards as a person with an attorney.

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	1 of 	9 	
 	
FAMILY LAW INFORMATION	 AND INSTRUCTIONS	 	
 	
 CONFIDENTIALITY:   	If  you  have  concerns  about  keeping  information  confidential	, such  as 	
your  address  and/or  social  security  number,  please  consult  an  attorney.    You  should  also  know 
that  Domestic  Violence  Protection	 Orders  or  Stalking  Orders  are  available  free  of  charge  at  the 	
circuit  court  clerks’  offices.    You  may  request  assistance  in  obtaining  Domestic  Violence 
Protection  or  Stalking  Orders  from  your  local  domestic  violence  or  sexual  assault  program  or 
you may ca	ll the Wyoming Coalition Against Domestic Violence & Sexual Assault 	(1-307	-755	-	
0992)	.  There are also private attorneys who may be willing to assist clients in these matters.   If 	
you  have  ever  obtained  a  Domestic  Violence  Protection  Order,  this  informatio	n  should  be 	
indicated  in  the 	Complaint  for  Divorce	 or  the 	Counterclaim	.     A  Domestic  Violence  Protection 	
Order  generally will be i	n effect  for up to  one (1)  year, 	and any provision  included in  that order 	
(such as child custody and/or support) will end when	 the order expires. If any orders are entered 	
as part of your divorce, custody or paternity action, those orders trump conflicting pro	visions in a 	
domestic violence 	protection or stalking order. 	 	
 
Read 	through the following information and instructions 	bef	ore completing 	the forms.	 	
 
Information	:  	 	
 
A  divorce  action  starts  with  the  filing  of  the 	Complaint  for  Divorce	.    A 	Complaint  for 	
Divorce	 is  a  written  request  to  the  court  for  a  divorce.    The  person  who  originally  asks  for  this 	
legal  action  is  called  the 	Plaintiff	 and  remains  the  P	laintiff  throughout  the  case.    The 	Plaintiff 	
will file the 	Complaint for Divorce	 with the 	Clerk of the District Court	, whose office is usually 	
located  in  the  county  courthouse  or  a  branch  of  the  county  courthouse.    A  case  number, 	also 	
called  a 	civil  action  number	, is  assigned  and  an  official  court  file  is  opened.    Delivering  the 	
Complaint for Divorce	 to the Clerk’s office is called 	filing	 a case.  	 	
 	
 	
 
 
 	
 	
Once  a  case  has  been  filed,  a  copy  must  be  formally  given  to  (a/k/a 	served	 on	)  the 	
Defendant.    The  person  against  whom  the  original  legal  action  is  being  requested  is  called  the 
Defendant	,  and  he  or  she  is  expected  to  answer  the 	Complaint  for  Divorce	.    The 	Defendant 	
remains the 	Defendant throughout the case.  	Personal service	 of th	e Complaint for Divorce	 and 	
Summons 	on  the 	Defendant  by  a 	Sheriff	 is  required  for  the 	Complaint  for  Divorce	 unless  the 	
Defendant  completes  an 	Acknowledgment  and  Acceptance  of  Service	 form.    Formal  service  is 	
required  for  the 	Complaint  for  Divorce	 so  the 	Co	urt	 has  proof  that  the 	Defendant	 actually 	
received the papers.  Other forms of service exist, but these are the easiest methods that meet the 
formal service requirement for a 	Complaint for Divorce	.   	
 
 	
Case Number	:  When you start a lawsuit by filing the paperw	ork with the Clerk of the District Court, a 	
case number will be assigned by the Clerk.  You must include that case number on all further paperwork 
in the “	caption	.” The caption is the top section of a pleading, motion, and complaint stating the name of 	
the	 Plaintiff, Defendant, the District Court the case is filed in and the case number.

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	2 of 	9 	
 
Instructions	:  	 	
 
STEP 1. 	 	Answer	 or 	Answer and Counter	claim.	   	
 
Two options exist 	– you may either answer the 	Complaint for Divorce	 or answer and file a 	
counterclaim.  Both options are explained below:	 	
 	 
OPTION A	. Answer  to  Complaint  for  Divorce	.   	 If  you  have  been  served  or  have 	
signed  an 	Acknowledgement  and	 Acceptance  of  Service 	form,  you  should  file  an 	Answer  to 	
Complaint  for  Divorce	 with  the  Clerk  of  District  Court  where  the 	Complaint  for  Divorce 	was 	
filed.    An 	Answer  to  Complaint  for  Divorce	 is  a  written  document  explaining  to  the  court 	
exactly which prov	isions you agree with and which provisions you deny. If you fail to answer, a 	
default judgment 	may	 be entered against you and your spouse may be entitled the relief he or she 	
asked for in the 	Complaint	 for Divorce	.  	
 	
You must fill in the caption.  DO NOT f	orget to include the case number.  This is located in the 	
caption of the 	Summons	 and/or 	Complaint for Divorce	. 	
  
 	i. 	Admit  or  Deny.	  To  answer  the  papers,  you  should  go  through  each  and  every 	
paragraph of the 	Complaint for Divorce	 and either “admit” or “de	ny” each paragraph.  If 	
you do not have sufficient information to either admit or deny a particular allegation, you 
must state that in your 	Answer to Complaint for Divorce	.  If you disagree with something 	
and you fail to “deny” it in your 	Answer to Complai	nt for Divorce	, the Judge can find that 	
you admitted it.	 	
 	
 	ii. 	Time  limit  to  answer.	  	You  have  only  a  limited  amount  of  time  to  file  an 	
Answer  to  Complaint  for  Divorce	.  Generally,  if  you  were  served  within  the  State  of 	
Wyoming,  you  will  have  20  days  to  fi	le  the 	Answer  to  Complaint  for  Divorce	.    If  you 	
were  served  outside  the  State  of  Wyoming,  you  generally  will  have  30  days  to  file  an 
Answer to Complaint for Divorce	.  If you do not file an 	Answer to Complaint for Divorce	 	
by  your  deadline,  then  your  spouse 	may  obtain  a 	Decree  of  Divorce	 giving  him/her 	
everything he/she requested in the 	Complaint for Divorce	. 	
 
 	iii.	 	Computation  of  Time  Limits	.   	In  computing  most  time  limits,  unless  otherwise 	
stated, the day the pleading is  served shall not  be  included. The la	st  day  of the period so 	
computed shall be included, unless it is a Saturday, a Sunday, or a legal holiday, or, when 
the  act  to  be  done  is  the  filing  of  a  paper,  a  day  on  which  weather  or  other  conditions 
have made the office of the clerk of the court inacc	essible, in which event the period runs 	
until  the  end  of  the  next  day  which  is  not  one  of  the  aforementioned  days.  When  the 
period  of  time  prescribed  or  allowed  is  less  than  11  days,  intermediate  Saturdays, 
Sundays,  and  legal  holidays  shall  be  excluded  in 	the  computation.  A  "legal  holiday" 	
includes any day officially recognized as a legal holiday in this state by designation of the 
legislature or appointment as a holiday by the governor.

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	3 of 	9 	
 
NOTE:  If you have any question or concerns as to when  the deadline 	to file the 	Answer to 	
Complaint for Divorce 	is, you should consult an attorney.	 	
 	
iv.	 	REQUIRED  INFORMATION  FOR  CHILDREN	: 	Certain  information  is 	
required  to  be  given 	under  oath	 for  each  child,  unless  you  have  a  court  order  or  are 	
operating  under  another  law 	allowing  you  to  maintain  confidentiality  of  addresses  or 	
other identifying information.  If the information  is  not  provided, the court, upon motion 
of a party or its own motion, may stop the case from going forward until the information 
is  provided.  The  in	formation  necessary  is  included  in  the 	Answer 	and  the 	Answer  and 	
Counterclaim	. 	
 
v. 	Notarizing  Signatures	:  	You  will  need  to  sign  the 	Answer  to  Complaint  for 	
Divorce 	and  hav	e  it  notarized.   	Nota	rial  Officers	 may  administer  the  oath  and  witness 	
your  signatur	e,  or  in  many  cases,  clerks  of  court  will  be  willing  to  administer  the 	
necessary oath.   Each clerk’s office has their own policy so check with  them  first  before 
seeking notarization of your signature on the forms.  	 	
 
vi.	 	Certificate  of  Service	:   	Copies  of 	all  documents  sent  to  or  filed  with  the  court 	
must  be  sent  to  the 	Plaintiff  before  the 	judge  will  consider  them.    This 	certificate  is 	
included at the end of each document that requires it.  	 	
 
vii.	 	Copies	:  Make two  (2) copies of the document.   The original	 will be filed by the 	
Clerk  of  District  Court,  one  copy  is  for  the 	Plaintiff  and 	the  other  copy  is  for  you  (the 	
Defendant).  You will need to repeat this step for all documents you file with the Clerk’s 
office.  	 	
 
OR	 	
 	
OPTION 	B.	 	Answer	 and  Counterclaim  for 	Divorce	.    If  you  want  the  Judge  to  grant 	
relief to you (for example, give you the divorce, award property to you, order your spouse to pay 
alimony,  take  your  previous  last  name  back,  etc.)  you  should  file  an 	Answer  and  Counterclaim 	
for  Divorce	.    An 	Answer 	and  Counterclaim  for  Divorce 	responds  to  the 	Complaint  for  Divorce	 	
and  gives  you  an  opportunity  to  tell  the  court  what  you  want  to  happen  with  the  divorce.    First, 
you  will  go  through  each  and  every  paragraph  of  the 	Complaint  for  Divorce	 and  either  “admit”	 	
or  “deny”  each  paragraph.    Second,  the 	Counterclaim  for  Divorce	 portion  of  the  document  asks 	
the Judge to give you what you want.  You must fill out all of the information in the 	Answer and 	
Counterclaim for Divorce	 completely.	 	
 	
i 	Restoration of Wife’s pre	vious name	:  The wife should state whether or not she 	
would  like  to  resume  her  prior  name  in  either  the 	Complaint	 for  Divorce	 if  she  is  the 	
Plaintiff, or 	in 	a Counterclaim	 if she is  the 	Defendant.   This  is  the wife’s  choice ONLY; 	
the husband cannot demand 	that his wife’s name be changed.	 	
 
ii.  	 	Follow 	Step A(ii)	 through 	Step A(vii)	 above.

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	4 of 	9 	
 
 
NOTE:  If you have any question or concerns as to when the deadline to file the 	Answer and 	
Counterclaim for Complaint for Divorce 	is, you should consult an attorney.	 	
 	
iii	. 	Plaintiff’s 	Reply  to 	Your 	Counterclaim.	  	The 	Plaintiff  must  reply  to  the	 	
Counterclaim	.   	If  you  file  a 	Counterclaim	,  the 	Plaintiff  will  have  20  days  to  “reply”  by  filing  a 	
Reply  to  Counterclaim	.    The 	Plaintiff  will  either  admit  or  deny  the  separate  allega	tions  in  your 	
Counterclaim.   	If  the 	Plaintiff  fails  to  reply  to  the 	Counterclaim	,  you  may  be  entitled  to  file 	
Default	 paperwork seeking the relief you request in your 	Counterclaim. 	 	
  
STEP 2.	 	Initial  Disclosures.	  	The  law  requires  certain  information  be  ma	de 	
available at least thirty (30) days after the 	Defendant is served, including a schedule of financial 	
assets;  schedule  of  non	-financial  assets;  schedule  of  all  debts  owed  individually  or  jointly; 	
location(s)  of  safety  deposit  box(es);  employment  informat	ion;  information  regarding  other 	
income  and  retirement  accounts;  and  a  summary  of  the  facts  believed  to  support  the  claim  of 
superior entitlement to custody where child custody is at issue.	  	
 
EXCEPTON	:  	If  you and the 	Plaintiff agree on all issues in your	 divorce and you both are 	
signing the 	Decree of Divorce	, then you do NOT need to complete the 	Initial Disclosures 	and 	
you can move on to	 Step 3	. 	
 	
A.	 	WHEN  TO  SERVE	:    Initial  Disclosures  must  be  sent  to  the 	Plaintiff  (or  his/her 	
attorney) WITHIN 30 DAYS AFTER 	YOU ARE	 SERVED.  	Be sure to keep a copy of 	
this document for your records.	 	
 
B.	 	DO  NOT  FILE  THE  INITIAL  DISCLOSURES  WITH  THE  CLERK	.  This 	
form is only given to the 	Plaintiff (or his/her attorney).	 	
 
STEP 3.  Fill out a 	Confidential Financial Affidavit	.  	
 	
A.	 	Fill ou	t a 	Confidential Financial Affidavit	 and attach all required documents.  	 	
 	
 	Both parties are required to file a 	Confidential Financial Affidavit	 with the court 	
with all the necessary supporting documentation.  	 	
 	
 	Required Attachments.	  The 	Confidential 	Finan	cial Affidavit	 must be supported 	
with  documentation  of  both  current  and  past  earnings.  Proper  documentation  of 
current earnings i	ncludes, but is not limited to 	pay stubs, employer statements, or 	
receipts  and  expenses  if  self	-employed.  Documentation  of  curr	ent  earnings  shall 	
be  supplemented  with  copies  of  the  most  recent  tax  return  to  provide  verification 
of  earnings  over  a  longer  period.	 Include  copies  of  income  tax  returns  for  the 	
previous two years and your most recent pay stub(s) to show how much you hav	e 	
made so far this year.

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	5 of 	9 	
 	
 	The 	Confidential  Financial  Affidavit	 may  be  filed  with  the  Clerk’s  office  at  the 	
same time you file your 	Answer	 or 	Answer and Counterclaim.	   	
 	
STEP	 4.	 	If  you  and  the 	Plaintiff  agree  on  all  of  the  terms  in  the 	Decree  of  Divorce	,  s	ign 	
bot	h  documents  in  front  of  a 	notarial  officer	.    Here  is  some  important  information  about  the 	
Decree of Divorce	: 	
 	
The 	Decree  of  Divorce	 will  need  to  be  filled  out  complete	ly,  signed  by  you  and  the 	
Plaintiff 	and both of 	your 	signatures 	need to be 	notariz	ed.  	 	
 	
 	Custody and Visitation	.  You and the 	Plaintiff	 need to determine which custody 	
and  visitation  plan  will  apply  in  your  circumstances.    It  is 	unusual	 for  the 	Court	 	
not to award any visitation or	 supervised visitation for the non	-custodial parent	.  	
 	
o 	 If  there  is  a  concern  that  your  child(ren)  may  be  harmed  by  the  other 
parent  physically  and/or  emotionally,  you  should  seek  advice  from 
someone  familiar  with  parenting  and  child  development  issues.    There 
may  be  an  organization  in  your  community  that  can  he	lp  facilitate 	
visitation between the children and you or the other parent.   You can also 
contact  the  facilitators  of  any  parenting  classes  in  your  community  for 
ideas or additional resources.  	 	
 	
 	Factors  to  be  considered  for  awarding  custody  and  visitation	.   	The 	Decree  of 	
Divorce	 contains several options 	for custody and visitation arrangements.  I	deally	, 	
both  parents  will  work  together  to  select  the  proper 	custody  and  visitation	 plan 	
depending upon the family circumstances.   	In awarding custody and setting	 forth 	
a  visitation  plan,  Wyoming  law  requires  that  the  Court  consider  the  following 
factors	: 	
 	
1. 	The geographic location of each parent;	 	
2. 	Each  parent's  willingness  and  ability  to  perform  the  child  care 
duties  associated  with  the  child(ren),  relative  to  the  ch	ild(ren)'s 	
stage of development such as feeding, changing, bathing, preparing 
the  child(ren)  for  school,  taking  responsibility  for  the  child(ren)'s 
homework, etc.;	 	
3. 	Each parent's ability to care for the child(ren)'s needs (consider not 
only historical invol	vement but a parent's willingness and ability to 	
learn the necessary skills, as well);	 	
4. 	The lack of hostility between the parents;	 	
5. 	The  ability  of  both  parents'  work  schedules  and  the  child(ren)'s 
schedule to accommodate extended access;	 	
6. 	The child(ren)'s age	(s) and strength of attachment to each parent;	 	
7. 	The child(ren)'s relationship with his/her friends.

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	6 of 	9 	
 	
 	Child’s interests should control.	  The use of a calendar for scheduling purposes 	
is  highly  recommended.    The  parents'  work  schedules  and  the  child(ren)'s  sc	hool 	
and  extracurricular  activities  need  to  be  considered  when  developing 	a  visitation 	
plan	.  This is especially true for those parents who do not enjoy a traditional work 	
week.    While 	visitation	 should  be  an  enjoyable  and  enriching  experience,  it  is  an 	
ob	ligation  and  responsibility  for  each  parent  as  well  as  a  right  and  a  privilege.  	
Both parents must also have a good faith commitment to developing and carrying 
out a 	visitation plan	.  You need to focus on what type of schedule would be in the 	
child(ren)’s 	best interest.   	 	
 	
 	Parenting  classes	. At  any  time  the 	Court	 may  require  parents  to  attend 	
appropriate  parenting  classes,  including,  but  not  limited  to,  parenting  classes  to 
lessen  the  effects  of  divorce  on  children.    Both  parents  are  generally  required  to 
attend  classes  when  they  are  ordered.    If  the  class  is  ordered,  you  MUST  file  a 
Certificate of Completion	 with the 	Clerk	’s office.  This  certificate is provided by 	
the class instructor.	 	
 	
 	Child  Support  Payments	.    You  will  need  to  determine  the  amount  of  chi	ld 	
support due based upon the 	Confidential Financial Affidavits	 you and the P	laintiff	 	
completed	.   	You  may  use  the 	Child  Support  Computation  Form	 as  a  guide  to 	
help you calculate the support due.  	Another option is to go online to:	 	
 	
http://www.laramiecounty.com/_departments/_district_court/calculator.aspx	  	
 
to calculate child support.	 	
 	
 You  CANNOT  agree  that  no  support  will  be  paid	.    The  statutes  allow 	
for a reduced amou	nt of support when you agree on 	joint	 physical custody	 	
and each 	parent 	keeps the child(ren) overnight for more than forty percent 	
(40%) of the year and both parents contribute substantially to the expenses 
of the children in addition to the payment of chil	d support.	 	
 	
 Where the combined	 net monthly	 income of 	both 	parents is less than eight 	
hundred and thirty three  dollars ($833.00), the non	-custodial parent  has to 	
pay  twenty	-five  percent  (25%)  of  his/her  net  income,  but  the  minimum 	
amount  of  child  support  a 	person  has  to  pay  cannot  be  less  than  fifty 	
dollars ($50.00) per month for each family unit in which there are children 
to whom the noncustodial parent owes a duty of support.	 	
 	
 There  are  NO  DEVIATIONS  from  the  presumed  support	 allowed 	
UNLESS the 	Court	 CHOO	SES to deviate from the set amount because the 	
amount was unjust  or inappropriate in  the particular case. The 	Court	 must 	
include the specific reasons for deviation in the 	Decree of Divorce	.

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	7 of 	9 	
 	
 NO  AGREEMENTS  FOR  LESS  THAN  THE  PRESUMED 
SUPPORT  CAN  BE  APPROVED	 IF  GOVERNMENT  OR  STATE 	
BENEFITS  (SUCH  AS  MEDICAID  (TITLE  19),  FOOD  STAMPS, 
POWER,  ETC.	) ARE  BEING  PROVIDED  ON  BEHALF  OF  ANY 	
CHILD.	  This  means the 	Court	 cannot  lower the amount of  child support 	
calculated by using	 the net income of you and the 	Plaintiff	 even if you and 	
the 	Plaintiff	 agree to a lower amount of support.	 	
 	
 	Medical  Support	.  The  law  requires  that  m	edical  support  for  the  child(ren)  be 	
included  as  part  of  any  child  support  order.    T	he  Court  shall  order  either  or  both 	
of  the  parents  to  provide  med	ical  support,  if  insurance  can  be  obtained  at  a 	
reasonable  cost  and  the  benefits  under  the  insurance  policy  are  accessible  to  the 
children.    This  may  include  dental,  optical  or  other  health  care  needs  for  the 
child(ren).    In  addition,  the  Court  will  order 	that  any  medical  expenses  not 	
covered  by  insurance  and  any  deductible  amount  on  the  required  insurance 
coverage  be  paid  by  one  or  both  parents.    If  both  parents  are  ordered  to  pay  for 
expenses  not  covered  by  insurance,  the  Court  will  specify  the  proportion	 for 	
which  each  parent  is  responsible  (for  example,  50%  to  Plaintiff  and  50%  to 
Defendant).	 	
 	
 	When  will  your  divorce  become  final	?   	Your  divorce  will  not  be  final  until  the 	
judge  signs  the 	Decree  of  Divorce	 and  it  is  filed  with  the 	Clerk	 of 	Court	.    It  may  t	ake  several 	
days  for  the  judge  to  sign  the 	Decree  of  Divorce	.    You  must  verify  with  the 	Clerk	’s  office  that 	
the 	Decree  of  Divorce	 has  been  file	-stamped  before  you  can  be  sure  your  divorce  is  final.    The 	
time  limit  to  appeal  a  decree  begins  to  run  from  the 	day  the 	Decree  of  Divorce	 is  filed  with  the 	
Clerk	’s office.  	 	
 
 
STEP 5.	 	If you and the 	Plaintiff	 do NOT agree on all issues of your 	
divorce, 	you will need to have a trial	: 	
A.	 	Trial	.  If 	you and the 	Plaintiff cannot agree on all issues, 	your case will have to 	be 	
heard	 and decided by a J	udge at a trial.  	 	
 	Caution	:    It  is  strongly  recommended  that  you  hire  or  find  an  attorney  to 	
represent  you  at  trial,  though  you  may  represent  yourself.    You  proceed  at 
your own risk and will be expected to know the laws.	 	
B.	 	Request 	a trial date.	  If the 	Plaintiff has 	NOT	 done so, y	ou will need to request a 	
hearing by  completing  a 	Request  for Setting	.  Write in  “trial” where it asks the type of hearing.  	
Indicate  how  much  time  you  think  it  will  take  for  you  and  the  other  party  to  pres	ent  your 	
evidence and write that in (usually 	one (1) to 	three (3) hours).  You also need to decide whether 	
or  not  you  want  a 	Court	 reporter  to  record  the  proceeding.    If  you  request  a 	Court	 reporter,  you 	
will be responsible for paying the fees. SEE BELOW F	OR DETAILS ON GETTING A 	COURT

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	8 of 	9 	
 
REPORTER.	  If a hearing is not recorded by an official court reporter, a transcript of the hearing 	
will not be available.	  It is very difficult to appeal the Judge’s decision if  you do not get a 	Court	 	
reporter to take down eve	rything that is said at the trial.  	 	
 	
 You  must  file  the 	Request  for  Setting	 and  the 	Order  Setting  Divorce  Trial  and 	
Requesting Pretrial Statements 	with the 	Clerk	’s office and someone there will fill in 	
the hearing date and time and mail  a copy to  you and t	he other party.  You will need 	
to provide an addressed, st	amped envelope for you and the 	Plaintiff	 to the 	Clerk	.   	
 
Once a trial date has been set, do the following:	 	
 	
C. 	Pretrial  Disclosures	. -  	Both  parties	 must  provide  to	 the	 other 	party	 AND 	
PROMPTLY FIL	E WITH THE 	COURT	 the 	Pretrial Disclosures	 regarding the evidence that it 	
may present at trial.	 If you have questions, you should contact an attorney.	 	
 	
 When  are  the 	Pretrial  Disclosures	 due?  Unless  otherwise  directed  by  the 	
Court	, these disclosures must be 	made at least 	30 days before trial	.   	
 	
 Take the original and two (2) copies to the 	Clerk	 for filing.  Keep one copy for 	
your records 	and send the other copy to the 	Plaintiff	 (or his/her attorney).	 	
 
 	Settlement  before  trial.	  In  the  event  that  your  case  sett	les  before  the  trial,  you 	
must  present  the 	Court	 with  the  completed  and  signed 	Decree  of  Divorce	 in  writing  before  the 	
Court	 will  take  the  trial  off  of  the  schedule.  There  will  be  no  continuances  or  canceling  of  the 	
trial  date  based  on  telephone  calls.    If	 you  need  a  continuance,  you  should  contact  an  attorney 	
for assistance in seeking one. 	 	
 
 	Court	 reporter.	  If you wish to have a 	Court	 reporter you are required to	 provide 	
notice  to  the  official 	Court	 reporter  at  least	 three  (3	) working  days	 before  the  matt	er  is  set  for 	
hearing.    The  three	-day  notice  requirement  will  not  be  waived  by  the 	Court	.    The  notice  is 	
required  for  all  civil  matters  including  jury  trials.    Payment  of  the	 statutory  reporting  fee  of 	
$45.00  per  day 	must  be  paid  to  the  official 	Court	 repo	rter  prior  to  the  commencement  of  the 	
hearing/trial.  Checks for the statutory reporting fee shall be made payable to the Wyoming State 
Treasurer.	   	
 	
 	Evidence and witnesses.	  At the hearing,  you will need to  present  your evidence 	
and witnesses.  If the 	Ord	er Setting Divorce Trial and Requesting Pretrial Statements	 is entered 	
(signed  by  the  J	udge),  you  must  follow  the  terms  and  provide  the 	Court	 with  the  information 	
requested in that document, including copies of exhibits you want to introduce at the trial a	nd a 	
list  of  your  proposed  witnesses  and  what  their  testimony  is  going  to  be  about  within  the  time 
frame ordered (usually 3 to 5 days prior to the trial).  Under the law, the Judge cannot help you 
or assist you at trial.  You are on your own without an att	orney.	 	
 
 	Final  Decision  (	Decree  of  Divorce	).  Following  the  trial,  the  J	udge  will  make  a 	
decision  or  may  take  the  matter  under  advisement,  meaning  he  or  she  will  need  to  think  further

Family Law Information	 and Instructions	 	
Revised	 October 2012	 	
Page 	9 of 	9 	
 
before m	aking a determination.  If the J	udge instructs  you,  you must take	 that decision and type 	
it into the 	Decree of Divorce	 incorporating the J	udge’s decision.	 	
 	
 You  are  again  reminded  that,  if  you  choose  to continue  without  an  attorney, 
you  are  expected  to  know  what  to  do  and  how  to  do  it.    The  judge  will  not 
guide you throu	gh the trial/hearing, tell you how to proceed or advise you on 	
the law.	 	
 	When  will  your  divorce  become  final	?   	Your  divorce  will  not  be  final  until  the 	
judge  signs  the 	Decree  of  Divorce	 and  it  is  filed  with  the 	Clerk	 of 	Court	.    It  may  take  several 	
days  for 	the  judge  to  sign  the 	Decree  of  Divorce	.    You  must  verify  with  the 	Clerk	’s  office  that 	
the 	Decree  of  Divorce	 has  been  file	-stamped  before  you  can  be  sure  your  divorce  is  final.    The 	
time  limit  to  appeal  a  decree  begins  to  run  from  the  day  the 	Decree  of  Div	orce	 is  filed  with  the 	
Clerk	’s office. 	 	
 	
RECAP for Defendant’s Documents	:   	
 	
1. 	File an 	Answer	 or 	Answer and Counterclaim	 within 20 days from the date  you were served (or 30 	
days if served out of state)	 	
 	Mail a copy to the 	Plaintiff and keep a copy for your re	cords	 	
2. 	File a 	Confidential Financial Affidavit	 and the required attachments 	 	
 	Mail a copy to the 	Plaintiff and keep a copy for your records	 	
3. 	Assist the 	Plaintiff in filling out the 	Decree of Divorce 	if you both agree on all of the terms.  	 	
Sign 	the 	Decree of 	Divorce	 in front of a 	notar	ial officer. 	 	
4. 	If you and the 	Plaintiff do NOT agree on all of the terms, and a trial is needed, follow these steps:  	 	
a. 	File  a 	Request  for  Setting 	and 	Order  Setting  Divorce  Trial  and  Requiring  Pretrial 	
Statements 	ONLY 	if the 	Plaint	iff has 	NOT	 done so.	 	
b. 	Take  an  original  and  two  (2)  copies  of  the 	Order  Setting  Divorce  Trial  and  Requiring 	
Pretrial  Statements 	for  filing  with  the 	Clerk	 and  two  (2)  addressed,  stamped  envelopes 	
(one  addressed  to  you  and  one  to  the 	Plaintiff	 with  enough  post	age  to  cover  the  cost  of 	
mailing the 	Order Setting Divorce Trial and Requiring Pretrial Statements 	to you and the 	
Plaintiff	).   	 	
c. 	File your 	Pretrial Disclosures	 30 days	 before the trial date.	 	
 	Mail  a  copy  to  the 	Plaintiff  and  keep  a  copy  for  your  records  (do	 not  file  with  the 	
Court)	 	
d. 	At  least  3  working  days  before  the  trial,  request  a  court  reporter,  if  desired  (and  if  the 
Plaintiff has not already done so)	 	
e. 	Attend the Trial	 	
f. 	Complete and file any additional documents required by your Court.	 	
 	
Your divorce is fin	al when the 	Decree of Divorce	 has been signed by the Judge and filed by the Clerk.

Checklist for 	Packet 2	 	
October 2012	 	
Pa	ge 	1 of 	2 	
CHECKLIST FOR PACKET 2	 	
DEFENDANT DIVORCE WITH MINOR CHILDREN	 	
 	
These forms are required in all divorce cases where you and the 	Plaintiff	 agree on 	
all of the issues:	 
 	Answer	 to Complaint for Divorce (with Children)	; and	 	
 	Confidential Financial Affidavit	 	
You  wi	ll  also  need  to  work  with  the 	Plaintiff  to  complete  the 	Decree  of  Divorce	 (with 	
Children)	 and sign it in front of a 	Nota	rial Officer	.  	
 
STEP	 1.   If  you were served with  a copy of the 	Summons 	and 	Complaint for 	Divorce	 or 	
if you signed an 	Acknowledgement and	 Acceptance of Service, 	file	 one of the following:	 	
 	 Answer; 	OR	 	
 	 Answer and Counterclaim	 	
 	Take an	 original and 2 copies of the 	Answer	 or 	Answer and Counterclaim	 	
to the Clerk for filing	. 	
 	Mail a copy to the 	Plaintiff and k	eep a copy for your records.	 	
STEP	 2.    File  a 	Confidential  Financial  Affidavit 	and  include  the  required  attachments.  	
Note:	  This may be filed at the same time as the 	Answer	 or 	Answer and Counterclaim	. 	
 	Con	fidential Financial Affidavit	  	
 	 	If employed, attach tax returns for prior 2 years; and	 	
 	 	 	Attach statement of earnings for the current year; OR	 	
 	If  self	-employed,  attach  verified  income  and  expense  statem	ents 	
for prior two years; and	 	
 	Attached tax returns for prior two years.	 	
 
STEP	 3.  Complete the 	Initial Disclosures	 	
 	Send the 	Initial  Disclosures	 to  the 	Plaintiff within 	30 days	 after  you were 	
personally  served  by  the  Sher	iff  or  signed  the  Ackn	owledgment  and 	
Acceptance  of  Service	 form.    DO  NOT  FILE  the 	Initial  Disclosures	 with 	
the Court.	 	
 	Exception	:  If you and the 	Plaintiff	 agree on all issues in your divorce and 	
you  both  are  signing  the 	Decree  of  Divorce	, then  you  do 	NOT	 need  to 	
complete the 	Initial Disclosures	 and you can move on to 	Step 4	. 	
STEP	 4.  If you and the 	Plaintiff agree on all of the terms in the 	Decree of Divorce	, sign	 	
it in front of a 	Nota	rial Officer	.  	
 	 	Sign the 	Decree of Di	vorce	 	
 	 	A copy will be mailed to you if the Judge signs the 	Decree	 of Divorce.	 	
 
Your divorce will be complete when the Judge signs the 	Decree of Divorce	 and it is 	
filed with the Clerk.

Checklist for 	Packet 2	 	
October 2012	 	
Pa	ge 	2 of 	2 	
STEP	 5.   If 	you and the 	Plaintiff	 do NOT agree on al	l of the issues of your divorce, fill 	
out and file the following forms and attend the trial to finish your Divorce:	 	
 
*Caution:  It is strongly recommended that you hire or find an attorney to represent 
you at trial, even though you may represent yourself. 	 You proceed at your own risk 	
and will be expected to know the rules and laws.	 	
 	
 	If the 	Plaintiff has 	NOT	 requested a trial date, you must request one.  	 	
 	 	Request for Setting	  	
 	Order Setting Divorce Trial	 and Requesting Pretrial Statements	 	
(Judge will fill out date and time)	 	
 	Take original and two copies to 	the Clerk	 for fi	ling	 	
 	Take	 an envelope addressed to you with postage for the Clerk to 	
mail a copy of the 	Order Settin	g Divorce Trial and Requesting 	
Pretrial Statements	 to you	 	
 	Take an	 envelope addressed to the D	efendant with postage for the 	
Clerk to mail a copy of the 	Order Setting Divorce Trial and 	
Requesting Pretrial Statements	 to the 	Plaintiff	 	
 	Mail a copy of the 	Request for Setting	 to the 	Plaintiff and keep a 	
copy for your records.	 	
 	
Once a trial date has been set, do the following:	 	
 	
 	Pretrial Disclosures	 and 	Pretrial Memorandum	 	
 	 	File at least 	30 days	 before the trial date	 	
 	 	Take original and two copies to the 	Clerk	 for filing	 	
 	 	Mail copy to the 	Plaintiff and k	eep a copy for your records	 	
 	At least 3 working days before the trial, request a court report	er if desired 	
and if the 	Plaintiff has not already done so.	 	
 	Attend the Trial	:  Present your evidence and witnesses.	 	
 	Additional Forms	:  The Court may also require additional forms 	
depending on the county where your case i	s filed.  As	k the Clerk if 	
additional forms are required:	 	
 	Copies and Envelopes for each additional form:	 	
 	Take an	 original and 2 copies of each additional form to the 	
Clerk	 for filing	 	
 	Mail  a  copy  of  any 	additional  form  filed  with  the 	Clerk	 to 	
the 	Plaintiff and k	eep a copy for your records	 	
 	
Your divorce will be complete when the Judge signs the 	Decree of Divorce	 and it is 	
filed with the Clerk.

Answer to Complaint for Divorce 	(with 	Children)	 	
Revised 	October 2012	 	
Page 	1 of 	5 	
STATE OF WYOMING	 	) 	IN THE DISTRICT COURT	 	
 	 	 	 	 	) ss	 	
COUNTY OF ________________	 	) 	_______________ JUDICIAL DISTRICT	 	
 
Plaintiff:____________________________,	 )  	Civil Ac	tion Case No. ___________	 	
(Print name of person filing)	 	 	) 	
 	  	 	 	 	 	) 	
vs.	 	 	 	 	 	 	) 	
 	 	 	 	 	 	) 	
Def	endant:	__________________________	. ) 	
(Spouse)	 (Print name)	 	
 	  	
 	 	 	 	 	 	 	 	 	 	 	 	 	
ANSWER TO COMPLAINT	 FOR DIVORCE (with Children)	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	
The Defendant sets forth the following as the answers and responses to Plaintiff’s 	
Complaint for Divorce	 (with Children	): 	
 	
1. Defendant admits the allegations in Par	agraphs 	  	 	 	 	 	  	
(list paragraphs that are accurate statements)	 	
of Plaintiff’s 	Complaint for Divorce	. 	
 
2. Defendant denies the allegations in Paragraphs 	  	 	 	 	 	 	
 	(list paragraphs that you 	believe are not accurate	) 	
of P	laintiff’s 	Complaint for Divorce	. 	
 
3. Defendant does not have information sufficient to either admit or deny the allegations 	
in Paragraphs 	  	 	 	 	 	. 	
 	 	
4. 	The 	Plaintiff  and  I  are  the  natural  or  adoptive  parents  of  the  following  minor 	
child(ren):	 	
 	
Child’s 	initial	s: 	 	 	 	 	 	 	 	 	 	
Child’s year of birth	:  	 	 	 	 	 	 	 	 	
Present address:	 	 	 	 	 	 	 	 	 	 	
 
Name(	s) of person(s) with 	
whom child(	ren	) have 	lived 	
with 	during the past 5 years	 	
Beginning        Ending  	 	
Date                  Date	 	
Present address of person(s) 
with whom child(ren) 	lived	 	
with 	during this period	 	
 	       	 	 	
 	      	 	 	
 	       	 	 	
 Attach a separate sheet if necessary

Answer to Complaint for Divorce 	(with 	Children)	 	
Revised 	October 2012	 	
Page 	2 of 	5 
Child’s 	initials	: 	 	
 	Child’s year of birth	:  	                                     	 	
Present address:	 	 	 	 	 	 	 	 	 	 	
Name(	s) of person(s) with 	
who	m child(	ren	) have 	lived 	
with 	during the past 5 years	 	
Beginning        Ending  	 	
Date                  Date	 	
Present address of person(s) 
with whom child(ren) lived 
with 	during this period	 	
 	 	 	
 	 	 	
 	 	 	
 Attach a separate sheet if necessary	                          	 	
                                         	 	
Child’s 	initials	: 	 	 	 	 	 	 	 	 	 	
Child’s year of birth	:   	 	 	 	  	 	 	 	                                    	 	
Present a	ddress:	 	 	 	 	 	 	 	 	 	 	
Name(	s) of person(s) with 	
whom child(	ren	) have	 lived 	
with 	during th	e past 5 years	 	
Beginning        Ending  	 	
Date                  Date	 	
Present address of person(s) 
with whom child(ren) lived 
with 	during this period	 	
 	 	 	
 	 	 	
 	 	 	
 Attach a separate sheet if necessary	 	
 
 	
Child’s 	initials	:  	 	 	 	 	 	 	 	 	           	                                                                                  	 	
Child’s year of birth	:     	 	      	 	 	 	 	 	 	 	 	
Present address:	 	 	 	 	 	 	 	 	 	 	
Name(s) of person(s) with 
whom child	(ren	) have	 lived 	
with 	during the past 5 years	 	
Beginning        Ending	   	
Date                  Date	 	
Present address of person(s) 
with whom child(ren) lived	 	
with	 during this period	 	
 	 	 	
 	 	 	
 	 	 	
 Attach a separate sheet if necessary	 	
 
5. 	 I  have  not  participated  as  a  party  or  a  witness  or  in  any  o	ther  capacity  in  any 	
other  court  case  concerning  the  custody  of  the  minor  child(ren)	, and  no  other 	
court  proceedings  concerning  the  minor  child(ren)  (including  proceedings  for 
enforcement,  domestic  violence,  protective  orders,  termination  of  parental  right	s 	
or adoptions) are currently pending in the State of Wyoming or in any other state; 
OR

Answer to Complaint for Divorce 	(with 	Children)	 	
Revised 	October 2012	 	
Page 	3 of 	5 
 	 I have  participated 	as  a  party  or  witness  or  in  another  capacity  in  another 	
court  proceeding  concerning  the  custody,  allocation  of  decision	-making, 	or 	
visitation/parenting  time  of  the  child(ren)  listed  in  this 	Answer  to 	Complaint	 for 	
Divorce 	as  follows:  (Please  be  specific  and  include  the  case  number,  court,  state 	
and  nature  of  case,  date  of  child	-custody  determination,  if  any,  and  the  initials  of 	
the	 child(ren) involved	) 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	 	 	 	 	
 	
6. 	 	  I  know  of  no  person  not  a  party  to  these  proceedings  who  has  physical 	
custody of the minor child(ren) or who claims to have custody or visitation rights 
with respect to the minor chil	d(ren); OR 	 	
 	 	
  The following people are not parties in this matter, but have physical custody 	
of  the  child(ren)  or  claim  rights  of  parental  responsibilities,  legal  custody  or 
physical custody, or visitation/parenting time with the child(r	en):	 	
 	 	 	 	 	 	 	 	 	 	 	 	
(List Names and Addresses	) 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	WHEREFORE	,  Defendant  respectfully  requests  that  the 	court  find  generally  in 	
her/his  favor  and  against  the  Plaintiff,  that  Plaintiff  take  nothing  by  way  of  his/her 
Complaint  for  Divorce	, and  for  such  other  and  further	 relief  as  the 	court  deems  just  and 	
proper.	 	
 	DATED  this _______ day of ___________________________, 20___.	 	
 	
 	 	 	 	 	
 	 	 	 	 	 	 	 	
Signature	 	
Printed Name: 	 	 	 	 	 	 	
Address: 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
Phone Number:	 	 	 	 	 	 	
 	 	 	 	 	
 	 	
 
STATE OF WYOMING	 	 	) 	
 	 	 	 	 	) ss.	 	
COUNTY OF ____________	  	) 	
 	
The  Defendant,  ___________________________________,  under  the  penalty  of 	
perjury,  verifies  that  she/he  has  read  the 	Answer	 to  Complaint  for  Divorce  (with 	
Children)	,  knows  the  contents  of  the 	Answer	,  and  that  the  statement	s  in  the 	Answer,

Answer to Complaint for Divorce 	(with 	Children)	 	
Revised 	October 2012	 	
Page 	4 of 	5 	
including  the  required  statements  about  the  child(ren) 	are  true  to  the  best  of  her/his  own 	
knowledge. 	 	
 
  	DATED	 this _____ day of  ___________________, 	20	_______.	 	
 	
 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
Signature	 	
Printed Name: 	 	 	 	 	 	 	
Address: 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
Phone N	umber:	 	 	 	 	 	 	
 	
Subscribed and sworn to before me this ______ day of ______________	_______	, 	
20	______ 	. 	
 
Witness my hand and official seal.	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	Notarial Officer 	 	
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 	
was filed with the 	Clerk of District 	Court; and, a true and accurate copy of th	is 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 Plaintiff/Plaintiff’s Attorney’s Name and Address)	 	
 
 
TO:  ______________________________________	 	
 
        	______________________________________	 	
 
        	______	________________________________	 	
 
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	Your signature	 	
 	
 	 	 	 	 	 	 	 	 	 	 	 	
  	 	 	 	 	 	 	Print name

Answer to Complaint for Divorce 	(with 	Children)	 	
Revised 	October 2012	 	
Page 	5 of 	5 	
 
 
--------------------------------------------------	Fill in, if applicable	----------------------------------	 	
Pursuant  to  Rule  102(a)(1)(B)  of  the  Wyoming  U	niform  Rules  of  District  Court  the 	
following attorney has participated in the preparation of this pleading but said attorney is 
NOT deemed to have entered an appearance in this matter:	 	
_________________________________ 	 	
Attorney’s Name	 	
 
Attorney’s Address/	Telephone:	 	
__________________________________ 	 	
__________________________________ 	 	
__________________________________ 	 	
__________________________________

Answer and Counterclaim to Complaint for Divorce (with Children)	 	
Revised October 2012	 	
Page 	1 of 	6 	
STATE OF WYOMING	 	) 	IN THE DISTRICT COURT	 	
 	 	 	 	 	) ss	 	
COUNTY OF ________________	 	) 	_______________ JUDICIAL DISTRICT	 	
 
Plaintiff:____________________________,	 )  	Civil Ac	tion Case No. ___________	 	
(Print name of person filing)	 	 	) 	
 	  	 	 	 	 	) 	
vs.	 	 	 	 	 	 	) 	
 	 	 	 	 	 	) 	
Def	endant:	__________________________	. ) 	
(Spouse)	 (Print name)	 	
 	 	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	
ANSWER AND COUNTERCLAIM	  	
TO COMPLAINT FOR DIVORCE	 (WITH CHILDREN)	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 
 	The Defendant set	s forth the following as the answer	s and response	s to Plaintiff’s 	
Complaint for Di	vorce	 (with Children)	: 	
 
1. Defendant admits the allegations in Par	agraphs 	  	 	 	 	 	  	
 	(list paragraphs that are accurate statements)	 	
of Plaintiff’s 	Complaint for Divorce	. 	
 
2. Defendant denies the allegations in Paragraphs 	  	 	 	 	 	 	
 	(list paragraphs that you 	believe a	re not accurate	) 	
of Plaintiff’s 	Complaint for Divorce	. 	
 
3. Defendant does not have information sufficient to either admit or deny the allegations in 	
Paragraphs 	 	 	 	 	 	 	. 	
 
 	WHEREFORE	, Defendant respectfully requests that the 	court find generally in her/his 	
favor and against the Plaintiff, that Plaintiff take nothing by way of his/her 	Complaint for 	
Divorce	, and for such other and further relief as the 	court deems just and proper.	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
COUNTER	CLAIM	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 
 	DEFENDANT	, 	 Husband  	 Wife	, sets forth the following as the counter	claim 	to 	
Plaintiff’s 	Complaint for Divorce	 (with Children)	:

Answer and Counterclaim to Complaint for Divorce (with Children)	 	
Revised October 2012	 	
Page 	2 of 	6 	
1. 	Defendant is a resident of ___________________ County	, Wyoming, and has lived in the 	
State  of  Wyoming  for  more  than  sixty  (60)  days 	immediately 	prior  to  the  filing  of  this  Answer 	
and Counterclaim. (If not, did marriage take place in Wyoming 	and have you resided in this state 	
from the time of the marriage until the filing of the Answer and Counterclaim? 	 yes 	 no	.) 	
 	
2. 	Plaintiff and Defendant were married to each other on 	 	 	 in 	 	 	     	 	
             	(Date of Marriage	) 	
  	 	 	 	. 	
(City, County and State where marriage took place	) 	
 
3. 	The Plaintiff and Defendant separated on 	 	 	 	       	 	 	 	 	. 	
 	 	 	 	 	  (Date of Separati	on) 	
 	 	
4. 	Irreconcilable  di	fferences  exist  in  the  marriage	 and	 Defendant	 is  the  aggrieved  party  in  this 	
case and should be grant	ed a divorce from the Plaintiff.	 	
 
5. 	The 	Plaintiff and I are the natural or adoptive parents of the following minor child(ren):	 	
 	
Child’	s initials	: 	 	 	 	 	 	 	 	 	 	
Child’s year of birth	:  	 	 	 	 	 	 	 	 	
Present address:	 	 	 	 	 	 	 	 	 	 	
 	
Name(	s) of person(s) with 	
whom child(	ren	) have 	lived 	
with 	during the past 5 years	 	
Beginning        Ending  	 	
Date                  Date	 	
Present address of person(s) 
with whom ch	ild(ren) lived	 	
with 	during this period	 	
 	       	 	 	
 	      	 	 	
 	       	 	 	
 Attach a separate sheet if necessary	 	
 
 	
Child’s 	initials	: 	 	
 	Child’s year of birth	:  	                                     	 	
Present address:	 	 	 	 	 	 	 	 	 	 	
Name(	s) of person(s	) with 	
whom child(	ren	) have 	lived 	
with 	during the past 5 years	 	
Beginning        Ending  	 	
Date                  Date	 	
Present address of person(s) 
with whom child(ren) lived 
with 	during this period	 	
 	 	 	
 	 	 	
 	 	 	
 Attach a separate sheet if ne	cessary

Answer and Counterclaim to Complaint for Divorce (with Children)	 	
Revised October 2012	 	
Page 	3 of 	6 
Child’s 	initials	: 	 	 	 	 	 	 	 	 	 	
Child’s year of birth	:   	 	 	 	  	 	 	 	                                    	 	
Present a	ddress:	 	 	 	 	 	 	 	 	 	 	
Name(	s) of person(s) with 	
whom child(	ren	) have	 lived 	
with 	during the past 5 years	 	
Beginning        Ending  	 	
Date                  Date	 	
Present address of person(s) 
with whom child(ren) lived 
with 	during this period	 	
 	 	 	
 	 	 	
 	 	 	
 Attach a separate sheet if necessary	 	
 
 	
Child’s 	initials	:  	 	 	 	 	 	 	 	 	                                                                                             	 	
Child’s year of birth	:     	 	      	 	 	 	 	 	 	 	 	
Present address:	 	 	 	 	 	 	 	 	 	 	
Name(s) of person(s) with 
whom child	(ren	) have	 lived 	
with 	during the past 5 years	 	
Begin	ning        Ending  	 	
Date                  Date	 	
Present address of person(s) 
with whom child(ren) lived	 	
with	 during this period	 	
 	 	 	
 	 	 	
 	 	 	
 Attach a separate sheet if necessary	 	
 
6.       T	hat the child(ren) named in this 	Complaint for Di	vorce	  	 have 	 have not been in the 	
State  of  Wyoming  for  a  period  of  six  (6)  months  or  more  immediately  before  filing  this 
Complaint	.  (If not, seek the ad	vice of a lawyer before filing	.) 	
 
7. 	 I  have  not  parti	cipated  as  a  party  or  a  witness  or  in  any  other  capacity  in  any  other 	
court  case  concerning  the  custody  of  the  minor  child(ren)	, and  no 	other  court  proceedings 	
concerning  the  minor  child(ren)  (including  proceedings  for  enforcement,  domestic  violence, 
prote	ctive  orders,  termination  of  parental  rights  or  adoptions)  are  currently  pending  in  the  State 	
of Wyoming or in any other state; OR	 	
 
 	 	 I  have  participated 	as  a  party  or  witness  or  in  another  capacity  in  another  court 	
proceeding concerning 	the custody, allocation of decision	-making, or visitation/parenting time of 	
the child(ren) listed in this 	Answer and Counterclaim 	as follows: (Please be specific and include 	
the case number, court, state and nature of case, date of child	-custody determinat	ion, if any, and 	
the initials of the child(ren) involved	)

Answer and Counterclaim to Complaint for Divorce (with Children)	 	
Revised October 2012	 	
Page 	4 of 	6 	
8. 	 	  I know of no person not a party to these proceedings who has physical custody of the 	
minor  child(ren)  or  who  claims  to  have  custody  or  visitati	on  rights  with  respect  to  the  minor 	
child(ren); OR 	 	
 	 	
 	  The  following  people  are  not  parties  in  this  matter,  but  have  physical  custody  of  the 	
child(ren)  or  claim  rights  of  parental  responsibilities,  legal  custody  or  physical  custody,  or 
visitation/parenting time with the child(ren):	   	 	 	 	 	 	 	 	
 	 	 	 	    	(List Names and Addresses	) 	 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	 	
9. 	To the best of 	my	 knowledge,  	 	
 	 	Wife is not pregnant, 	OR	 	
 	Wife is pregnant (If pregnant, consult an atto	rney.  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. 	 	
 
10.	 	 Plaintiff  OR 	  Defendant  is  a  fit  and  proper  person  to  have  the  pr	imary  care, 	
custody  and  control  over  the  minor  child(ren)  subject  to  the  other  parent’s  right  of  reasonable 
visitation; OR	 	
 
 	 	 Both  parties  are  fit  and  proper  persons  to  share  custody  and  control  over  the  minor 	
child(ren).	 	
 
11	.   	 Plaintiff  OR 	 Defendant	 is  capable  of  paying  child  support 	in  an  amount 	
determined by the Wyoming Child Support Guidelines.   	 	
 
12.	 	The  Court  should  order  that 	 Plaintiff  OR 	  Defendant  OR 	 Both  Parents  provide 	
medical  insurance  for  the  minor 	child(ren)  if  it  can  be  obtained  through  an  employer  or  if  it  is 	
otherwise  reasonably  available  and  that 	 Plaintiff  OR 	  Defendant  OR 	 Both  P	arents  be 	
liable to pay any medical expenses, including any deductible or co	-pay, not covered by insurance 	
coverage.	 	
 
13.  	The parties have accumulated certain property and d	ebts during the course of their 	
marriage 	which should be equitably divided by the 	Court.  	 	
 
14. 	The  Court  should  award 	 Plaintiff  OR 	 Defendant 	spousal  support/alimony  in  a 	
reasonable amount	 to be determined by the court; OR 	 	
 	
 Neither	 party 	should	 be awarded spousal support/alimony.	 	
 	
15. 	The Wife’s previous name may be restored if she desires.

Answer and Counterclaim to Complaint for Divorce (with Children)	 	
Revised October 2012	 	
Page 	5 of 	6 	
WHEREFORE	, the 	Defendant	 respectfully requests that the Court:	 	
 
1. 	Grant	 the 	Defendant	 a divorce from the 	Plaintiff	 and dissolv	e the marriage;	 	
 
2. 	Award	: 	
a. 	 Plaintiff  OR 	  Defendant  primary  physical  custody  of  the  minor  child(ren) 	
subject to visitation rights of the other party; OR 	 	
b. 	 Joint  physical 	custody  of  the  minor  child(ren)  (the  parties  will  share  custody 	
and control over the minor child(ren)); OR 	 	
c. 	 Shared 	custody (each parent will have custody of at least one of the children);	 	
 
3. 	Order that the 	 Plaintiff OR 	  Defendant pay child support  in an amount determined 	
by the court using the Wyoming Child S	upport Guidelines;   	 	
  
4.             	Order	 that  the	   	 Plaintiff  OR 	  	 Defendant,  OR	   	 Both  parents  provide  medical 	
support for the minor child(ren);	 	
 
5. 	Order a just and equitable division of the marital pro	perty and debts; 	 	
 
6. 	Order that:	 	
 	  No party is entitled to	 spousal support; OR	 	
 	  Reasonable  spousal  support 	should 	be  paid  by 	 Plaintiff,  OR 	 Defendant  as  the 	
circumstances and facts ma	y require;	 	
 
7. 	Order  that  the  Wife  resume  her  previous  name  at  the  conclusion  of  this  lawsuit  if  she 	
wishes; and	 	
 
8. 	Order such other and further relief as the Court deems just and equitable.	 	
 
STATE OF WYOMING	 	 	) 	
 	 	 	 	 	) ss.	 	
COUNTY OF ____________	  	) 	
 
 	The 	Def	endant	, ___________________________________, under the penalty of perjury, 	 	
verifies that she/he has read the 	Co	unterclaim	, knows the contents of the 	Co	unterclaim	, and that 	
the statements in the 	Counterclaim	 are true to the best of her/his own knowledge. 	 	
 
  	DATED	 this _____ day of  ___________________, 	20	_______.	 	
 	 	 	 	 	 
 	 	 	 	 	 	 	 	
Signature	 	
Printed Name: 	 	 	 	 	 	 	
Address: 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
Phone Number:

Answer and Counterclaim to Complaint for Divorce (with Children)	 	
Revised October 2012	 	
Page 	6 of 	6 	
 	
 	
Subscribed and sworn to before me 	this ______ day of ______________, 	20	_________.	 	
 	
Witness my hand and off	icial seal.	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	Notarial Officer 	 	
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 th	is document 	was se	rved 	
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 	Plaintiff	/Plaintiff’s	 Attor	ney’s Name and Address)	 	
 
TO:  ______________________________________	 	
 
        	______________________________________	 	
 
        	______________________________________	 	
 
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	Your signature	 	
 	
 	 	 	 	 	 	 	 	 	 	 	 	
  	 	 	 	 	 	 	Print name	 	
 
 ---------------------	-----------------------------	Fill in, if applicable	------------------------------------	------	 	
Pursuant  to  Rule  102(a)(1)(B)  of  the  Wyoming  Uniform  Rules  of  District  Court  the  following 
attorney  has  participated  in  the  preparation  of  this  pleading  but  said 	attorney  is  NOT  deemed  to 	
have entered an appearance in this matter:	 	
_________________________________ 	 	
Attorney’s Name	 	
 
Attorney’s Address/Telephone:	 	
__________________________________ 	 	
__________________________________ 	 	
_________________________________	_  	
__________________________________

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	1 of 	14 	
 
STATE OF WYOMING	 	) 	IN THE DISTRICT COURT	 	
 	) ss	 	 	 	 	 	) ss	 	
COUNTY OF ________________	 	) 	_______________ JUDICIAL DISTRICT	 	
 
Plaintiff:	____________________________,	 ) 	Civil Action Case No. __________ 	 	
(Print name of person filing)	 	 	) 	
 	  	 	 	 	 	) 	
vs.	 	 	 	 	 	 	) 	
 	 	 	 	 	 	) 	
Defendant:	__________________________	. ) 	
(Spouse)	 (Print name)	 	
  	 	 	 	
 
 	
INITIAL DISCLOSURES 	 	
 	
 	
The	 following initial disclosures 	are submitted 	by 	the	 Plaintiff	 pursuant to Wyoming Rule 	
of  Civil  Procedure  26(a)(1.1).  This  information  is  required  in  all  divorc	e  proceedings  to  the 	
extent  that  the  information  pertains  to  a  particular  claim  or  defense  in  the  action.  This 
information  must be made available to  the opposing party’s 	attorney or the opposing party  if he 	
or she does not have an attorney for the divorce 	action	 within thirty (30) days after the 	Defendant 	
has  been  served	 with  the 	Complaint  for  Divorce	. For  any  of  the  following  disclosures  that  do 	
not pertain to you, write “not applicable” on the appropriate schedule	. 	
1. 	 A  schedule  of  financial  assets  owned	 individually  or  jointly,  such  as  savings  or 	
checking  accounts,  stocks,  bonds,  cash  or  cash  equivalents,  including  the  name  and  address  of 
the  depository,  the  date  such  account  was  established,  the  type  of  account,  the  account  number, 
and  whether  the  accou	nt  is  acknowledged  to  be  a  marital  asset  or  asserted  to  be  a  non	-marital 	
asset  and,  if  asserted  to  be  a  non	-marital  asset,  an  explanation  of  the  legal  and  factual  basis  for 	
such assertion. (See attached 	Schedule of Financial Assets	.) 	
2. 	A  schedule  of  non	-financial  assets	,  such  as  personal  or  real  property  (i.e.  house, 	
land, vehicles, household items, etc.) 	owned individually or jointly, including the purchase price 	
and  the  date  of 	purchase  or  acquiring  the  property	,  the  present  market  value,  any  indebtednes	s 	
relating  to  such  asset,  the  state  of  record  ownership,  whether  purchased  from  marital  asset	s or

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	2 of 	14 	
 
obtained by gift or inheritance, and whether acknowledged to be a marital asset or asserted to be 
a  non	-marital  asset  and,  if  asserted  to  be  a  non	-marital  ass	et,  an  explanation  of  the  legal  and 	
factual basis for such assertion. (See attached 	Schedule of Non	-Financial Assets	.)   	
3. 	A  schedule  of  all  debts  owed  individually  or  jointly,  identifyi	ng  the  date  any 	
obligation was in	curred, the spouse in whose name the	 debt was incurred, the present amount of 	
all  debts  and  monthly  payments,  the  use  to  which  the  money  was  put  which  caused  the  debt  to 
arise, identification of any asset which serves as security for such debt, and an acknowledgement 
of whether each debt is 	a marital or non	-marital debt, and if asserted to be a non	-marital debt, an 	
explanation of the legal and factual basis for such assertion. (See attached 	Schedule of Debts	.) 	
4. 	A  schedule  of	 safe  deposit  boxes,  including  the  name  and  address  of  the 	
institut	ion  where  the  box  is  located,  the  box  number,  the  name  and  addre	ss  of  the  individual(s) 	
who  has	 access  to  the  box,  an  inventory  of  the  contents,  and  the  value  of  the  assets  located 	
therein.	 (See attached 	Schedule of Safety Deposit Boxes	.) 	
5. 	A  schedule  of	 employment,  including  the  name  and  address  of  your  employer; 	
gross  monthly  wage;  payroll  deduction(s),  specifically  identifying  the  type  and  amount;  the 
amount  of  other  benefits  including  transportation,  employer  contributions  to  health  care,  and 
employer 	contributions to retirement accounts; and outstanding bonuses.	 (See attached 	Schedule 	
of Employment	.) 	
6. 	A schedule of	 all other sources of income, including the name and address of the 	
source  and  the  amount  and  date  the  income  was  received.	 (See  attached 	Schedule  of  Other 	
Income	.) 
7. 	A schedule of all	 retirement accounts or benefits, including the name and address 	
of  the  institution  holding  the  accounts  or  benefits,  the  present  value  if  readily  ascertainable,  the 
initial  date  of  any  account,  the  expected  p	ayment  upon  retirement  and  the  specific  retirement 	
date,  and  the  value  of  the  account  at  the  date  of  the  marriage  if  the  account  existed  prior  to 
marriage.	 (See attached 	Schedule of Retirement Accounts or Benefits	.)

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	3 of 	14 	
 	
8. 	If seeking  custody	, or  a  change  in 	cu	stody	, set  forth  the  facts 	believed  to  support 	
your	 claim  of  superior  entitlement  to  custody. 	 In  addition,  as  to  a  change  of  custody, 	set  forth 	
the	 facts  comprising  a  sub	stantial  change  in  circumstances	 and  disclose  any  supporting 	
documentation.	 (See atta	ched 	Schedule of Custody	.) 	
 	9. 	NOTE: 	Supplementation of disclosures and responses. 	Wyoming Rules of Civil 	
Procedure 26(e)(1):   	A party  who has made  a disclosure or responded to  a request  for discovery 	
with a disclosure or response is under a duty to supple	ment or correct the disclosure or response 	
to  include  information  thereafter  acquired,  if  ordered  by  the  court  or  in  the  following 
circumstances: 	 	
 	A  party  is  under  a  duty  to  supplement  at  appropriate  intervals,  its 
disclosures  if  the  party  learns  that  in 	some  material  respect  the  information 	
disclosed  is  incomplete  or  incorrect  and  if  the  additional  or  corrective 
information  has  not  otherwise  been  made  known  to  the  other  parties  during 
the discovery process or in writing.  	 	
    	
 	DATED this _____ day of __	___________, 20___.	 	
 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
Signature	 	
Printed Name: 	 	 	 	 	 	 	
Address: 	 	 	 	 	 	 	 	
Phone Number:

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	4 of 	14 	
 	
 	
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)  a  true  and  accurate  copy  of  th	is 	
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 Other Party’s/Other Party’s 	Attorney’s Name and Address)	 	
 
TO:  _____	_________________________________	 	
 
        	______________________________________	 	
 
        	______________________________________	 	
 
 
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	Your signature	 	
 	
 	 	 	 	 	 	 	 	 	 	 	 	
  	 	 	 	 	 	 	Print name

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	5 of 	14 	
 
 	
 	
SCHEDULE	-A 	
 Not 	Applicable	 	 	 	 	                             	Financial Assets	 	 	 	 	      	 	
Name and Address of 	
Depository	 	
Account Number	 	Type of Account	 	Source of Funds	 	Acknowledged to be a 
Marital Asset or not**	 	
Award to Husband/ Wife	 	
1.Savings/Checking Accounts:	 	
 
 
 
 	
 	 	 	 	 	
2. Stocks:	 	
 
 
 
 
 
 	
 	 	 	 	 	
3. Bonds:	 	
 
 
 
 
 	
 	 	 	 	 	
4. Cash:	 	
 
 
 
 
 	
 	 	 	 	 	
5. Cash Equivalents:	 	
 
 
 
 	
 	 	 	 	 	
6. Other Financial Assets:	 	
 
 
 
 	
 	 	 	 	 	
**If not a marital asset, an explanation of legal and factual basis for such assertion is required.	 	
 Attach	 additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	6 of 	14 	
 	
 	
SCHEDULE	-B 	 	
 Not Applicable 	 	 	 	 	 	        	Non	-Financial Assets	 	
Description of Asset	 	How Acquired:	 	
1. Gift	 	
2. Inheritance	 	
3. Marital	 	
Acquired By:	 	
1. Husband	 	
2. Wife	 	
3. Joint	 	
Record Ownership:	 	
1. Joint	 	
2. Individual	 	
3. Other	 	
Date Acquired	 	Present Market 	
Value	 	
Award to 	
Husband/ Wife	 	
Other information	 	
List Personal Property 
(i.e., household 
furnishings, jewelry, etc.)	 	
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 Attach additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	7 of 	14 	
 	
 	
SC	HEDULE	-B 	
 Not Applicable 	 	 	 	 	 	          	   Non	-Financial Assets	 	
Description of Asset	 	How 
Acquired:	 	
1-Gift	 	
2-Inheritance	 	
3-Marital	 	
Acquired By:	 	
 	
1-Husband	 	
2-Wife	 	
3-Joint	 	
Record Ownership:	 	
1. Joint	 	
2. Individual	 	
3. Other	 	
Date of 
Acquisition	 	
Present Market 	
Value	 	
Award to 	
Husband/ Wife	 	
Other Information	 	
List All Vehicles by 
Year, Model &	 VIN 	
Number	 	
a. 
 
b.  	 	
 
c. 
 
d. 
 	
 
 
 
a. 
 
b. 
 
c. 
 
d. 	
 
 
 
a. 
 
b. 
 
c. 
 
d. 	
 
 
 
a. 
 
b. 
 
c. 
 
d. 	
 
 
 
a. 
 
b. 
 
c. 
 
d. 	
 
 
 
$ 
 
$ 
 
$ 
 
$ 	
 
 
 
a. 
 
b. 
 
c. 
 
d. 	
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 	
 Oth	er Personal Property	 	
a. 
b. 
c. 
d. 	
 
a. 
b. 
c. 
d. 	
 
a. 
b. 
c. 
d. 	
 
a. 
b. 
c. 
d. 	
 
a. 
b. 
c. 
d. 	
 
$ 
$ 
$ 
$ 	
 
a. 
b. 
c. 
d. 	
 
a. 
b. 
c. 
d. 
 	
 Real Property	 	
a. 
 
 
b. 
 
 
 
 	
 
a. 
 
 
b. 	
 
a. 
 
 
b. 	
 
a. 
 
 
b. 
 	
 
a. 
 
 
b. 	
 
$ 
 
 
$ 	
 
a. 
 
 
b. 	
 
a. 
 
 
b. 	
 Interest in Any Business	 	
a. 
b. 
c. 	
 
a. 
b. 
c. 
 	
 
a. 
b. 
c. 
 	
 
a. 
b. 
c. 
 	
 
a. 
b. 
c. 
 	
 
$ 
$ 
$ 
 	
 
a. 
b. 
c. 
 	
 
a. 
b. 
c. 
 	
 Attach additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	8 of 	14 	
 	
 	
SCHEDULE	-B 	
 Not Applicable	 	 	 	 	 	      	       	Non	-Financial Assets	 	
Description of Asset	 	How 
Acquired:	 	
1-Gift	 	
2-Inheritance	 	
3-Marital	 	
Acquired By:	 	
 
1-Husband	 	
2-Wife	 	
3-Joint	 	
Record Ownership:	 	
1-Joint	 	
2-Individual	 	
3-3rd Party/ 	
Partnership	 	
Date of 
Acquisition	 	
Present Market 	
Value	 	
Award to 
Husband/Wife	 	
Other Information	 	
Collectibles (Guns, 
Coins, Stamps, Antiques, 
Etc.) 	
a. 
b. 
c. 
d. 
e. 
f. 
g. 
h. 
i. 
j. 
k. 
l. 
m.	 	
 
 
 
a. 
b. 
c. 
d. 
e. 
f. 
g. 
h. 
i 
j. 
k. 
l. 
m.	 	
 
 
 
a. 
b. 
c. 
d. 
e. 
f. 
g. 
h. 
i. 
j. 
k. 
l. 
m.	 	
 
 
 
a. 
b. 
c. 
d. 
e. 
f. 
g. 
h. 
i. 
j. 
k. 
l. 
m.	 	
 
 
 
a. 
b. 
c. 
d. 
e. 
f. 
g. 
h. 
i. 
j. 
k. 
l. 
m.	 	
 
 
 
$ 
$ 
$ 
$ 
$ 
$ 
$ 
$ 
$ 
$ 
$ 
$ 
$ 	
 
 
 
a. 
b. 
c. 
d. 
e. 
f. 
g. 
h. 
i. 
j. 
k. 
l. 
m.	 	
 
 
 
a. 
b. 
c. 
d. 
e. 
f. 
g. 
h. 
i. 
j. 
k. 
l. 
m.	 	
 	
Any Other Assets	 	
a. 
 
 
 
 
 
 
b. 
 
 
 
 
 
 
 	
 
a. 
 
 
 
 
 
 
b. 	
 
a. 
 
 
 
 
 
 
b. 	
 
a. 
 
 
 
 
 
 
b. 	
 
a. 
 
 
 
 
 
 
b. 	
 
$ 
 
 
 
 
 
 
$ 	
 
a. 
 
 
 
 
 
 
b. 	
 
a. 
 
 
 
 
 
 
b. 	
 Attach additional sheets of paper if neede	d

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	9 of 	14 	
 	
 
 	
SCHEDULE	-C 	
 Not Applicable 	 	 	 	 	 	Debts (Incurred Individually or Jointly)	 	
Name of Creditor and 	
Account #	 	
Date Obligation 
Was Incurred	 	
Individual or Marital 	
Debt	 	
Monthly Payment	 	
 	
Due Date/ Amt.	 	
What You Received For 
Obligation or Use to	 	
Which Money was Put	 	
Current Balance of 	
Obligation	 	
Proposed Responsible 	
Party	 	
Husband/Wife	 	
1. 
 
 
Acct. #:	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
2. 
 
 
Acct.#:	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
3. 
 
 
Acct.#:	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
4. 
 
 
Acct.#:	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
5.  
 
 
Acct.#:	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
6. 
 
 
Acct.#:	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
7. 
 
 
Acct.#:	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
8. 
 
 
Acct.#	 	
 	 	/ 
/ 
/ 
/ 	
 	 	 	
 Attach additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	10 of 	14 	
 	
 
 
 	
SCHEDULE	-D 	
 Not Applicable 	 	 	 	 	 	           	   Safe Deposit Boxes	 	
1. Name and Address of 
Institution Where Located	 	
2. Box Number	 	
All Names to Whom Box is 	
Registered	 	
Identity of All Who Have Access	 	Inventory of Contents	 	Value	 	
1. 
 
 
 
 
 
2. 
 
 
 
 
 
 
3. 
 
 
 
 
 	
 	 	 	 	
 	
 Attach additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	11 of 	14 	
 	
 
 
 	
SCHEDULE	-E 	
 Not Applica	ble 	 	 	 	 	 	 	      	  Employment	 	
Employer’s Name and Address	 	Gross Monthly Wage and Payroll	 	
Deductions (Identify Type and Amount)	 	
Other Benefits and Amount Received 
(including transportation, employer 	
contributions to health care, and employer 	
contributions to	 retirement account)	 	
Outstanding Bonuses	 	
1. 	Amount	 	
2. 	Date Due	 	
 	Gross:	 	
 
Fed Tax:	 	
FICA (Social Security):	 	
Medicare:	 	
Children’s Health Ins. Premiums:	 	
 
 
Total Deductions:	 	
Net:	 	
 	
 	 	
 	Gross:	 	
 
Fed Tax:	 	
FICA (Social Security):	 	
Medicare:	 	
Children’s Health Ins. Premiums:	 	
 
 
Total Deductions:	 	
Net:	 	
 	
 	 	
 	Gross:	 	
 
Fed Tax:	 	
FICA (Social Security):	 	
Medicare:	 	
Children’s Health Ins. Premiums:	 	
 
 
Total Deductions:	 	
Net:	 	
 	
 	 	
 Attach additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	12 of 	14 	
 	
 
 
 	
SCHEDULE	-F 	
 Not Applicable 	 	 	 	 	 Other Income (Not Previously Indicated Herein)	 	
Source:	 	Amount Received	 	Date Received	 	
1. Compensation as a Contractor	 	
 
 
 	
 	 	
2. Temporary Total Disability	 	
 
 
 	
 	 	
3. Permanent Partial Disability	 	
 
 
 	
 	 	
4. Permanent Total Disability Payments	 	
 
 
 	
 	 	
5. Unempl	oyment	 	
 
 
 	
 	 	
6. Disability	 	
 
 
 	
 	 	
7. Annuity	 	
 
 
 	
 	 	
8. Retirement Benefits	 	
 
 
 	
 	 	
9. Any Other Payments Made By Any Payor	 	
 
 
 	
 	 	
 Attach additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	13 of 	14 	
 
 
 	
 Not Applicable 	 	 	 	 	 	               	SCHEDULE	-G 	
Retirement Accounts or Benefits (Annuities, Pensions, Profit Sharing, Certificate of Deposits, IRA’s, 401K’s, Retirement Plans	, etc.)	 	
Carrier or 
Administrating 	
Agency, Address and 
Description of the 
circumstances under 
which you may draw 	
on benefits	 	
ID 	
Numb	er 	
Type of 
Plan	 	
Loans Against Plan	 	Date Plan 
Acquired	 	
Expected Date 
of Retirement	 	
Value of 	
Account on Date 
of Marriage	 	
Present Value	 	Marital Asset	 	
(Y/N)**	 	
1. 
 
 
 	
 	 	 	 	 	 	 	 	
2. 
 
 
 
 	
 	 	 	 	 	 	 	 	
3. 
 
 
 
 	
 	 	 	 	 	 	 	 	
4. 
 
 
 	
 	 	 	 	 	 	 	 	
5. 
 
 
 	
 	 	 	 	 	 	 	 	
6. 
 
 
 
 	
 	 	 	 	 	 	 	 	
 Attach additional sheets of paper if needed

Initial Disclosures	 	
Revised 	October 2012	 	
Page 	14 of 	14 	
 	
 
 	
SCHEDULE	-H 	
 Not Applicable	 	 	 	 	 	                  	    Custody	 	
1. If you are seeking custody, set forth the facts supporting your claim to superior entitlement to custody:	 	
 
 
 
 
A. I 	have been the primary caretaker of the child(ren) as follows:	 	
 
 
 
 
B. I have a good quality of relationship with the child(ren) as follows:	 	
 
 
 
 
C. I have the ability to take care of the child(ren) as follows:	 	
 
 
 
 
D. I am the more fit and competent parent to	 have custody as follows:	 	
 
 
 
 
E. I am willing to support my child(ren) maintaining a relationship with both parents as follows:	 	
 
 
 
 
F. I have the physical ability to care for the child(ren) as follows:	 	
 
 
 
G. Other	 	
 
 
 	
 Attach additional s	heets of paper if needed

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	1 of 	9 	
STATE OF WYOMING	 	) 	IN THE DISTRICT COURT	 	
 	 	 	 	 	) ss	 	
COUNTY OF ________________	 	) 	_______________ JUDICIAL DISTRICT	 	
 
Plaintiff:	____________________________,	 ) 	Civil Action Case No. __________ 	 	
(Print name of person filing)	 	 	) 	
 	  	 	 	 	 	) 	
vs.	 	 	 	 	 	 	) 	CONFIDENTIAL	 	
 	 	 	 	 	 	) 	
Defendant:	__________________________	. ) 	
(Print name	 of other parent	) 	
_______________________________________________________________________________	 	
 	
CONFIDENTIAL	  	
FINANCIAL AFFIDAVIT	 	
W.S. 	§20	-2-308 	
________________________________________________	_______________________________	 	
 
 	A financial affidavit must be completed by each parent.  You must attach copies of your tax 	
returns and W	-2 forms for the most recent two  years and a copy of 	the total amount of wages  you 	
have  earned  so  far  this  year	.   	Par	ents  who  are  self	-employed  must  supply  verified  income  and 	
expense statements from their business for the two most recent years	. 	
 	THE UNDERSIGNED	,                                            	  	___	, hereby swears or affirms,	  	
 	 	 	 	 	(Print Your Name	) 	
under 	pen	alty of perjury, that the following answers are correct and complete.	 	
 
 
1. 	Your N	ame:  (First, Middle, Last) ______________	________________________________	 	
 	 	Gender:	 	 	 Male	 	 	 Female	 	 	
 
2. 	Your 	Present Address	: ____________	___________________________________________	 	
 
 	City, State, Zip Code: 	_______________________________________________________	 	
 
 	How long have you resided at this location? 	______________________________________	 	
 
 	Your Mailing Address (if different from abov	e) ___________________________________	 	
 
 	City, State, Zip Code: 	_______________________________________________________	 	
 
3. 	Your 	Home Phone Number	: (___) _____________________________________________	                                                         	                          	 	
 
 	Your 	Cell Phone Number	: (____) ______________________________________________	 	
PERSONAL INFORMATION

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	2 of 	9 	
 
 	A 	Message Phone Num	ber:	 (       	) 	 	 	 	 	 	 	 	 	
 	 	
4. 	Your Social Security Number is:  ______________________________________________ 	 	
5. 	Your Date of Bir	th is:	  	 	 	 	 	 	 	 	 	 	
6. 	Your 	Education is: ________years 	of 	high school; _________years 	of 	college;	 	
 	________ 	 years	 of trade school;	  _______ years other	 (list training) 	  	 	 	 	
7. 	List you	r degree(s) or certificate(s):	 	 	 	 	 	 	          	  	 	
8.         List all chil	d(ren) involved in 	this matter	: 	
Child’s Name	 	
 
Sex	 	Birth Date	 	Social Security No.	 	Does this child live 
with you?	 	
 	 M  	 F 	 	 	 Yes   	 No	 	
 	 M  	 F 	 	 	 Yes   	 No	 	
 	 M  	 F 	 	 	 Yes   	 No	 	
 	 M  	 F 	 	 	 Yes   	 No	 	
 	 M  	 F 	 	 	 Yes   	 No	 	
  Additional sheets of paper are attached (if needed)	 	
9. 	List 	YOUR	 minor 	children 	(not named above) 	who 	live with you	: 	
Child’s Name	 	Birth Date	 	Social Security No.	 	
 	 	 	
 	 	 	
 	 	 	
 	 	 	
 	 	 	
  Additional sheets of paper are attached (if needed)

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	3 of 	9 	
10	. 	List 	YOUR	 minor  children  (not  named  above)  who	 do	 not  live  with  you	 but  for  whom 	
YOU	 are court	-ordered to pay child support	: 	
 
Child's Name	 	Birth Date	 	Social Security No.	 	
Court 	and Date of Order	 	Support/Month	 	Arrears (Amount Past Due)	 	
Child's Name	 	Birth Date	 	Social Security No.	 	
Court and Date of Order	 	Support/Month	 	Arrears (Amount Past Due)	 	
Child's Name	 	Birth Date	 	Social Security No.	 	
Court and Date of Order	 	Support/Month	 	Arre	ars (Amount Past Due)	 	
Child's Name	 	Birth Date	 	Social Security No.	 	
Court and Date of Order	 	Support/Month	 	Arrears (Amount Past Due)	 	
  Additional sheets of paper are attached (if needed)	 	
 
11	. 	Do you owe back child support (arrears) in 	this	 case?  If so, how much?  $____________.	 	
 
12	. 	List 	any	 income	-qualified stat	e or federal benefits that your child(ren) receive (	POWER	, 	
Medicaid	, Kid Care,	 Title 	19	,  General Assistance, Food Stamps, Supplemental Security Income, 	
etc.):	 
 CHILD'S 	NAME	 	
BIRTH	 	
DATE	 	STATE	 	
TYPE OF	 	
BENEFIT	 	
 	 	 	 	
 	 	 	 	
 	 	 	 	
 	 	 	 	
 	 	 	 	
  Additional sheets of paper are attached (if needed)

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	4 of 	9 	
 
 
13.	 	Are you currently:	   	 Employed    	 Self	-Employed    	 Unem	ployed	 	
 	 	 	If you are employed, please provide the following:	 	
Job No. 1:	 	
 	Employer’s Name:	 __________________________________________________________	 	
 	Employer’s Address: 	________________________________________________________	 	
 	City, State	, Zip Code:	  _______________________________________________________	 	
 	Employer’s Phone	:  _________________________________________________________	 	
 	Your Occupation	:  __________________________________________________________	 	
 	Your Hourly Wage or Monthly Sa	lary	:  _________________________________________	 	
Job No. 2:	 	
 	Employer’s Name	:  _________________________________________________________	 	
 	Employer’s Address	:  _______________________________________________________	 	
 	City, State, Zip Code	:  ________________	_______________________________________	 	
 	Employer’s Phone	:  _________________________________________________________	 	
 	Your Occupation	:  __________________________________________________________	 	
 	Your Hourly Wage or Monthly Salary	:  ______________________	___________________	 	
Job No. 3:	 	
 	Employer’s Na	me:  _________________________________________________________	 	
 	Employer’s Address	:  _______________________________________________________	 	
 	City, State, Zip Code	:  _____________________________________________	__________	 	
 	Employer’s Phone	:  _________________________________________________________	 	
 	Your Occupation	:  __________________________________________________________	 	
 	Your Hourly Wage or Monthly Salary	:  _________________________________________	 	
INCOME & EXPENSE INFORMATION

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	5 of 	9 	
 Add additional sheets of paper if necessary to list additional jobs.	 	
 
 	How many hours do you work each week?	 	
 	
Job No. 1:	 	 	 	Job No. 2:	 	 	 	Job No. 3	 	
Regular     	 	 	 	Regular     	 	 	 	Regular      	 	 	 	
Overtime  	 	 	 	Overtime  	 	 	 	Overtime   	 	 	 	
Total	 	     	 	 	 	Total	 	     	 	 	 	Total	 	      	 	 	 	
 	
 	How often do you receive overtime compensation	?  ________________________________	 	
 	How often are you paid:	 	
Job No. 1:	 	 	 	Job No. 2:	 	 	 	Job No. 3	 	
  weekly	 	 	 	  weekly	 	 	 	  weekly	 	 	
  every two weeks	 	 	  every two weeks	 	 	  every two weeks	 	
  twice per month	 	 	  twice per month	 	 	  twice per month	 	
  monthly	 	 	 	  monthly	 	 	 	  monthly	 	
  annually	 	 	 	  annually	 	 	 	  annually	 	 	
 	
 	Date of your last salary increase or decrease	:  _____________________________________	 	
14	. 	List all income 	you have receive	d for the last 12 months:	 	
Income Source	 	Monthly Amount	 	Income Source	 	Monthly Amount	 	
Gross Wages	**	 	
 	
Job 1 	- $ __________	 	
Job 2 	- $__________	 	
Job 3 	- $__________	 	
Annuity	 	$ 	
Unemployment	 	$ 	Spousal Support	 	$ 	
Workers’ Compensation	 	A 	Contract Receipts	 	A 	
Socia	l Security Benefits	 	
(Excluding SSI)	 	
A 	Rental Income	 	A 	
Retirement	 	A 	Fringe Benefits/Bonuses	 	A 	
Interest/Dividend Income	 	A 	Profit (Loss) from Self	-	
Employment	  	
A 	
Reimbursements	 	A 	Other   	  	 	A 	
Veterans’ Disability	 	A 	Other   	  	 	A 	
**Gross 	Wage	 - Monthly amou	nts are calculated by multiplying weekly amount by 52 and dividing by 12; multiplying 	
bi-weekly 	(every two weeks) 	amounts by 26 and dividing by 12; and multiplying semi	-monthly	 (i.e., paid on the 1	st and 	
15th)  amounts by 24 and dividing by 12.	 	
  Additional sheets of paper are attached (if needed)

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	6 of 	9 	
15. 	IF YOU ARE EMPLOYED	:  Please complete	 list and calculate the following:	 	
 	
A. Gross income	: 	 	 	 	 	$ 	 	   per month	 	
(Amount of income from all sources before deductions	) 	
B. Federal Income Tax:	  	 	 	 	$____	________	  per month	 	
C. State Income Tax:	 	 	 	 	 	$ 	 	  per month	 	
D. Social Security Tax:	  	 	 	 	$ 	 	  per month	 	
E. Medicare Tax:	 	 	 	 	 	$ 	 	  per month	 	
F. 	Mandatory Retirement/Pension:	 	 	 	$ 	 	  per month	 	
G. Premium Paid for Child(ren)’s Health Insurance:	 	$ 	 	  per month	 	
H. Current Child Su	pport Paid for Other Children:	 	$ 	 	  per month	 	
I. 	  	 	 	Total Mandatory Deductions	: $ 	 	  per month	 	
 	
J. 	Net Income	 (line A minus line I):	 	 	 	$ 	 	  per month	 	
 
K. Income Tax 	Filing Status:	 	 	 	 	 	 	 	 	 	 	
 
L. 	Number of Dependents Claimed	 for Tax Purposes	: 	 	 	 	 	 	 	
 
 	 	Please provide copies of pay	-stubs for all payroll deductions	. 	
 
 	  	Attach copies of your tax returns and W	-2 forms for the most recent two years and a 	
copy of a cumulative earning statement(s) for the current year	 	
 
16. 	IF YOU ARE 	SELF	-EMPLO	YED	:  Please list the following:	 	
A. Gross income	 : 	 	 	 	 	$ 	 	   per month	 	
*amount of income from all sources before deductions	 	
B. Federal Income Tax:	  	 	 	 	$ 	 	  per month	 	
C. State Income Tax:	 	 	 	 	 	$ 	 	  per month	 	
D. Social Security Tax:	  	 	 	 	$ 	 	  per month	 	
E. Medicare Tax:	 	 	 	 	 	$ 	 	  per month	 	
F. 	Unreimbursed Business Expenses	: 	 	 	$ 	 	  per month	 	
G. Premium Paid for Child(ren)’s Health Insurance:	 	$ 	 	  per month	 	
H. Current Child Support Paid for Other Children:	 	$ 	 	  per month	 	
I. 	  	 	 	Total Mandatory Deductions	: $ 	 	  per month	 	
 	
J. 	Net Income	 (line A m	inus line I):	 	 	 	$ 	 	  per month	 	
 
K. Income Tax 	Filing Status:	 	 	 	 	 	 	 	 	 	 	
 
L. 	Number of Dependents Claimed	 for Tax Purposes	: 	 	 	 	 	 	 	
 
 	  	Attach 	verified income and expense statements from your business	, copies of 	
your 	personal and business t	ax returns	, and 	1099 	forms for the most recent 	two 	years	.

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	7 of 	9 	
17	. 	List your work experience for the last three years:	 	
  COMPANY AND	 	
LOCATION	 	
DATES	 	
FROM 	-  TO	 	
JOB	 	
DESCRIPTION/	
TITLE	 	
SALARY	 	
OR WAGE	 	
REASON  YOU 	
LEFT	 	
 	
 	 	 	 	 	
 	 	 	 	 	
 	 	 	 	 	
 	 	 	 	 	
  Additional sheets of paper are attached (if needed)	 	
18. 	Has anyone been ordered to provide health insurance	 for the child(ren) involved in this case	, 	
or is there any other medical provision in an existing court order?	  	 YES	 	 NO	 	
 
 	If yes, please list who is ordered to provide insurance: 	 	 	 	 	 	
 	 	
 	Are the children 	currently 	covered by insurance?  	 YES	 	 NO	 	
 	 	
 	If yes, please list who is providing the insurance:	 	 	 	 	 	 	
 	
 	 	If you are 	currently providing insurance for your children, y	ou must provide 	
current written proof from your insurance carrier verifying the names of the actual person(s) 
covered under your policy.	 	
 
 	Is health insurance available for the minor child(ren) through your	 employment?  	 	
 	 YES	 	 NO	 	
 
 	If yes, how much is the monthly premium to cover 	ONLY	 the	 minor child(ren) on the 	
policy?	 	
 	$________________	 	
 	
19	. 	Attach	 the following to this 	Confidential 	Financial 	Affidavit	:  	
 
If Employed:	 	
 	
  Copies of my las	t two years income tax returns;	 	 	
  Copies of my W	-2 Forms for the last two years; 	and	 	
  Copies of statements of earnings from each of my employers showing cumulative 	
pay for this year.

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	8 of 	9 	
If Self	-Employed:	 	
 	
  Verified income and expense statements 	for the 	busines	s for the two most recent 	
years;	 and	 	
  Copies of my last two years 	personal 	income tax returns.	 	
  Copies of my last two years b	usiness income tax returns.	 	
 	
PERJURY STATUTE	 	
 
20. 	Wyoming Statute § 6	-5-301 (	Perjury	) provides:	 	
 
 	(a)	 	A  person  commits  perjury  if,  while  under  a  lawfully  administered  oath  or 	
affirmation,  he  knowingly  testifies  falsely  or  makes  a  false  affidavit,  certifica	te, 	
declaration,  deposition  or  statement,  in  a  judicial,  legislative  or  administrative 
proceeding  in  which  an  oath  or  affirmation  may  be  required  by  law,  touching  a  matter 
material to a point in question.	 	
 
 	(b)	 	Perjury is a felony punishable by imprisonmen	t for not more than five (5) years, 	
a fine of not more than five thousand dollars ($5,000.00), or both.	 	
 	
OATH	 	
 
 	I have read and understand the provisions of the above perjury statute.  	I affirm that 	
this  Confidential  Financial  Affidavit  (including  attachme	nts)  contains  a  complete  disclosure  of 	
my income from all sources and that the representations made herein  concerning my income are 
accurate  to  the  best  of  my  knowledge.  I  am  aware  that  the  court  may  punish  as  perjury  any 
materially false statements knowin	gly made with intent to defraud or mislead.	 	
 
 	DATED	 this _____ day of ________________, 20_	___.	 	
 
 	 	 	 	 	 	      	______________________________	________	 	
 	 	 	 	 	 	      	Your Signature	 	
 	 	 	 	 	 	       	(Sign only in front of Notarial Officer or	 Court 	Cle	rk)	 	
 	
JURAT	 	
STATE	 OF _____________   	 ) 	
                    	 	 	 	) ss.	 	
COUNTY OF ___________	 ) 	
 
 	Subscribed and sworn to before me on	 this _____ day of ________________20____, by 	
________________________________.	 	
 	WITNESS my hand and official seal.	 	
 	 	 	 	 	 	 	___________________	___________	 	
 	 	 	 	 	 	 	Notarial Officer 	 	
 
My Commissions Expires: ___________________

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	9 of 	9 	
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 	Confidential 	
Financial Affidavit	 was filed with the 	Clerk of District 	Court; and, a true and accura	te 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:	 	
 
(P	rint Plaintiff/Plaintiff’s	 Attorney’s Name and Address)	 	
 
TO:  ______________________________________	 	
 
        	______________________________________	 	
 
        	______________________________________	 	
 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	Your signature	 	
 	
 	 	 	 	 	 	 	 	 	 	 	 	
  	 	 	 	 	 	 	Print name

Request for Setting	 	
Revised 	October 2012	 	
Page 	1 of 	2 	
STATE OF WYOMING	 	) 	IN THE DISTRICT COURT	 	
 	 	 	 	 	) ss	 	
COUNTY OF ________________	 	) 	_______________ JUDICIAL DISTRICT	 	
 
Plaintiff:	____________________________,	 ) 	Civil Action Case No. __________ 	 	
(Print name of person filing)	 	 	) 	
 	  	 	 	 	 	) 	
vs.	 	 	 	 	 	 	) 	
 	 	 	 	 	 	) 	
Defe	ndant:	__________________________	. ) 	
(Spouse)	 (Print name)	 	
 
 	 	 	 	 	 	 	 	 	 	 	 	 	
REQUEST FOR SETTING	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	
 
 
 	The  Defendant	,  ____________________  (name)  requests  a 	time  and  date  for  a 	
hearing	/trial	 in the District Court. The hearing	/trial	 wi	ll take approxima	tely ________ 	 	
hours/ 	_______ 	 minutes and will address the following issues:	 	
 	
1) 	  	The  parties  have  reached  an  agreement  (both  parties  have  signed  the 	
Decree  of  Divorce 	and  this  Court  requires  a  hearing  b	efore  it  will  enter  a 	Decree  of 	
Divorce	). (NOTE:  submit the 	Order Setting Hearing	 if this option is selected); 	OR	 	
2) 	  Default  was  entered  against 	 Plaintiff 	OR 	 Defendant	 and  this 	Court 	
requires  a  hearin	g  before  it  will  enter  a 	Decree  of  Divorce	.  (NOTE:  submit  the 	Order 	
Setting Hearing	 if this option is selected); 	OR	   	
 	3) 	  The  parties  are  not  able  to  agree  on  all  of  the  terms  of  the  divorce  and  a 	
hearing is needed on the following issu	es:	 	
 	Allocation of 	parental 	responsibilities	 	
 	Child 	support	 	
 	Property distribution 	 	
 	Motion for _______________________________	 	
 	Other: __________________________________	 	
(NOTE:  submit the 	Order Setting Hearing	 if this option is selected)	; OR	 	
 	
4) 	 The  parties  are  not  able  to  agree  on  any  issues  and  a  trial  is  needed  for  a 	
Divorce  (With  Minor  Children)	. (NOTE:  submit  the 	Order  Setting  Divorce  Trial  and 	
Requ	iring Pretrial Statements	). 	
 
     	 	5)   Any party  requesting the  reporting of  a particular matter by the official court 	
reporter  shall	 make  a  request  by  phone  to  the  appropriate  official  court  reporter 	at  least 	
three  (3)	 working  days	 before  the  matt	er  is  s	et  for  hearing.   	The  clerk  will  be  able  to 	
inform you which court reporter to contact.  	The three	-day notice requirement will not be

Request for Setting	 	
Revised 	October 2012	 	
Page 	2 of 	2 	
waived  by  the  Court.    The  notice  is  required  for  all  civil  matters  including  jury  trials. 
Payment of the statutory reportin	g fee of 	$45.00	 per day shall be paid to the official court 	
reporter  prior  to  the  commencement  of  the  hearing/trial.    Checks  for  the  statutory 
reporting  fee  shall  be  made  payable  t	o  the  Wyoming  State  Treasurer. 	If  a	 hearing  is  not 	
record	ed by a	n official	 court reporter, a transcript of the hearing will not be available.	   It 	
is  very  difficult  to  appeal  the  Judge’s  decision  if  you  do  not  have  a  transcript  of 
everyt	hing that is said at the trial.	 Rule 904 and 905 of the Uniform Rules of the District 	
Courts of	 the State of Wyoming.	  	
   
 	 	 	 	 	 	 	 	 	 	 	 	
 	DATED	 this ______ day of _____________________, 20____.	 	
 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
Signature	 	
Printed Name: 	 	 	 	 	 	 	
Address: 	 	 	 	 	 	 	 	
Phone Number:	 	 	 	 	 	 	
 	
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  doc	ument 	
was filed with the 	Clerk of District 	Court; and, a true and accurate copy of th	is document 	
was served on the other party by 	 Hand Delivery  OR 	 Faxed to this number 	  	
 	 	   OR 	 by  placing  it  in  the  Un	ited  States  mail,  postage  pre	-paid,  and 	
addressed to the following:	 	
 	
(Insert Plaintiff/Plaintiff’s 	Attorney’s Name and Address)	 	
 
TO:  ______________________________________	 	
 
        	______________________________________	 	
 
        	__________________________	____________	 	
 
 
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	Your signature	 	
 	
 	 	 	 	 	 	 	 	 	 	 	 	
  	 	 	 	 	 	 	Print name

Order Setting Divorce Trial and Requiring Pretrial 	Statements	 	
Revised 	October 2012	 	
Page 	1 of 	3 	
STATE OF WYOMING	 	) 	IN THE DISTRICT COURT	 	
 	 	 	 	 	) ss	 	
COUNTY OF ________________	 	) 	_______________ JUDICIAL DISTRICT	 	
 
Plaintiff:____________________________,	 ) 	Civil Action Case No. __________ 	 	
(Print name of person filing)	 	 	) 	
 	  	 	 	 	 	) 	
vs.	 	 	 	 	 	 	) 	
 	 	 	 	 	 	) 	
Defe	ndant:__________________________.	 ) 	
(Spouse)	 (Print name)	 	
 
 	 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	
ORDER SETTING DIVORCE TRIAL	 	
 	AND REQUIRING PRETRIAL STATEMENTS	 	
 	 	 	 	 	 	 	 	 	
 	
THIS MATTER	 having come before the Court upon 	a Request for Setting	, and the Court 	
being generally advised i	n the premises; 	 	
IT  IS  HEREBY  ORDERED	 that  a  trial  of  the  above  matter  is  hereby  scheduled  for 	
Courtroom No. 	____	 of 	the 	______________	 County Courthouse, 	______________	, Wyoming on 	
the 	_____	 day of 	________	, 20___	 commencing at 	__	:____	 o’clock 	__	.m	.   	
(__	__) minutes/hour(s)/	day	(s)	 has been set aside for the trial of this matter. 	 	
             	IT IS FURTHER ORDERED	 that each party shall file and serve on 	the 	opposing 	party or 	
their attorney, if represented	, no later than five 	(5) 	days prior to the trial	, th	e party’s sworn statement 	
setting forth the facts, to the best of the party’s knowledge and belief, called for by Section “A” of 
the attached list of information, and a statement by counsel	 (attorney)	, if any,	 of the client’s position 	
and proof as called f	or by Section “B.”  These filings are required to narrow and simplify the issues, 	
prevent  surprise and to eliminate unnecessary proof.  The material may be presented in narrative 
form but must be complete for purposes called for by this order.  To avoid du	plication, 	the parties or 	
their attorneys, if any,	 may submit a joint statement of those items not in dispute.	 	
 	Any party requesting the reporting of a particular matter by the offic	ial court reporter 	
shall  make  a  request  by  phone  to  the  appropriate  offici	al  court  reporter	 at  least  three  (3)	 	
working days	 before the matter is set for hearing.	  The clerk will be able to inform you which 	
court reporter to contact.  The three	-day notice requirement will not be waived by the Court.  	
The  notice  is  required  for  al	l  civil  matters  including  jury  trials.    Payment  of  the  statutory

Order Setting Divorce Trial and Requiring Pretrial 	Statements	 	
Revised 	October 2012	 	
Page 	2 of 	3 	
reporting  fee  of  $45.00  per  day  shall  be  paid  to  the  official  court  reporter  prior  to  the 
commencement  of  the  hearing/trial.    Checks  for  the  statutory  reporting  fee  shall  be  made 
payable to t	he Wyoming State Treasurer.  	 If a hearing is not recorded by an official court 	
reporter,  a  transcript  of  the  hearing  will  not  be  available.      It  is  very  difficult  to  appeal  a 
decision if you do not have a transcript of everything that is said at the trial	.  Rule 904	 and 905 	
of the	 Uniform Rules of the District Courts of the State of Wyoming	. 	
 	In the event that this case settles, the parties are informed that there will be no change in the 	
scheduling of this matter by the Court until such time as the settle	ment is reduced to writing and a	 	
written agreement is presented to the court.	  There will be no continuances or canceling of the trial 	
date based on telephone calls.	 	
DATED	 this ______ day of ___	 	 	 	, 20____	. 	
 
 	
_________________________________________	 	
DISTR	ICT 	COURT 	JUDGE	 	
 
Copies sent to:	 	
 
Plaintiff/Plaintiff’s Attorney’s Name and Address	 	
 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
 
Defendant/Defendant’s Attorney’s Name and Address

Order Setting Divorce Trial and Requiring Pretrial 	Statements	 	
Revised 	October 2012	 	
Page 	3 of 	3 	
 
 	SECTION “A”	 	
 	SWORN STATEMENT OF PARTY	 	
 
Items to be included:	 	
1. 	Personal data and his	tory	 relevant to the issues, including name, age, prior marriages, if any, 	
children	 (use children’s initials only	), present living situation of the parties and their immediate 	
family.  	For instance, where each	 party and the children are residing, with whom	 the children 	
are residing, and how the children are being cared for during the day.  	  This item calls for a 	
brief  but  comprehensive  statement  of  the  party's  personal  history  as  it  may  relate  to  the  divorce 
litigation.	 	
2. 	Present employment	, including ide	ntity and location of employer, nature of the job, length of 	
employment, gross and net income and benefits, including health and accident coverage, if any, its 
convertibility to non	-group plan in event of loss of employment, terms of retirement program, al	l 	
deductions from salary or wages, and prospects for the continuation of the employment.	 	
3. 	Employment  history  and  employability	,  including  previous  employment  and  incomes, 	
education,  training  and  work  experience  affecting  employability.    Include  any  other	 factors 	
substantially affecting employability.	 	
4. 	Other income	, whatever the source.	 	
5. 	All assets	 showing source of the asset (i.e., jointly purchased, gift prior to marriage), present 	
value, basis of statement of value and statement of present salabilit	y.  (Use the last 4 digits of any 	
financial account numbers only	.) 	
6. 	Liabilities	, including amount, source, terms of the indebtedness.	 	
7. 	Any other information	 which counsel, or the party, believe to be material to the determination 	
of the issues.	 	
 
 
 	SECT	ION “B”	 	
 	STATEMENT OF COUNSEL	 	
 
Statement of the case	 by counsel of the client's position with respect to:	 	
1. 	Division of assets and allocation of liabilities.	 	
2. 	Amount of child support:  	 	
 	a. 	Amount called for by the child support guidelines;	 	
 	b. 	Why,  if 	it  is  urged,  there  should  be  departure  from  the 	
guidelines.	 	
3. 	If alimony is claimed, the basis of the claim and the amount and duration proposed by the 	
party.	 	
4. 	If  client  claims  exclusive  or  superior  entitlement  to  "the  divorce,"  the  reasons  for  that 	
pos	ition.	 	
5. 	If superior suitability for primary custody of children is claimed and disputed, reasons for the 	
claim.	 	
6. 	Reasons, if any, for departure from "standard rules for custody and visitation."	 	
7. 	List of witnesses and specific summary of expected test	imony.	 	
8. 	Exhibits.

Pretrial	 Disclosures	 	
Revised 	October 2012	 	
Page 	1 of 	4 	
 
STATE OF WYOMING	 	) 	IN THE DISTRICT COURT	 	
 	 	 	 	 	) ss	 	
COUNTY OF ________________	 	) 	_______________ JUDICIAL DISTRICT	 	
 
Plaintiff:____________________________,	 ) 	Civil Action Case No. __________	 	  	
(Print name of person filing)	 	) 	
 	  	 	 	 	 	) 	
vs.	 	 	 	 	 	 	) 	
 	 	 	 	 	 	) 	
Defe	ndant:__________________________.	 ) 	
(Spouse)	  (Print name)	 	
 
 	
PRETRIAL 	DISCLOSURES 	 	
 	
 
 	 
 
 
 
 
 
Defendant	 submits  the  following  initial  disclosures,  pursuant  to  Wyoming  Rule  of  Civil 	
Procedure 26(a)(3), required in pretrial proceedings. This information must 	be made available to 	
the opposing party or the opposing party’s  counsel  and the Court at  least  thirty (30) days before 
the trial.	 	
 	A.	 	The  name  and,  if  not  previously  provided,  the  address  and  telephone  number  of 	
each witness, separately identifying those w	hom the party expects to present and those whom the 	
party may call if the need arises.	 	
NOTE	: Unless otherwise directed by the court, these disclosures must be made 	
at least 30 days before trial	. Within 14 days thereafter, unless a different tim	e 	
is specified by the court, a party may serve 	and promptly file	 with the Clerk 	
of District Court	 a list disclosing (i) any objections to the use under Rule 32 	
(a) of a deposition designated by another party under Rule 26(a)(3)(B), and (ii) 
any objection, 	together with the grounds therefor	e, that may be made to the 	
admissibility of materials identified under Rule 26(a)(3)(C). Objections not so 
disclosed, other than objections under Rules 402 and 403 of the Wyoming 
Rules of Evidence, are waived unless excuse	d by the court for good cause.

Pretrial	 Disclosures	 	
Revised 	October 2012	 	
Page 	2 of 	4 	
 
 	B.	 	The  designation  of  those  witnesses  whose  testimony  is  expected  to  be  presented 	
by means of a deposition and, if not taken stenographically (i.e. by a court reporter)	, a transcript 	
of the pertinent portions of the deposition testimony.	 	
 	C.	 	An  appropriate  identification  of  each  document  or  other  exhibit,  including 	
summaries  of  other  evidence,  separately  identifying  those  which  the  party  expects  to  offer  and 
those which 	the party may offer if the need arises. 	 	
NOTE: 	Supplementation  of  disclosures  and  responses. 	Wyoming  Rules  of  Civil  Procedure 	
26(e)(1) states that:   	A party  who has made  a disclosure or  responded to  a request  for discovery 	
with a disclosure or response is 	under a duty to supplement or correct the disclosure or response 	
to  include  information  thereafter  acquired,  if  ordered  by  the  court  or  in  the  following 
circumstances: 	 	
 	A party is  under a duty to supplement at  appropr	iate intervals,  its disclosures 	if the	 party 	
learns  that  in  some  material  respect  the  information  disclosed  is  incomplete  or  incorrect  and  if 
the additional or corrective information has not otherwise been made known to the other parties 
during the discovery process or in writing. 	     	
  	
DAT	ED this _____ day of _____________, 20___.	 	
Signature	 	 	 	 	 	 	
 	Printed name: 	  	 	 	 	 	
 	Address: 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	
 	Phone Number:

Pretrial	 Disclosures	 	
Revised 	October 2012	 	
Page 	3 of 	4 	
 	
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 th	is 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 Plaintiff/Plaintiff’s Attorney’s Name and Address)	 	
 
TO:  ______________________________________	 	
 
        	______________________________________	 	
 
        	______________________________________	 	
 
 
 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	Your signature	 	
 	
 	 	 	 	 	 	 	 	 	 	 	 	
  	 	 	 	 	 	 	Print name

Pretrial	 Disclosures	 	
Revised 	October 2012	 	
Page 	4 of 	4 	
 
 
 	   	 	 	 	 	 	 	                 	(check one)	 	
Name of Witness	 	Address and Telephone 
Number	 	
Expect to call 
witness to 
testify	 	
May	 call 	
witness to 
testify if the 
need arises	 	
 
 	
 	 	 	
 
 	
 	 	 	
 
 	
 	 	 	
 
 	
 	 	 	
 Additi	onal sheets 	of paper are attached if needed	  	 	 	        	 	 	 	 	
           	(check one)	 	
Document or Exhibit	 	Summary of Evidence	 	Expect to 
offer	 	
May	 offer 	
if the need 
arises	 	
 
 	
 	 	 	
 
 	
 	 	 	
 
 	
 	 	 	
 
 	
 	 	 	
 Additional sheets of paper are attached if n	eeded
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