Wyoming Divorce Package For Petitioner With Children Form

01 Jul, 2017 Divorce, Legal Forms, wyoming 0

This package of forms is provided by the Wyoming Courts to Petitioners of divorce cases. In divorce cases, the term “Petitioner” is used to refer to the spouse who filed for the divorce. Use of this package is limited to Petitioners of divorce cases involving minor children.Download

Extracted Text for Proper Search

Divorce (with Children )
Revised October 2012
Packet 1

Divorce
(With Minor Children )

Forms and Procedures

For Wyoming

PLAINTIFF

201 2

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 1
PLAINTIFF DIVORCE WITH MINOR CHILDREN

1. List of Forms
2. Overview – Divorce with Children
3. Family Law Information and Instructions
4. Checklist
5. Civil Cover Sheet
6. Vital Statistics Form
7. Complaint for Divorce (with Chil dren)
8. Summons
9. Confidential Statement of Parties for Child Support Order
10 . Acknowledgement and Acceptance of Service
11. Initial Disclosures
12. Confidential Financial Affidavit
13. Affidavit of Imputed Income
14. Child Support Computation Form & N et Income Calculation
15. Reply to Counterclaim
16. Application for Entry of Default
17. Affidavit in Support of Default
18. Entry of Default
19. Affidavit for Divorce Without Appearance of Parties
20 . Request for Setting
21. Order Setting Hearing
22. Orde r Setting Divorce Trial and Requiring Pretrial Statements
23. Pretrial Disclosures
24. Decree of Divorce (with Children )
25. Order for Income Withholding
26. Income Withholding for Support (or, you can open up a case with your local child
support enforcem ent agency)
27. Certificate of Mailing Decree of Divorce
28. Supplemental Order (Use in Laramie County, Wyoming Only)
29. List of Addresses for the Clerk of District Court offices

*All underlined forms are required in a divorce with children action where the parties
agree.
**Other forms may be required by your Court.

Overview: D ivorce (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. Ma ny 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 inten ded 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 form s, as some forms may not apply .
Fill out the necessary forms completely and correctly.

Pr int or type all of the documents. DO NOT SIGN YOUR NAME WHERE
THE JUDGE OR CLERK SHOULD SIGN.

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 will not
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 as sistance 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 yo u 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 cha rge 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
protection o rder involving your spouse, you should include this information in the Complaint for Divorce
or Counterclaim under the “Other Proceedings” section.

Overview: D ivorce (with Children)
Revised October 2012
Page 2 of 3
sign orders that are incorr ect or incomplete, nor will the Judge give you l egal 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. Mo st 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.st ate.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 you r county has a court
facilitator, employees in the Clerk of District Court’s office and in the Judge’s office
cannot help you or give you legal advice.

The Judge Cannot Talk to You, Answer Your Questions or Assist You. Ex
parte communication is communic ation 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 h onored 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 o f 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 or
a “qualified medical child support order .”

In add ition to the above situations, you should consult an attorney if:
You are a vict im 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 becau se 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 completing all forms. There are penalties for attempting to mislead the Court.
You should read Wyoming Rules of Civil Procedure, Rule 11 (representations to the
court) and Wyoming Statute § 6 -5-301 (perjury).

Overview: D ivorce (with Children)
Revised October 2012
Page 3 of 3
Unauthorized Practice of Law Notice. The purpose of th is 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 punishment 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 greater 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 2 012
Page 1 of 14

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 cal l 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 information should be
indicated in the Complaint for Divorce or the Counterclaim . A Domestic Violence Protection
Order generally will be in 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 instruction s befo re completing the forms to
make sure you qualify to file a divorce in Wyoming. To file a complaint you must live in
Wyoming for at least sixty (60) days immediately before you file.

Step 1. Getting Started . The following forms are required in all unconte sted
divorce cases. It is recommended that you complete all of these forms before you file the
Complaint for Divorce so that they will be ready to be filed at the appropriate time:

1. Civil Cover Sheet
2. Vital Statistics form
3. Complaint for Divorce (with Child ren)
4. Summons
5. Acknowledgement and Acceptance of Service
6. Confidential Statement of the Parties for Child Support Order
7. Confidential Financial Affidavit
8. Affidavit for Divorce Without Appearance of Parties
9. Decree of Divorce (with Children)
10. Order for Income Wi thholding
11. Income Withholding for Support (or, you can open a case with your local child
support enforcement agency)

*If you are getting divorced in Laramie County, a Supplemental Order is also required.
**Other forms may be required depending on the Cour t and on your situation. If additional
forms are needed, they will be discussed below where applicable.

Family Law Information and Instructions
Revised October 2 012
Page 2 of 14

Step 2. File your divorce case . A divorce case begins with the filing of a
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
Plaintiff throughout the case.

Where to file. You will file your case in the District Court in the county where either you
or you r spouse resides. The Complaint for Divorce is given to the Clerk of the District Court ,
whose office is usually located in the county courthouse or a branch of the county courthouse. A
list of the Clerk s of District Court for each Judicial Distr ict is in cluded in the packet. A filing fee
is required. Ask the Clerk what the amount of the filing fee is and what forms of payment are
accepted.

Other forms to file with the Complaint .

A. When you file the Complaint for Divorce , you will also need to file the Civil
Cover Sheet . Follow the instructions that accompany this form.

B. You will also need to file the Vital Statistics form . Fill out all portions of this
form EXCEPT the “Decree” section, which will be completed by the Clerk when your divorce is
final.

C. You will also need to fill out and file a Confidential Statement of the Parties for
Child Support Order . This form provides the Court with personal information (such as social
security numbers and birth dates) of the parties involved in your case as required by statute, but
permits the information to be located in a confidential file so that the general public does not
have access to the information .

D. You will also need to have the Clerk sign (a/k/a “issue”) the Summons .

How many copies . Take t he original and two (2) copies of each document to the Clerk’s
office. The Clerk will give copies of each document back to you after stamping them with the
date they were filed. This is called a “ file stamp .” You should keep one copy of each document
for your records. The other set of documents will need to be served upon the Defendant.

Notarizing Signatures . You will need to sign the Complaint for Divorce and have it notarized.
Notarial Officers may administer the oath and witness your signature, or in many cases, Clerks of Court
will be willin g 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.

Case Number : When you start a lawsuit by filing the paperwork with the Clerk of the Di strict 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, the Defendant, the District Court the case is filed in and the case number.

Family Law Information and Instructions
Revised October 2 012
Page 3 of 14

Step 3. Serve the Defendant . Once the Complaint for Divorce and Confidential
Statement of the Parties for Child Support Order have been filed, a file -sta mped copy of each
must be formally given to (a/k/a served on) the Defendant. The person being served with the
documents 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 the
Complaint for Divorce , Confidential Statement of the Parties for Child Support Order and
Summons on the Defendant by a Sheriff is required unless the Defendant completes an
Acknowledgment and Acceptance of Service form. Formal service is required for the Complaint
for Divorce and Confidential Statement of the Parties for Child Support Order so the Court has
proof that the other party actually received the papers. Other forms of service exist, but these are
the easiest m ethods that meet the formal service requirement for a Complaint for Divorce. If you
cannot serve the Defendant by either of these methods, ask the Clerk for additional forms for
alternative methods of service.

You MUST give the Defendant official notice that you have filed for divorce within 90
days from the date you filed the Complaint for Divorce and Confidential Statement of the Parties
for Child Support Order . This is done by serving a file -stamped copy of the Summons , the
Complaint for Divorce , and t he Confidential Statement of the Parties for Child Support Order
upon the Defendant or by having the Defendant sign a n Acknowledgment and Acceptance of
Service form statin g that copies of those documents were received. If you do not serve the
Defendant wi thin 90 days, your case can be dismissed by the Court .

A. How to Serve the Defendant. Choose ONLY ONE of the following options to
serve the Defendant:

Option 1 – Service by Sheriff

Summons . It is recommended to have a Sheriff in the county where the Defendant can
be found serve him or her with the papers. There will be a separate service fee (usually fifty
($50.00) dollars in Wyoming). You can contact the Sheriff’s department in the county where
the Defendant lives to determine the fee charged by the Sheriff. This is also true if your spouse
Summary of Step 2 : To start your divorce case, you will need to file the following documents with the Clerk of
the D istrict Court ’s office located in the county court house in the county where e ither you or your spouse resides :
A. Civil Cover Sheet
a. Follow the instructions that accompany this form for help completing it correctly;
B. Vital Statistics Form
a. Fill out all portions, EXCEPT the “Decree ” section, which will be completed by the Clerk
when your divorce is final ;
C. Complaint for Divorce (with Children) ;
D. Confidential Statement of the Parties for Child Support Order; and
E. Summons ;
F. Pay the filing fee ;
G. Take the original and two (2) copies of each document to the Clerk ’s office.
a. Th e Clerk will give both copies back to you after file -stamping them .
b. You should keep one copy for your records.
c. The other set of documents will need to be served upon the Defendant (Step 3).

Family Law Information and Instructions
Revised October 2 012
Page 4 of 14

is going to be served out of state. You will need to provide the Sheriff in the county where your
spouse resides with a file -stamped copy of the Summons , Complaint for Divorce , and
Confidential Statement of the Parties for Child Support Order to be served on the Defendant.

Proof of Service. The Sheriff’s office will complete the last page of the Summons called
the “ Return ” (or they may have their own form – an “Affidavit of Service ”) and will usually file
the original with the Clerk ’s office and send you a copy. If you receive what looks like the
original “ Return ” or “ Affidavit of Service ” from the Sheriff, call the Clerk ’s office to ensure the
original has been filed. If it has not, then file the original wi th the Clerk ’s office and keep a copy
for yourself. This is the proof that the Defendant was given proper notice.

Note : Once the Defendant has been served, you MUST file the original Summons and
the Return (or Affidavit of Service ) with the Clerk’s offi ce so that the Judge knows that
proper service was made.
OR :

Option 2 – Acknowledgement and Acceptance of Service . If the Defendant agrees, he or she
may sign a form stating that a file -stamped copy of the Summons , Complaint for Divorce , and
Confidential Statement of the Parties for Child Support Order were received. If the Defendant
agrees, you will need to fill out an Acknowledgement and Acceptance of Service form. The
Defendant must sign this docum ent in front of a notarial officer.

Proof of Servi ce. Once the Acknowledgement and Acceptance of Service form is signed,
the original and two (2) copies of the signed form must go to the Clerk’s office for filing. You
should keep one copy for your records and provide the other copy to the Defendant.

No te: You must file the signed Acknowledgment and Acceptance of Service AND the
Summons with the Clerk’s office so that the Judge knows that proper service on the
Defendant was made.

Summary of Step 3 : You MUST give the Defendant official noti ce that you have filed for divorce within 90 days
from the date you filed the Complaint for Divorce . Choose one of the following methods:
Option 1 – Service by Sheriff
A. Provide a file -stamped copy of the Summons, Complaint for Divorce, and Confidential Sta tement of the
Parties for Child Support Order to the Sheriff where the Defendant lives;
B. Pay the service fee ; and
C. Once the Defendant is served, be sure the original Summons and the original Return or Affidavit of Service
are filed with the Clerk’s office; OR
Option 2 – Acknowledgement and Acceptance of Service
A. Provide a file -stamped copy of the Summons, Complaint for Divorce, and Confidential Statement of the
Parties for Child Support Order to the Defendant;
B. Have the Defendant sign the Acknowledgment and Acc eptance of Service form in front of a notarial
officer;
C. File the original Acknowledgment and Acceptance of Service form with the Clerk’s office; and
D. File the original Summons with the Clerk’s office

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Revised October 2 012
Page 5 of 14

Step 4. Wait for the Defendant’s time to Answer to expire . Once
the Defendant is served, he or she has 20 days (if served in the State of Wyoming ) or 30 days (if
served out -of-state) to file an Answer to the Complaint for Divorce . You must wait for the
appropriate time period to expire before you can proceed wi th the divorce case. You must wait
the 20 days (or 30 days if se rved out -of-state) even if the Defendant tells you that he or she is not
going to file an Answer .

Computation of Time Limits . - In computing most time limits, unless otherwise
stated, the d ay the document is served shall not be included. The last day of the time
period is included, unless it lands on a Saturday, a Sunday, or a legal holiday, or, if
the Court is closed , then the time limit will be on the very next day that the
Court house is o pen. If you have questions about time limits you should seek the
advice of an attorney.

While waiting, move on to Step 5 . You can also use this time to continue to work on
the other required forms to be sure they are filled out completely and correctly .

Step 5. Initial Disclosures . The law requires certain information be made
available no longer than thirty (30) days after the Defendant is served . The required information
includes , among other things, a schedule of what you and your spouse ow n and your debts. It
also includes information about what each of you want for a custody and visitation plan for
children and why such an arrangement is in the best interests of the child(ren). Both parties are
required to provide this information in ord er to fully disclose all assets and debts of the parties.
EXCEPTON : If you and the Defendant agre e on all issues in your divorce, you and the
Defendant are aware of all of your assets and debts, and you both are signing the Decree of
Divorce , then you d o NOT need to complete the Initial Disclosures and you can move on to
Step 6 .

A. WHEN TO SERVE : Initial D isclosures must be sent to the Defendant (or
his/her attorney) WITHIN 30 DAYS AFTER THE DEFENDANT IS SERVED. Be sure
to keep a copy of this document for your records.

B. DO NOT FILE THE INITIAL DISCLOSURES WITH THE COURT . This
form is only given to the Defendant (or his/her attorney ).

Summary of Step 4: You MUST wait for the Defendant’s t ime to file an Answer to expire before you can
proceed with your divorce case. In the meantime:
A. Mark on the calendar when the Defendant’s time to Answer expires;
B. Move on to Step 5 while waiting; and
C. Use this time to ensure the required forms are filled ou t completely and correctly.

Family Law Information and Instructions
Revised October 2 012
Page 6 of 14

************************************************************************

Step 6. Once the time for the Defendant to file an Answer has expired and , if
applicable, you sent your Initial Disclosures to the Defendant, then several options exist
to move your case forward to get a Decree of Divorce . Pick the option that best describes
your situation:

Option A . If the Defendant filed an Answer or Answer and Counterclaim and
you both agree on all of the issues of your divorce, follow O ption A below.

Option B . If the Defendant did not file an Answer or Answer and
Counterclaim , follow O ption B below.

Option C. If the Defendant filed an Answer or Answer and Counterclaim and
you do NOT agree on all of the issues of your divorce, follow O ption C .

Option A. The following instructions apply if the D efendant file d an
Answer or Answer and Counterclaim , and you both agr ee on all of
the issues of your divorce . If you and the Defendant agree on the issues involved in
your divorce, then you will need to c omplete the following:

A. Fill out a Confidential Financial Affidavit and attach all required documents.

Both parties a re required to file a Confidential Financial Affidavit including the
required attachments with the Court. If the Defendant does NOT file a
Confidential Financial Affidavit , you will need to complete an Affidavit of
Imputed Income to show the Court how muc h money the Defendant makes. This
is an additional form contained in your packet.

Required Attachments. The Confidential Financial Affidavits of the parties
must be supported with documentation of both current and past earnings. Proper
documentation of current earnings inclu des, but is not limited to, pay stubs,
employer statements, or receipts and expenses if self -employed. Documentation
of current earnings shall be supplemented with copies of the most recent tax
return to provide verification of earnin gs over a longer period. Include copies of
Summary of Step 5: You MUST provide your Initial Disclosures to the Defendant within 30 days after the
Defendant is served with the Summons, Complaint for Divorce and Confidential Statement of the Parties for Child
Support Or der unless you and the Defendant agree on all issues in your divorce and you both are signing the
Decree of Divorce .
A. Mark on the calendar the deadline to send your Initial Disclosures ; and
B. Send your Initial Disclosures to the Defendant by the deadline .
C. DO NOT file the Initial Disclosures with the Clerk’s office .

Family Law Information and Instructions
Revised October 2 012
Page 7 of 14

income tax returns for the previous two years and your most recent pay stub(s) to
show how much you have made so far this year. Be sure to also include copies of
your health insurance cards, if applicable.

B. Fill out an Affidavit for Divorce Without Appearance of Parties . This form
provides the admissible evidence the Court needs to enter a Decree without
requiring the parties to attend a hearing.

C. Fill out a Decree of Divorce (with Children) Th is form will need t o be filled out
completely, signed by both you and the Defendant and both of your signatures
must be notarized. Here are some helpful hints in completing the Decree of
Divorce :

Custody and Visitation . You and the Defendant need to determine which
custod y and visitation plan will apply in your circumstances. It is unusual for the
Court not to award any visitation or supervised visitation to the non -custodial
parent .

o If there is a concern that your child(ren) may be harmed by the other
parent physicall y 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 help 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
other ideas.

Factors to be considered for awarding custody and visitation . The Decree of
Divorce contains several options for custody and visitation arrangements. I deally ,
bo th 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 geog raphic 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 child(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 involvement but a parent's willingness and ability to
learn the necessary skills, as well);
4. The lack of host ility 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;

Family Law Information and Instructions
Revised October 2 012
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7. The child(ren)'s relationship with his/her friends.

Chi ld’s interests should control. The use of a calendar for scheduling purposes
is highly recommended. The parents' work schedules and the child(ren)'s school
and extracurricular activities need to be considered when developing a visitation
plan . This is e specially true for those parents who do not enjoy a traditional work
week. While visitation should be an enjoyable and enriching experience, it is an
obligation 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 p arenting 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 Completi on with the Clerk ’s office. This certificate is provided by
the class instructor.

Child Support Payments . You will need to determine the amount of child
support due based upon the Confidential Financial Affidavits you and the
Defendant completed (or by the Affidavit of Imputed Income if the Defendant did
not complete his/her own Confidential Financial Affidavit ). You may use the
Child Support Computation Form as a guide to help you calculate the support
due or contact your local child support enforcemen t agency for assistance.
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 . Wyoming law
allow s for a reduced amount of support when you agree on joint physical
custody , each parent keeps the child(ren) overnight for more than forty
percent (40%) of the year , and both parents contr ibute substantially to the
expenses of the children in addition to the payment of child 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 twent y-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 sup port.

 There are NO DEVIATIONS from the presumed support allowed
UNLESS the Court CHOOSES to deviate from the set amount because the

Family Law Information and Instructions
Revised October 2 012
Page 9 of 14

amount was unjust or inappropriate in the particular case. The Court must
include the specific reasons for deviation in the Decree of Divorce .

 NO AGREEMENTS FOR LESS THAN THE PRESUMED
SUPPORT CAN BE APPROVED IF GOVERNMENT OR STATE
BENEFITS (SUCH AS TITLE 19, KID CARE, 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 Defendant even if you
and t he Defendant 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 chi ld support order. T he Court shall order either or both
of the par ents to provide medical 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, optica l 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).

D. Fill out an Order for Income Withholding . The Court is required by statute to
enter an Order for Income Withholding in every case where child support has been ordered.

E. Fill out an Income Withholding for Support . This form is required if you need to
have the child support paid directly from a non -custodial parent’s employer. If you need
assistance in filling out this form, or if you need assistance in collecting child support, you
should contact the c hild support enforcement a gency in your district. The Clerk can provide you
with the agency’s contact information.

F. Other Forms : The Court may also require a Certificate of Mailing and a
Supplemental Order depending on the county where your case is filed. Ask the Clerk if these
additional forms are required.

G. Copies and Envelopes . Take an original and two (2) copies of each of the above
documents for filing with the Clerk and two (2) addressed, stamped envelopes (one addressed to
you and one to the Defendant with enough postage to cover the cost of mailing the Decree of
Divorce to you and the Defendant). A copy of any documents t hat you file (other than the
Decree of Divorce ) must be sent to the D efendant on the date that you filled out on the
Certificate of Service on each document.

 If a hearing is not required by your Court , the Clerk will mail a copy of your
Decree of Divorc e if accepted by the Court .

Family Law Information and Instructions
Revised October 2 012
Page 10 of 14

 If a hearing is required by your Court , follow the next steps:

H. Hearing . In some Court s, a hearing is required before the Judge will sign the
Decree of Divorce . If this is the case, you will need to request a hearing by com pleting the
Request for Setting . If you have reached an agreement, check the box that states that the parties
have reached an agreement. Indicate how much time you will need for the hearing (usually 15
minutes if there is an agreement). You will file th e Order Setting Hearing with the Clerk ’s
office and they will fill in the hearing date and time and mail a copy to you and the Defendant.
You will need to provide an addressed, stamped envelope for you and the Defendant to the
Clerk . The se documents are additional forms that are contained in your packet.

I. Evidence . At the hearing, you will need to inform the Judge that you have lived
in Wyoming for at least 60 days immediately before you filed the Complaint for Divorce , the
reason(s) why there are irreco ncilable differences in the marriage and the settlement you reached
(who gets what) and give the Decree of Divorce to the Judge. The Judge may ask you questions.
The Judge will not guide you through the hearing, tell you how to proceed or advise you on t he
law. Following the hearing, the Judge will make any necessary changes to the Decree of Divorce
and will sign it.

J. 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 . It may take several days for the
Judge to sign the Decree of Divorce . You must verify with the Clerk that the Decree of Divorce
has been file -stamped before you can be sure your divorce is final.

Summary of Option A : If you and the Defendant agr ee on all issues in the divorce and the D efendant filed an
Answer or Answer and Counterclaim , complete the following :

Remember: Take an original and two copies of each document to file with the Clerk’s office. You will need to send
a copy of any filed d ocument to the Defendant unless otherwise stated below.

1. Confidential Financial Affidavit ;
2. Affidavit for Divorce Without Appearance of Parties ;
3. Order for Income Withholding ;
4. Income Withholding for Support (or, you can open up a case with your local child s upport
enforcement agency) ;
5. Decree of Divorce (with Children)
 Take an original and two (2) copies of the Decree of Divorce for filing with the Clerk and two
(2) addressed, stamped envelopes (one addressed to you and one to the Defendant with
enough postag e to cover the cost of mailing the Decree of Divorce to you and the Defendant );
6. Complete and file any additional d ocuments required by your Court;
7. If your Court requires a hearing before entering a Decree of Divorce , then you will also need to
file and do the following:
 Request for Setting
 Order Setting Hearing
 Take an original and two (2) copies of the Order Setting Hearing for filing with the Clerk and
two (2) addressed, stamped envelopes (one addressed to you and one to the Defendant with
enough pos tage to cover the cost of mailing the Order Setting Hearing to you and the
Defendant);
 Attend the Hearing .
Your divorce is final when the Decree of Divorce has been signed by the Judge and filed by the Clerk.

Family Law Information and Instructions
Revised October 2 012
Page 11 of 14

Option B. If the Defendant does not file an Answer or Answer and
Counterclaim , obtain a default d ivorce by following these steps :

A. Default Divorce . After the required waiting period has expired, you may obtain
what is referred to as a divorce by default if the Defendant does NOT file an Answer or Answer
and Counterclaim to the Complaint for Divorce.

B. Necessary forms . Fill out and sign the Application for Entry of Default and
Affidavit in Support of Default . Take an original and two (2) copies of these documents to the
Clerk and the blank Entry o f Default . If your paperwork is correct, the Clerk will sign the
Entry of Default . These are additional forms that are contained in your packet.

C. Additional Documents . After the Entry of Default is signed by the Clerk ,
complete Step 6 , Option A, items A through G above. MAKE SURE TO MARK
“DEFAULT” ON THE DECREE.

D. Default Hearing . Some Court s will not enter a Default Decree of Divorce unless
there is a hearing. Ask the Clerk if this is required for your Court . If it is, fill out a Request for
Settin g and request 15 minutes for the hearing. You will file the Order Setting Hearing with
the Clerk ’s office and they will fill in the hearing date and time and mail a copy to you and the
Defenda nt. You will need to provide an addressed, st amped envelope fo r you and the
Defendant to the Clerk .

E. Evidence . At the hearing, you will need to inform the Judge that you have lived
in Wyoming for at least 60 days immediately before you filed the Complaint for Divorce , the
reason(s) why there are irreconcilable diffe rences in the marriage and the settlement you
reached (who gets what) and give the Decree of Divorce to the Judge. The Judge may ask you
questions. The Judge will not guide you through the h earing, tell you how to proceed, or advise
you on the law. Foll owing the hearing, the Judge will make any necessary changes to the
Decree of Divorce and will sign them.
F. 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 . It m ay take several days for the
Judge to sign the Decree of Divorce . You must verify with the Clerk 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 t he Decree of Divorce is filed with the Clerk ’s office.

Summary of Option B : If the D efendant did NOT file an Answer or Answer and Counterclaim , complete the
following :

Remember: Take an original and two copies of each document to file with the Clerk’ s office. You will need to
send a copy of any filed document to the Defendant unless otherwise stated below.

1. Application for Entry of Default
2. Affidavit in Support of Default

Family Law Information and Instructions
Revised October 2 012
Page 12 of 14

3. Entry of Default (Clerk will sign if your paperwork is correct)
4. Confidential Fin ancial Affidavit
5. Affidavit for Divorce Without Appearance of Parties
6. Order for Income Withholding
7. Income Withholding for Support (or, you can open up a case with your local child support
enforcement agency)
8. Decree of Divorce (with Children) MAKE SURE TO MARK “DEFAULT” ON THE DECREE.
Take an original and two (2) copies of the Decree of Divorce for filing with the Clerk and
two (2) addressed, stamped envelopes (one addressed to you and one to the Defendant with
enough postage to cover the cost of mailing the Decree of Divorce to you and the
Defendant).
9. Complete and file any additional documents required by your Court.
10. If your Court requires a hearing before entering a Decree of Divorce , then you will also need to file
and do the following:
Request for S etting
Order Setting Hearing
Take an original and two (2) copies of the Order Setting Hearing for filing with the Clerk
and two (2) addressed, stamped envelopes (one addressed to you and one to the Defendant
with enough postage to cover the cost of maili ng the Order Setting Hearing to you and the
Defendant).
Attend the Hearing

Your divorce is final when the Decree of Divorce has been signed by the Judge and filed by the Clerk.

Option C. If the D efendant Answers or Answers and Counterclaims ,
and you and the D efendant do NOT agree on all issues of your
divorce, you will need to have a trial :
A. You must file a Reply to the Counterclaim . If the Defendant has filed an
Answer and Counterclaim for a divorce, you will have a time limit (usually 20 days) to fi le a
written response ( Reply to Counterclaim ) to the counterclaim. The original, signed copy of your
reply must be filed with the Clerk and a copy must be sent to the Defendant (or his/her attorney).
Caution: If you do not file the original Reply to Co unterclaim with the Clerk
within the time allowed, the Defendant can seek a default divorce against you
and may get what he/she asked for in his/her counterclaim.
B. Trial . If there is no agreement, your case will have to be heard and decided by a
Judge 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.
C. Request a trial date. You will need to requ est 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 present your evidence and write that in
(usually one (1) to three (3) hour s). You also need to decide whether or not you want a Court

Family Law Information and Instructions
Revised October 2 012
Page 13 of 14

reporter to record the proceeding. If you request a Court reporter, you will be responsible for
paying the fees. SEE BELOW FOR DETAILS ON GETTING A COURT REPORTER. If a
hearing is not recorded b y 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 everything that is said at the trial.

 You must file the Request for Se tting 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 the other party. You will need
to provide an addressed, stamped envel ope for you and the Defendant to the Clerk .
Both the Request for Setting and the Order Setting Divorce Trial and Requiring
Pretrial Statements are additional forms contained in your packet.

D. Pretrial Disclosures . Both parties must provide to the other party AND
PROMPTLY FILE WITH T HE 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 , the se 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 Defendant (or his/her attorney).

E. Settlement before trial. In the eve nt that your case settles before the trial, you
must present the Court with the completed and signed Decree of Divorce 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.

F. Court reporter. If you wish to have a Court Reporter you are required to make a
request by phone to the appropriate official court reporter at lea st 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 all civil matters includin g jury trials. Payment of the statutory 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 the Wyoming State
Treasure r.

G. Evidence and witnesses. At the hearing, you will need to present your evidence
and witnesses. If the Order Setting Divorce Trial and Requesting Pretrial Statements is entered
(signed by the judge), you must follow the terms and provide the Court wi th the information
requested in that document, including copies of exhibits you want to introduce at the trial and 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 t he trial). Under the law, the Judge cannot help you
or assist you at trial. You are on your own without an attorney.

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Revised October 2 012
Page 14 of 14

H. Final Decision ( Decree of Divorce ). Following the trial, the Judge will make a
decision or may take the matter under advisement, meanin g he or she will need to think further
before making a determination. If the Judge instructs you, you must take that decision and type
it into the Decree of Divorce incorporating the Judge’s decision.

 You are again reminded that, if you choose to continu e without an attorney,
you are expected to know what to do and how to do it. The judge will not
guide you through the trial/hearing, tell you how to proceed , or advise you on
the law.

 You MUST also file the documents outlined in Step 6 , Option A, items A and
C through G above .
I. 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 Divorce is filed with the
Clerk’s office.
Summary of Option C : If the Defendant filed an Answer or Answer and Counterclaim and you do NOT agree on
the issues, complete the following:

Remember: Take an original and two copies of each document to file with the Clerk’s offi ce. You will need to send
a copy of any filed document to the Defendant unless otherwise stated below.

1. If the Defendant filed an Answer and Counterclaim , file a Reply to the Counterclaim within 20 days after
you receive the Answer and Counterclaim .
2. Req uest a trial date
a. Request for Setting
b. Order Setting Divorce Trial and Requiring Pretrial Statements
c. 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 Defendant with enough postage to cover the cost of mailing the Order Setting Divorce
Trial and Requiring Pretrial Statements to you and the Defendant)
3. File your Pretrial Disclosures and Pretrial Me morandum
4. At least 3 working days before the trial, request a court reporter, if desired
5. Attend the Trial
6. Decree of Divorce (with Children)
a. Take an original and two (2) copies of the Decree of Divorce for filing with the Clerk and two (2)
addressed, st amped envelopes (one addressed to you and one to the Defendant with enough postage to
cover the cost of mailing the Decree of Divorce to you and the Defendant)
7. Order for Income Withholding
8. Income Withholding for Support (or, you can open up a case with your local child support enforcement
agency)
9. Complete and file any additional documents required by your Court.

Your divorce is final when the Decree of Divorce has been signed by the Judge and filed by the Clerk.

Checklist for Packet 1
Revised October 2012
Pa ge 1 of 7

CHECKLIST FOR PACKET 1
PLAINTIFF DIVORCE WITH MINOR CHILDREN

STEP 1. These forms are required in all divorce cases where you and the Defendant
agree on all of the issues:

Civil Cover Sheet
Vital Statistics F orm
Complaint for Divorce (with Children)
Summo ns
Acknowledgment and Acceptance of Service
Confidential Statement of the Parties for Child Support Order
Confidential Financial Affidavit
Affidavit for Divorce Without Appearance of Parties
Decree of Divorce (with Children)
Order for Income Withholding
Income Withholding for Support (or , you can open up a case with your
local child support enforcement agency)
*Other forms may be required based on your situation or on the Court where you are
filing your divorce. If other forms are required based on your s ituation, they will be
discussed below. You will need to check with the Clerk to determine if the Court
requires further documents.

STEP 2. File your Divorce in the District Court where either you or your spouse
resides within the State of Wyoming. Take an original and two copies with you. The
Clerk will keep the original. Keep one copy for yourself. The other copy is for service
upon the Defendant as described in Step 3 .
Civil Cover Sheet
Vital Statistics Form
Complaint for Divorce (with Children)
Summons
Confidential Statement of the Parties for Child Support
Pay f iling fee (check with Clerk for amount and payment options)

STEP 3. Serve the Defendant (Choose 1 option below).
Defendant signed the Acknowledgement and Acceptance of Service form
File original Acknowledgment and Acceptance of Service form ; and
File original Summons with the Cou rt; OR
Defendant was personally served by the Sheriff

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Revised October 2012
Pa ge 2 of 7

File original Summons and the Return or Affidavit of Service
completed by Sheriff with the Court .

STEP 4. Wait the required time for Defendant to file an Answer to t he Complaint .
20 days have elapsed. Defendant was personally served in the State of
Wyoming or signed an Acknowledgement and Acceptance of Service form;
OR
30 days have elapsed . Defendant was personally served outside the State
of Wyoming ; OR
Exception : If you and the Defendant agree on all issues in your divorce
and you both are signing the Decree of Divorce , then you can move on to
Step 6 .
STEP 5. Complete the Initial Disclosures
Send the Initial Disclosures to the Defendant within 30 days after the
Defendant was personally served by the Sheriff or signed the
Ackn owledgment and Acceptance of Service form. DO NOT FILE the
Initial Disclosures with the Court.
Excep tion : If you and the Defendant agree on all issues in your divorce ,
you are both fully informed about all of your assets and debts, and you
both are signing the Decree of Divorce , then you do NOT need to
complete the Initial Disclosures and you can move o n to Step 6 .

STEP 6. There are three options to choose from on this step depending on your
situation. Review each option carefully and pick the option that best describes your
situation.

Option A : If the Defendant filed an Answer or Answer and Counte rclaim and
you both agree on all issues, complete Option A .

Option B : If the Defendant did not file an Answer or Answer and
Counterclaim , complete Option B .

Option C : If the Defendant filed an Answer or Answer and Counterclaim and
you do NOT agree on all issues, complete Option C .
OPTION A: If the Defendant filed an Answer or Answer and Counterclaim and you
both agree on all issues, fill out and file the following documents to finish your Divorce:

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Revised October 2012
Pa ge 3 of 7

Reply to Counterclaim . If the Defend ant filed an Answer and
Counterclaim , you must file a Reply to Counterclaim within 20 days from the
date the Defendant filed the Answer and Counterclaim . You do NOT need to
complete this form if the Defendant only filed an Answer .
Confid ential Financial Affidavit
If employed, a ttach tax returns for prior 2 years; and
Attach statement of earnings for the current year ;
Attach documentation about health insurance if applicable OR
If self -employed, attach verified income and expense statements
for prior two years ;
Attac h tax returns for prior 2 years; and
Attach documentation about health insurance if applicable.

Additional form that may be needed :
Affidavit of Imputed Income . If the Defendant does NOT file a
Confidential Financial Affidavit, you will need to complete the
Affidavit of Imputed Income form to show the Court how much
money the Defen dant makes. You do not need to complete this
form if the Defendant filed a Confidential Financial Affidavit .
Affidavit for Divorce Without Appearance of Parties
Decree of Divorce (with Children)
Order for Income Withholding
Income Withholding for Support (or , you can open up a case with your
local child support enforcement agency).
Copies and Envelopes:
Take an original and 2 copies of each form to the Clerk for filing .
One envelope addressed to you with postage for the Clerk to mail a
copy of the Decree of Divorce to you .
One envelope addressed to the Defendant with postage for the
Clerk to mail a copy of the Decr ee of Divorce to the Defendant .
Mail a copy of the other forms to the Defendant and k eep a copy
for your records.
Additional Forms : The Court may also require these additional forms (or
others) depending on the county w here your case is filed. Ask the Clerk if
these additional forms are required. DO NOT COMPLETE THESE
FORMS FOR ALL DISTRICT COURTS.
Certificate of Mailing
Supplemental Order (Use in Laramie County Only)

Checklist for Packet 1
Revised October 2012
Pa ge 4 of 7

Certificate of Completion of a Parenting Class (If you are required
to complete a parenting class, the instructor for the class will give
you this form for you to file with the Clerk .)
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 Defendant and k eep a copy for your records .
Hearing. Some Court s require a hearing before the Judge will sign the
Decree of Divorce . Ask the Clerk if this is required. If so, you will need
to request that the Court set a date to hold the hearing.
Request for Setting
Order Setting Hearing (Judge will fill out date and time)
Take an envelope addressed to you with postage for the
Clerk to mail a copy of the Order Setting Hearing to you .
Take an envelope addressed to the Defendant with postage
for t he Clerk to mail a copy of the Order Setting Hearing to
the Defendant.
Mail a copy of the Request for Setting to the Defendant and
keep a copy for your records.
Attend the Hearing : Inform the Judge that you have lived i n Wyoming for
at least 60 days before you filed the Complaint for Divorce , the reasons
why there are irreconcilable differences in the marriage and the settlement
you reached (who gets what) and give the Judge the Decree of Divorce
you completed.
Your divo rce will be complete when the Judge signs the Decree of Divorce and it is
filed with the Clerk.

OPTION B. If the Defendant does NOT file an Answer , fill out and file the following
documents to finish your Divorce:
Application for Entry of Default
Affidavit in Support of Default
Take a blank Entry of Default for the Clerk to sign
Confidential Financial Affidavit
Attach tax returns for prior 2 years; and
If employed, a ttach tax returns for prior 2 years;
Attach statement of earnings for the current year ; and
Attach documentation about health insurance if applicable ; OR
If self -employed, atta ch verified income and expense statements
for prior two years ;

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Revised October 2012
Pa ge 5 of 7

Attach tax ret urns for prior 2 years; and
Attach documentation about health insurance if applicable.
Affidavit of Imputed Income . You will need to complete the Affidavit of
Imputed Income form to show the Court how much money the Defendant
makes.
Affidavit for Divorce Without Appearance of Parties
Decree of Divorce (with Children)
Order for Income Withholding
Income Withholding for Support (or , you may open up a case with your
local child support agency)
Copies and Envelopes.
Take an original and 2 copies of each form to the Clerk for filing .
Take an envelope addressed to you with postage for the Clerk to
mail a copy of the Decree of Divorce to you .
Take an envelope addressed to the Defendant with postage for the
Clerk to mail a copy of the Decree of Divorce to the Defendant .
Mail a copy of the other forms to the Defendant and keep a copy
for your records.
Additional Forms : The Court may also require these additional forms (or
others) depending on the county whe re your case is filed. Ask the Clerk if
these additional forms are required. DO NOT COMPLETE THESE
FORMS FOR ALL DISTRICT COURTS.
Certificate of Mailing
Supplemental Order (Laramie County Only)
Certifi cate of Completion of a Parenting Class (If you are required
to complete a parenting class, the instructor for the class will give
you this form for you to file with the Clerk )
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 Defendant and k eep a copy for your records .

Hearing. Some Courts require a hearing before the Judge will sign the
Decree of Divorce . Ask the Clerk if this is required. If so, you will need
to request that the Court set a date to hold the hearing.
Request for Setting
Order Setting Hearing (Judge will fill out date and time)
Take an envelope addressed to you with postage for the Clerk to
mail a copy of the Order Setting Hearing to you .

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Pa ge 6 of 7

Take an envelope addressed to the Defendant with postage for the
Clerk t o mail a copy of the Order Setting Hearing to the
Defendant.
Mail a copy of the Request for Setting to the Defendant and k eep a
copy for your records.
Attend the Hearing : Inform the Judge that you have lived in Wyoming for
at least 60 days before you filed the Complaint for Divorce , the reasons
why there are irreconcilable differences in the marriage and the settlement
you reached (who gets what) and give the Judge the Decree of Divorce
you completed.

Your divorce will be complete when the Judge signs the Decree of Divorce and it is
filed with the Clerk.

OPTION C. If the Defendant files an Answer or Answer and Counterclaim , and you
both do NOT agree on all 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 ru les and laws.

Request a Trial Date.
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 Setting Divorce Trial and Requesting
Pretrial Statements to you .
Take an envelope addressed to the Defendant with postage for the
Clerk to mail a copy of the Order Setting Divo rce Trial and
Requesting Pretrial Statements to the Defendant.
Mail a copy of the Request for Setting to the Defendant and k eep a
copy for your records.

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Revised October 2012
Pa ge 7 of 7

Pretrial Disclosures and Pretrial Memorandum
Fil e at least 30 days before the trial date .
Take original and two copies to the Clerk for filing .
Mail copy to the Defendant and k eep a copy for your records .
At least 3 working days before the trial, r equest a Court Reporter , if
desired
Attend the Trial : Present your evidence and witnesses.
Decision by Judge : The Court will tell you at the end of the trial if it will
prepare the Decree of Divorce or if it wants you or the other party to
prepare the Decree of Divorce and the terms to include in it. Have a blank
Decree of Divorce ready to fill out in case the Judge asks you to prepare
the Decree of Divorce . This way, you can fill it out as he gives his ruling.
Decree of Divorce (with Children) (Unless the Court is preparing this for
you)
Order for In come Withholding
Income Withholding for Support (or , you can open up a case with your
local child support enforcemen t agency)
Copies and Envelopes.
Take an original and 2 copies of each form to the Clerk for filing .
Take an envelope addressed to you with postage for the Clerk to
mail a copy of the Decree of Divorce to you .
Take an envelope addressed to the Defendant with postage for the
Clerk to mail a copy of the Decree of Divorce to the Defendant .
Mail a copy of the other forms to the Defendant and keep a copy
for your records.
Additional Forms : The Court may also require these additional forms (or
others) depending on the county where your case is filed. Ask the Clerk if
these additional forms are required. DO NOT COMPLETE THESE
FORMS FOR ALL DISTRICT COURTS.
Certificate of Mailing
Supplemental Order (Laramie County Only)
Certificate of Completion of a Parenting Class (If you are required
to complete a parenting class, the instructor for the class will give
you this form for you to file with the Clerk .)
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 additiona l form filed with the Clerk to
the Defendant 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.

CIVIL COVER SHEET
This civil cover sheet and the information contained herein neither replace s nor supplement s the filing s and service of pleadings or other
papers as required by law. This form, approved by the Wyoming Supreme Court, is required for the u se of the Clerk of Court for the
purpose of initiating the civil docket sheet. ( SEE INSTRUCTIONS ON THE SECOND PAGE OF THIS FORM )

I. CAPTION
____________________ ____
______________________________
_________ _____________________
Plaintiff Name and Curr ent Address

______________________________
Defendant.
Docket # ________________________

II. NATURE OF SUIT (Place an “X” in One Box Only)
GENERAL CIVIL OTHER CIVIL
CONTRACT
DISSOLUTION OF MARRIAGE PROBATE □ Appointment/Removal of a Fi duciary
□ Business Organization Litigation □ Divorce w/Minor Children □ Ancillary Admin/Foreign Prob □ Arbitration Award Confirmation
□ Com. Const. Contract Litigation □ Divorce w/o Minor Children □ Decree of Title Distribution □ Birth Certific ate Amendment/Establishment
□ Contract Other (not Debt Collection) □ Judicial Separation □ Determination of Heirship □ Debt Collection
□ Annulment □ Letters of Administration □ Declaratory Judgment
□ Estate Unspecified □ Emancipa tion of Minor
TORT DOMESTIC RELATIONS □ Summary Probate □ False or Frivolous Lien
□ PI or WD - Environmental or Toxic Tort □ Custody/Parental Visitation □ Testate/Intestate Estate □ Foreign Judgment
□ PI or WD - Fed Employer Liability Act □ Grandparental Visitation □ Will Only Filings □ Foreign Protection Order/Foreign Stalking Order
□ PI or WD - Medical Malpractice □ Paternity □ Trust Matters □ Forfeiture of Property
□ PI or WD - Product Liability □ Child Support/Parental Contr ibution □ Guardianship □ Governmental Action Environmental Case
□ PI or WD - Vehicular □ Child Support w/ Paternity □ Conservatorship □ Injunction
□ Personal Injury Unspecified □ UIFSA w/Paternity □ Guardian & Conservatorship □ Material Wi tness/Foreign Subpoena
□ Property Damage □ UIFSA □ Name Change
□ Tort Unspecified □ Dom Register Foreign Judgment ADOPTION □ Involuntary Hospitalization
□ Wrongful Termination of Employment □ TPR State/DFS □ Adoption □ Public Nuisanc e
□ TPR Family/Private □ Confidential Intermediary □ Specific Relief
□ Structured Settlement Protection Act
□ Successor to Civil Trust Appointment
CIRCUIT COURT
PROPERTY □ Transcript Judgment from Circu it Court
□ Small Claims □ Property with Mineral Rights □ Writ of Habeas Corpus
□ Forcible Entry and Detainer □ Property w/o Mineral Rights □ Writ of Mandamus
□ Stalking Protection Order □ Writ of Replevin
□ Family Violence Pr otection Order □ Unspecified

III. RELATED CASE(S) IF ANY (see instructions)
Docket No. _____________ Judge _______________________ Court (if different) _________________________
Dock et No. _____________ Judge _______________________ Court (if different) _________________________

IV . $ AMOUNT IN CONTROVERSY, (estimated) (see instructions)
$____________________________

_______________________________________________________ ___________________ _______________________________
SIGNATURE OF ATTORNEY OF RECORD OR PRO SE LITIGANT DATE

INSTRUCTIONS FOR ATTORNEYS OR PRO SE LITIGANTS COMPLETING THE CIVIL COVER SHEET

Authority for Civil Cover Sheet

The civil cover sheet and t he information contained herein neither replace s nor supplement s the filing s and service
of pleadings or other papers as required by law. This form, approved by the Wyoming Supreme Court, is required
for the use of the Clerk of Court for the purpose of in itiating the civil docket sheet. Consequently , a civil cover sheet
is submitted to the Clerk of Court for each civil case filed. The attorney or pro se litigant filing a case should
complete the form as follows:

I. Caption. Enter names of the plaintiff and defendant and the address for the plaintiff . If the plaintiff or
defendant is a government agency, use only the full name or standard abbreviations. If the plaintiff or defendant is
an official within a governmental agen cy, identify first the agency and then the official, giving both name and title.

II. Nature of Suit. Place an “X” in the appropriate box. ONE AND ONLY ONE BOX SHOULD BE
CHECKED. If the nature of suit cannot be determined, because the cause of action fi ts more than one nature of suit,
select the most determinative. Some descriptions may require clarification . See below:

Contract Subtypes
Business Organization Litigation (Corporate, Partnership or L.L.C. dissolution or accounting)
Contract Other (not d ebt collection) (including Specific Performance but not Wrongful Termination)

Property Subtypes
Property with Mineral Rights ( e.g., Quiet Title, Ejectment)
Property w/o Mineral Rights ( e.g., Adverse Possession, Condemnation, Easements, Ejectment, Gifts, H istoric
Preservation Rights, Quiet Title, Solar Rights, Survivor Rights, Title, Trust, Unclaimed Property, Uniform
Transfer to Minors, Property Conveyance including Mortgages and Deeds of Trust)

Tort Subtypes
PI or WD = Personal Injury or Wrongful Death
Personal Injury Unspecified (e.g. , slip and fall, defamation, assault, battery, intentional infliction of emotional
distress, false imprisonment, invasion of privacy)
Property D amage (e.g., negligence, trespass, nuisance)
Tort Un specified ( e.g., fraud, res traint of trade, conversion, replevin)
Wrongful Termination of Employment ( sounding in Contract, Title VII, ADEA, or Breach of Implied Covenant of
Goo d Faith and Fair Dealing )

Domestic Relations Subtypes
A petition containing a child support action should be labeled a child support case even if other actions (i.e., custody,
visitation, paternity) are included in the petition.

III. Related Cases. This section is u sed to reference related cases, if an y. If there are related cases, involving
the same part ies or children, insert the docket numbers and the corresponding judge names for such cases.

IV. $ Amount in Controversy. In this space, enter the dollar amount (in thousands of dollars) being demand ed
or indicate other demand such as preliminary injunct ion.

Attorney or Pro Se Litigant Signature and Date. Sign and date the civil cover sheet.

Vital Statistics Form
Revised February 2011
Page 1 of 1
VITAL STATISTICS FORM
State of Wyoming
Department of Health
ABSOLUTE DIVORCE OR ANNULMENT STATE FILE NUMBER ______________________ 1. HUSBAND’S NAME (First, Middle, Last)
2a. RESIDENCE -CITY, TOWN, OR LOCATION

2b. COUNTY

2c. STATE

Birthplace (State or Foreign Country)

4. DATE OF BIRTH (Month, Day, Year)
5a. WIFE’S NAME (First, Middle, Last)

5b. MAIDEN SURNAME
6a. RESIDENCE -CITY, TOWN, OR LOCATION

6b. COUNTY
6c. STATE

7. BIRTHPLACE (State or Foreign Country)

8. DATE OF BIRTH (Month, Day, Year)
9a. PLACE OF THIS MARRIAGE -CITY TOWN, OR LOCATION

9b. COUNTY

9c. STATE OR FOREIGN COUNTRY

10. DATE OF THIS MARRIAGE (Month, Day, Year)
11. DATE COUPLE LAST RESIDED IN SAME HOUSEHOLD (Month, Day, Year)

12. NUMBER OF CHILDREN UNDER 18 IN THIS HOUSEHOLD AS OF THE DATE IN ITEM 11 Number _____ None
13. PLAINTIFF/ PETITIONER Husband Wife Both Other (Specify )
14a. NAME OF PLAINTIFF/ PETITIONER’S ATTORNEY ---------------- DO NOT FILL OUT BELOW THIS LINE
14b. ADDRESS (Street and Number or Rural Route Number, City or Town, State, Zip Cod e)

15. I CERTIFY THAT THE MARRIAGE OF THE ABOVE NAMED PERSONS WAS DISSOLVED ON : (Month, Day, Year)
16. TYPE O F DECREE -Divorce or Annulment (Specify)
17. DATE RECORDED (Month, Day, Year) _
18. NUMBER OF CHILDREN UNDER 18 WHOSE PHYSICA L CUSTODY WAS AWARDED TO: Husband Wife Joint (Husband/Wife) Other No Children
19. COUNTY OF DECREE
20. TITLE OF COURT

21. SIGNATURE O F CERTIFYING OFFICIAL
22. TITLE OF CERTIFYING OFFICIAL
23. DATE SIGNED (Month, Day, Year)

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 Action Case No. _________________
(Print name of p erson filing) )
)
vs. )
)
Defendant: __________________________ . )
(Spouse) (Print name)

COMPLAINT FOR DIVORCE
(with Children)

PLAINTIFF , for his/her complaint against the Defendant states and alleges as
follows:

1. Plaintiff is a resident of ___________________ Coun ty, Wyoming, and has lived in the
State of Wyoming for more than sixty (60) days immediately prior to the filing of this
Complaint . (If not, did the marriage take place in Wyoming and have you resided in this state
from the time of the marriage until the f iling of the complaint? 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 Defend ant separate d on .
(Date of Separation )

4. Irreconcilable di fferences exist in the marriage and Plaintiff is the aggrieved party in this case
and should be grant ed a divorce from the Defendant.

5. The Defendant and I are the natural or ad optive parents of the following minor child (ren ):

Child’s initials :
Child’s year of birth :
Present address:

Complaint for Divorce (with Children)
Revised October 2012
Page 2 of 5
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
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 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:

Complaint for Divorce (with Children)
Revised October 2012
Page 3 of 5
Name(s) of person(s) wit h
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 necessa ry

6. That the child(ren) named in this Complaint for Divorce 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 lawy er before filing.)

7. I have not participated 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
protective 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 ano ther capacity in another court
proceeding concerning the custody , allocation of decision -making, or visitation/parenting time of
the child (ren ) listed in this Complaint for Divorce as follows : ( Please be specific and include the
case number, court, state a nd nature of case , date of child -custody determination, if any, and the
initials of the child(ren) involved )

8. I know of no person not a party to these proceedings who has physical custody of the
minor c hild(ren) or who claims to have custody or visitation 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 respon sibilities, legal custody or physical custody, or
visitation/parenting time with the child(ren):
(List Names and Addresses )

9. To the best of Plaintiff’s knowledge,
Wife is not pregnant, OR
Wife is pregnant (If pregnant, consult an attorney. 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 Plai ntiff 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.

Complaint for Divorce (with Children)
Revised October 2012
Page 4 of 5
10. Plaintiff OR Defendant is a fit and proper person to have the primary 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 cu stody and control over the minor
child(ren).

11. Plaintiff OR Defendant is capable of paying child support .

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 at a reasonable cost with benefits
available to the minor child(ren) and that Plaintiff OR Defendant OR Bot h Parents 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 debts 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 shall be awarded spousal support/alimony.

15. The wife’s previous name may be restored if she desires.

WHEREFORE , the Plaintiff respectfully requests that the Court:

1. Grant the Plaintiff a divorce from the Defendant 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 C ourt 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 propert y and debts;

6. Order that :
No party is entitled to spousal support; OR
Reasonabl e spousal support should be paid by Plaintiff, OR Defendant as the

Complaint for Divorce (with Children)
Revised October 2012
Page 5 of 5
circumstances and facts may re quire;

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 Plaint iff, ___________________________________, under the penalty of perjury,
verifies that she/he has read the Complaint for Divorce , knows the contents thereof , and that the
statements in the Complaint for Divorce are true to the best of her/his own knowledge .

DATED this _____ day of ___________________, 20 _______.

Signature
Printed Name:
Address:
Phone Number:

Subscribed and sworn to before me this ______ day of _________________, 20______.
Witness my hand and official seal.

Notarial Officer
My Commission Expires:

-------------------------------------------------- Fill in, if applicable ------------------------------------ -------
Pursuant to Rule 102(a)(1)(B) of the Wyoming Uniform Rules of Distric t 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:
___________ _______________________
__________________________________
__________________________________
__________________________________

Summons
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. ) SUMMO NS
)
Defendant: __________________________ . )
(Spouse) (Print name)

To the above named Defendant :
Print Defendant’s Name:
Home Address: __________________________________________________________
Phone: ______________________________________ ___________________________
Employer Name & Address: ________________________________________________

YOU ARE HEREBY SUMMONED and required to file with the Clerk and serve upon the
Plaintiff or Plaintiff ’s attorney if s/he has one, an Answer to the Comp laint for Divorce which is herewith
served upon you, within 20 days after service of this Summons upon you, exclusive of the day of service.
(If service upon you is made outside of the state of Wyoming, you are required to file and serve your
answer to th e Complaint for Divorce within 30 days after service of this Summons upon you, exclusive of
the day of service .) If you fail to do so, judgment by default will be taken against you for the relief
demanded in the Complaint for Divorce .

Dated ____________ _______________, 20_______.

(Seal of District Court)
___________________________________
Clerk of Court

By: ________________________________
Deputy Clerk_________________________
___________________________
Plaintiff’ s Name
___________________________
___________________________
Address
___________________________
Phone Number

Summons
Revised October 2012
Page 2 of 2
STOP: SHERIFF WILL FILL THIS OUT (Attach to Summons )

RETURN

STATE OF WYOMING )
) ss
COUNTY OF ____________ ) TO BE USED BY WYOMING SHERIFF, UNDER
SHERIFF OR DEPUTY
I, ____________________________________, Sheriff in and for said County of
____________________, in the State aforesaid, do hereby certify that I received the within Summons ,
together with a copy of the Complaint for Divorce and the Confidential Statement of the Parties for Child
Support Order , filed in the above entitled matter, and that I served the same in the County aforesaid on
the ________ day of ____________________, 20_____ by delivering a copy of the same, together with a
copy of the Complaint for Divorce , to :
_____________________________________________________________________________________
_____________________________________________________________________________________

Sheriff
By:
Deputy Sheriff
Sheriff’s fees: Service, $___________; Return $_____________

Mileage $___________; Total $_____________
______________________________________________________________________________ _______
____________________________________________________________________________________
AFFIDAVIT OF SERVICE

STATE OF______________ )
)ss TO BE USED BY A PERSON OTHER THAN WYOMING
COUNTY OF _____________ ) SHERIFF, UNDER SHERIF F OR DEPUTY

_______________________________, being first duly sworn, on oath deposes and says that s/he
is over 18 years old and is not a party to the foregoing action or interested therein, and that s/he made
service of said Summons in the County afores aid on the ______ day of ___________, 20____, by
delivering a copy of the same, together with a copy of the Complaint for Divorce and the Confidential
Statement of the Parties for Child Support Order , to:

Name:

Address:

By:

Subscribed and sworn to before me this __________ day of ______________, 20_____.

_________________________________
Notarial Officer
My Commission Expires:

Confidential Statement for Child Support Order
Revi sed 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. ) CONFIDENTIAL
)
Defendant: __________________________ . )
(Spouse) (Print name)

CONFIDENTIAL STATEMENT FOR CHILD SUPPORT ORDER

Pursuant to the requirements of Wyo. Stat. §20 -2-309(b), the following
information is confidential and may only be accessed by the pa rties, their attorneys, or the
Department of Family Services to the extent necessary to enforce the Child Support
Enforcement Act and the Uniform Interstate Family Support Act. Other persons or
entities may examine this statement only if permitted by cour t order.

1. Information for each parent:
Name of Plaintiff :
Address:

Plaintiff’s Social Security Number:
Date of Birth:
Place of Birth:
Plaintiff’s Employer:
Employer’s Address:

Name of Defendant :
Address:

Defendant’s Social Security Number:
Date of Birth:
Place of Birth:
Defendant’s Employer:
Employer’s Address:

Confidential Statement for Child Support Order
Revi sed October 2012
Page 2 of 2
2. Information for each child for whom child support has been ordered in this case :
Child’s Name :
Address:

Child’s Social Security Number:
Date of Birth:
Place of Birth:

Child’s Nam e:
Address:

Child’s Social Security Number:
Date of Birth:
Place of Birth:

Child’s Name :
Address:

Child’s Social Security Number:
Date of Birth:
Pl ace of Birth:

Child’s Name :
Address:

Child’s Social Security Number:
Date of Birth:
Place of Birth:

Add add itional sheets of paper if needed to provide information for more children.

DATED this _____ day of ______________________, 2 0_____ .

Signature
Printed Name:
Address:

Phone Number:

Acknowledg ement and Acceptance of Service
Revised October 2012
Page 1 of 2
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)

ACKNOWLEDGEMENT AND ACCEPTANCE OF SERVICE

I, ____________________ ____ , hereby acknowledge receipt of a copy of the Summons ,
(Print Defendant’s Name)
Complaint for Div orce , and Confidential Statement of the Parties for Child Support Order , filed
in this case . In accepting service of process, I retain all defenses or objections to the lawsuit or
to the jurisdiction or venue of the court except for objections based on a defect in the Summons
or in the service of the Summons . I understand that I must answer or otherwise plead within 20
days from this date (30 days if copies of the papers were received outside of Wyoming) and that
if I fail to file an answ er or other plead ings with the Clerk of this C ourt and serve the same upon
the Plaintiff in accordance with the Wyoming Rules of Civil Procedure within the time limits
stated, I will be in default and Plaintiff may be affo rded the relief demanded in the Complaint for
Divor ce without a trial or other hearing.
DATED this _________ day of __________________________, 20____.

Defendant’s S ignature
Defendant’s Phone Number :
Defendant’s Address:
Defendant’s City/State/Zip Code:

Subscribed and sworn to before me on this ________ day of ____________________ __ ,
20_____.

WITNESS my hand and official seal.
____________________________________
Notarial Officer

My Commission Expires:

Acknowledg ement and Acceptance of Service
Revised October 2012
Page 2 of 2
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

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.)

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.

Oth er Personal Property
a.
b.
c.
d.

a.
b.
c.
d.

$
$
$
$

a.
b.
c.
d.

Real Property
a.

b.
Interest in Any Business
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.

Any Other Assets
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. #:
/
/
/
/

Acct.#:
/
/
/
/

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.

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.

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 Defendant/Defendant’s Attorney’s Name and Address)

TO: ______________________________________

______________________________________

Your signature

Print name

Affidavit of Imputed Income
Revised October 2012
Page 1 of 4
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)

AFFIDAVIT OF IMPUTED INCOME
___________________________________________________________________
(Only use this form if you are unable to get the other party to complete a
Confidentia l Financial Affidavit .)

I, _____________________, of lawful age, first being duly sworn upon my oath,
(print name)
depose and state as follows:
1. I am the Plaintiff OR Defendant in the above -captioned matter.
2. I am no t able to get a Confidential Financial Affidavit from the other party
because: .
3. The other party has certifications, degrees, education or training relevant to
his/her employability as follows:
___________________________________________ _______ _________ __ _
_______________________________________________________________
4. Explain , to the best of your knowledge, the other party’s work history or other
sources of income for the previous two years:

5. His/her inco me for this year is unknown, as she/he has not provide d financial
information and has failed, neglected or ot herwise refused to file a Confidential Financial
Affidavit .
6. I do OR do not have copies of the last two year’s income tax returns
showing the amount earned by Plaintiff OR Defendant . ATTACH ANY TAX

Affidavit of Imputed Income
Revised October 2012
Page 2 of 4
RETURNS, W -4s, CHECK STUBS OR OTHER INFO RMATION ABOUT THE
OTHER PARTY’S INCOME TO THIS DOCUMENT.
If you have information about the other parent’s previous or current employment by area and
occupation, you may be able to get information regarding wages by visiting the U.S. Department
of Labor Bureau of Labor Statistics website for wage information by area and occupation
http://www.bl s.gov/bls/blswage.htm. Attach any relevant documentation to this Affidavit.

7. Plaintiff’s OR Defendant’s income i s based on him/her being paid :
______ weekly
______ every two weeks
______ twice per month (i.e. 1st and 15 th of every month)
______ monthly
_______annually

Convert annual, bi - weekly, bi -monthly, and weekly amounts to monthly amounts below .
** Gross income (includes tips, commission and bonuses ). Monthly amounts are calculated by
multiplying w eekly amount by 52 and dividing by 12; multiplying bi -weekly amounts by 26 and dividing
by 12; and multiplying semi -monthly amounts by 24 and dividing by 12; annually by dividing by 12. If
only the “gross income” is known, multiply that number by .25 (or other number if instructed by Court) and
then subtract that amount from the gross to arrive at the net monthly income. If the other party has a
history of only working for minimum wage or less, and is capable, to your knowledge of working 40
hours/week, the court may impute his/her income at $ 1,141.25 net monthly for a noncustodial parent
and $1,185.67 net monthly for a custodial parent . You may call your local child support enforcement
office for more information on imputing a custodial or non -custodial p arent’s wage. Federal minimum
wage is $7.25/hour as of July 1, 20 12 .

8. Plaintiff’s OR Defendant’s estimated gross income (before deductions) is:
$_____________ per month , to the best of my information and belief .

"Inco me" means any form of payment or return in money or in kind to an individual, regardless of source.
Income includes, but is not limited to wages, earnings, salary, commission, compensation as an
independent contractor, temporary total disability, permanent partial disability and permanent total
disability worker's compensation payments, unemployment compensation, disability, annuity and
retirement benefits, and any other payments made by any payor, but shall not include any earnings derived
from overtime wo rk unless the court, after considering all overtime earnings derived in the preceding
twenty -four (24) month period, determines the overtime earnings can reasonably be expected to continue
on a consistent basis. In determining income, all reasonable unreim bursed legitimate business expenses
shall be deducted. Means tested sources of income such as Pell grants, aid under the personal opportunities
with employment responsibilities (POWER) program, food stamps and supplemental security income (SSI)
shall not b e considered as income . Gross income also means potential income of parents who are
voluntarily unemployed or underemployed .

"Net income" means income as defined in the box above , less personal income taxes, social security
deductions, cost of dependent health care coverage for all dependent children, actual payments being made
under preexisting support orders for current support of other children, other court -ordered support
obligations currently being paid and mandatory pension deductions. Payments towa rds child support
arrearage shall not be deducted to arrive at net income.

Affidavit of Imputed Income
Revised October 2012
Page 3 of 4
9. Based on the previous work history and /or income , Plaintiff OR Defendant
has the ability to earn a net ( after appropriate deductions ) monthly in come of
$___________ and said amount should be used to calculate child support under the
presumptive child support guidelines.
* If the other party has a history of only working for minimum wage or less, and is
capable, to your knowledge of working 40 hou rs/week , the court may impute his/her
income at $1,141.25 net monthly for a noncustodial parent and $1,185.67 net
monthly for a custodial parent .

10. Further your affiant sayeth naught.
DATED this _______day of _______ 2 0_____ .

Signature
Prin ted Name:
Address:
Phone Number:

STATE OF_____________ )
) ss.
COUNTY OF___________ )

The foregoing instrument was subscribed and sworn to before me by
____________________________ this ________ day of _____________, 2 0

Witness my hand and official seal.
________________________
Notarial Officer

My commission expires:

Affidavit of Imputed Income
Revised October 2012
Page 4 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
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 Other Party’s/Other Party’s Attorney’s Name and Address)

TO: ______________________________________

______________________________________

Your signature

Print name

Child Support Presumptive Guidelines Computation Fo rm
Revised October 2012
Page 1 of 4

1
DO NOT FILE WITH CONFIDENTIAL FINANCIAL AFFIDAVIT.
FOR COMPUTATION PURPOSES ONLY.
EFFECTIVE JULY 1, 2005.

§ 20 -2-304. Presumptive child support:
(i) One (1) child: (ii) Two (2) children :
Net Percentage of Base Support Plus Net Percentage of Base Support Plus
Monthly Income Marginal Percentage Monthly Income Marginal Percentage
Income of Allocated Income of Allocated
Both Parents For One Child Both Parents For Two Children
$ 833.00 26.2 $ 218.00 + 24.3% over $ 833.00 $ 833.00 36.8 $ 307.00 + 33.8% over $833.00
$ 2,083.00 25.1 $ 522.00 + 23.3% over $ 2,083.00 $ 2,083.00 35.0 $ 729.00 + 31.9% over $2,083.00
$ 2,917.00 24.6 $ 716.00 + 12.9% over $ 2,917.00 $ 2,917.00 34.1 $ 995.00 + 16.4% over $2,917.00
$ 3,750.00 22.0 $ 824.00 + 10.7% over $ 3,750.00 $ 3,750.00 30.2 $ 1,131.00 + 13.1% over $3,750.00
$ 5,000.00 19.2 $ 958.00 + 9.9% over $ 5,000.00 $ 5,000.00 25.9 $1,295.00 + 1 2.5% over $5,000.00
$ 6,667.00 16.8 $ 1,122.00 + 9.4% over $ 6,667.00 $ 6,667.00 22.5 $1,503.00 + 12.5% over $6,667.00
$ 8,958.00 14.9 $ 1,338.00 + 5.9% of anything over $ 8,958.00 20.0 $1,790.00 + 7.0% of anything over
$8,958.00 $8,958.00

(iii) Three (3) children: (iv) Four (4) children:
Net Percentage of Base Support Plus Net Percentage of Base Support Plus
Monthly Income Marginal Percentage Monthly Income Marginal Percentage
Income Allocated Income Allocated
Both Parents For Three Children Both Parents For Four Children
$ 833.00 42.7 $ 356.00 + 38.7% over $ 833.00 $ 833.00 47.6 $ 397.00 + 43.2% over $ 833.00
$ 2,083.00 40.3 $ 840.00 + 36.4% over $ 2,083.00 $ 2,083.00 45.0 $ 937.00 + 40.6% over $ 2,083.00
$ 2,917.00 39.2 $ 1,144.00 + 16.8% over $ 2,917.00 $ 2,917.00 43.7 $ 1,275.00 + 18.7% over $ 2,917.00
$ 3,750.00 34.2 $ 1,284.00 + 13.3% over $ 3,750.00 $ 3,750.00 38.2 $ 1,431.00 + 14.8% over $ 3,750.00
$ 5,000.00 29.0 $ 1,450.00 + 13.7% over $ 5,000.00 $ 5,000.00 32.3 $ 1,616.00 + 15.2% over $ 5,000.00
$ 6,667.00 25.2 $ 1,677.00 + 12.2% ove r $ 6,667.00 $ 6,667.00 28.1 $ 1,870.00 + 13.7% over $6,667.00
$ 8,958.00 21.9 $ 1,958.00 + 7.7% of anything over $ 8,958.00 24.4 $ 2,183.00 + 8.6% of anything over
$8,958.00 $8,958.00

(v)Five (5) or mo re children:
Net Percentage of Base Support Plus
Monthly Income Marginal Percentage
Income Allocated
Both Parents For Five Children
$ 833.00 52.4 $ 436.00 + 47.5% over $ 833.00
$ 2,083.00 49.5 $ 1,030.00 + 44.7% ove r $ 2,083.00
$ 2,917.00 48.1 $ 1,403.00 + 20.6% over $ 2,917.00
$ 3,750.00 42.0 $ 1,575.00 + 16.3% over $ 3,750.00
$ 5,000.00 35.6 $ 1,778.00 + 16.8% over $ 5,000.00
$ 6,667.00 30.9 $ 2,057.00 + 15.0% over $ 6,667.00
$ 8,958.00 26.8 $ 2,402.0 0 + 9.4% of anything over
$ 8,958.00

Child Support Presumptive Guidelines Computation Fo rm
Revised October 2012
Page 2 of 4

2
DO NOT FILE WITH CONFIDENTIAL FINANCIAL AFFIDAVIT.
FOR COMPUTATION PURPOSES ONLY. EFF ECTIVE JULY 1, 2005.
CHILD SUPPORT COMPUTATION FORM

A. COMPUTATION OF BASIC SUPPORT OBLIGATIONS: WYO. STAT. §20 -2-304
1. Mother's Net Monthly Income: $
2. Father's Net Monthly Income: $
3. Combined Net Monthly Income: $
4. Using the support tables for presumptive support at Wyo. Stat. § 20 -6-
304 (a) the basic joint support obligation of the pare nts.
$
5. Mother's Proportionate Share:
Line 1/Line 3 x Line 4 =
$
6. Father's Proportionate Share:
Line 2/Line 3 x Line 4 =
$
$

SUPPORT
DUE

NOTE: If the custody of the children is shared or split as defined under Wyo. Stat. § 20 -2-304 (c) and
(d) other formulas apply. If “split” (meaning each parent has physical custody of at least one (1) child,
the amount shall be allocated to each parent based upon the number of those children in the physical
custody of that parent (See subsection C below). If “shared” with each parent having actual overnight
custody of the children for a certain percentage of time, the amount will be allocated based on the
percentage of time, see below.

B. SHARED CUSTODY: Wyo. Stat. § 20 -2-304 (c) provides f or special support computation of
support when each parent keeps the children 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 child support. If this is the custodial arrangement, support may be computed as follows
assuming all other statutory provisions apply.
7. a) Percent of year children will
reside overnight with mother.
____ % b) percent of year children will
reside overnight with father.
____ %
8. Mother's support obligation: Line 5 x Line 7b $ ____________
9. Father's support obligation : Line 6 x Line 7a $ ____________
10. MONTHLY SUPPORT DUE: The difference between lines 8 and 9
represents the net monthly support due from the parent having the
greater support obligation.
$ ____________

Child Support Presumptive Guidelines Computation Fo rm
Revised October 2012
Page 3 of 4

C. SPLIT CUSTODY: Wyo. Stat. §20 -2-304 (d) provides for special computations of support
when each parent has physical custody of at least one (1) child. In such cas es the support should be
computed as follows:
11. Joint presumptive support per child:
Line 4 ÷ Total children of parents.
$ ____________
12. Mother's support obligation for children in custody of father: Line
1/Line 3 x Number of children with father x Line 11
$ ____________
13. Father's support obligation for children in custody of mother: Line
2/Line 3 x Number of children with mother x Line 11
$ ____________
14. MONTHLY SUPPORT DUE: The difference between lines 12 and
13 represents the net monthl y support due from the parent having the
greater support obligation.
$ ____________

Child Support Presumptive Guidelines Computation Fo rm
Revised October 2012
Page 4 of 4

DO NOT FILE WITH CONFIDENTIAL FINANCIAL AFFIDAVIT. FOR COMPUTATION PURPOSES ONLY.

NET INCOME CALCULATION WORKSHEET FOR CHI LD SUPPORT

A. For Employed Persons:

1. Gross income* (amount before any deductions): $ per month
2. Federal Income Tax: $ per month
3. State Income Tax: $ per month
4. Social Security Tax (FICA): $ per month
5. Medicare Tax: $ per month
6. Mand atory Retirement/Pension: $ per month
7. Premium Paid for Child(ren)’s Health Insurance: $ per month
8. Child Support Actually Paid for Other Children: $ per month
(Do not include payments towards back child support)
Total Mandatory Deductions : $ per month

9. Net Income (line 1 minus lines 2 - 8): $ per month

B. For Self -Employed Persons:

1. Gross income* (amount before any deductions): $ per month
2. Federal Income Tax: $ per month
3. State Income Tax: $ per month
4. Social Security Tax: $ per month
5. Medicare Tax: $ per month
6. Unreimbursed Business Expenses: $ per month
7. Premium Paid for Child(ren)’s Health Insurance: $ per month
8. Child Support Actually Paid for Other Children: $ per month
(Do not include payments towards back child support)
Total Mandatory Deductions : $ per month

9. Net Income (line 1 minus lines 2 -8): $ per month

C. For Unemployed Persons Who Are Capable of ONLY Earning Minimum Wage:

1. Imputed Net Monthly Income (Custodial Parent): $1,185.67 per month
2. Imputed Net Monthly Income (Non -custodial Parent): $1,141.25 per month
Net Income for Plaintiff/Petitioner : $ per month
Net Income for Defendant/Respondent : $ per month

*Gross Income: Gross income is your income from all sources, including, but not limited to, wages, draws,
commissions, bonuses, social security payments, workers’ compensation payments, etc. Please give the amount that you
make monthly even if you are paid annually, twice a month, weekly, etc. Monthly amounts are calculated by
multiplying weekly amount by 52 and dividing by 12; multiplying bi -weekly amounts by 26 and dividing by 12; and
multiplying semi -monthly amounts by 24 and dividing by 12.

Reply to Counterclaim
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 nam e) )
)
vs. )
)
Defendant:__________________________. )
(Spouse) (Print name)

REPLY TO COUNTERCLAIM

Plaintiff hereby replies to Defendant’s Counterclaim for Divorce as follows:

1. Plaintiff admits the allega tions in Par agraphs
(list paragraphs that are accurate statements)
of Defendant ’s Co unterclaim for Divorce .

2. Plaintiff denies the allegations in Paragraphs
(list paragraphs that you believe are not accurate )
of Defendant ’s Co unt erclaim for Divorce .

3. Plaintiff does not have information sufficient to either admit or deny the

allegations in Paragraphs of Defendant ’s
(list paragraphs that you don’t know are accurate or not )
Co unterclaim for Divorce .

WHEREFORE , Plainti ff respectfully requests that the court find generally in
her/his favor and against the Defendant , that Defendant take nothing by way of his/her
Co unterclaim for Divorce , and for such other and further relief as the court deems just
and proper.
DATED thi s _______ day of ___________________________, 20___.

Signature, Plaintiff
Printed Name:
Address:

Phone:

Reply to Counterclaim
Revised October 2012
Page 2 of 2
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 t he 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, post age pre -paid, and
addressed to the following:

(Print Defendant/Defendant’s Attorney’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
followi ng 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:
______________________________ ____
__________________________________
__________________________________
__________________________________

Application for Entry of Default
Revised October 2012
Page 1 of 1
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)

APPLICATION FOR ENTRY OF DEFAULT

The Plaintiff submits this Application for Entry of Default for a default judgment
against the Defendant, who was served with a copy o f the Summons and Complaint on
______________ (date ), and has failed to answer the Plaintiff’s Complaint for Divorce
filed in this case or otherwise appear and respond, and the time allowed by law for
answering or otherw ise responding has now expired. Appl ication is made to enter the
default against the Defendant according to law.
DATED this ______ day of _________________, 20_ __ _.

Signature
Printed Name:
Address:
Phone Number:

Subscribed and sworn to before me on this ____ day of ____________________,
20___.

WITNESS my hand and official seal.

_________________________________
Notarial Officer

My commission expires:

Affidavit in Support of Default
Revised October 2012
Page 1 of 2
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)

AFFIDAVIT IN SUPPORT OF DEFAULT

STATE OF WYOMING )
) ss.
COUNTY OF ________________ )

The Plaintiff ______________________________, who is of lawful age
(pri nt name)
and being first duly sworn deposes and states as follows:

1. Plaintiff has filed a Complaint for Divorce in this case.

2. Defendant was served with a copy of the Complaint for Divorce and Summons by
one of the following methods:

The Defendant was served with a copy of the Complaint for Divorce and
Summons by a duly authorized Deput y or the Sheriff of ___________ County,
State of ____________________ on _________________ _____ .
(insert date)
OR

The D efendant filed an Acknowledgment and Acceptance of Service
acknowledging that on _________ ____ __________________ he/she received a
(insert date)
copy of the Complaint for Divorce and the Summons .

An Affidavit to Allow Service by Publication was filed and the Defendant
was served by publication in the ________________________ Newspaper on the
following dates: ______________________________.

Affidavit in Support of Default
Revised October 2012
Page 2 of 2
OR

The Defendant was served with a copy of the Complaint for Divor ce and
Summons by Certified Mail, Restricted Delivery, Return Receipt requested on
______________________ ___________ , as evidenced by the green postal
(insert date)
signature card (attached ).

3. More than 20 days (if served in Wyoming) ; 30 days (if served outside of
Wyoming , by publication or by Certified Mail), excluding the day of service, has elapsed
since the date of service.

4. That the Defendant failed to answer or otherwise plead as required by law. The
Defe ndant is not a minor nor incompetent and is not in the military service of the United
States. This Affidavit is executed for the purpose of enabling Plaintiff to obtain an Entry
of Default against the Defendant.

DATED this ______ day of ________________ _, 20___.

Signature
Printed Name:
Address:
Phone Number:

Subscribed and sworn to before me b y _______________________________ this
_____ day of _______________, 20_ __ _.

Witness my hand and official seal.

________________ ______________
Notarial Officer
My Commission Expires:

Entry of Default
Revised October 2012
Page 1 of 1
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)

ENTRY OF DEFAULT

The Clerk of District Court, pursuant to the Plaintiff’s OR Defendant’s
Application for Entry of Default and Affida vit in Support of Default , does hereby enter
default against the Plaintiff OR Defendant for failure to plead or otherwise defend
as provided by the Wyoming Rules of Civil Procedure, as appears from examination of
the re cords and files herein or the return upon the original Summons filed in this cause.
DATED this _____ day of ________________________, 20___.
CLERK OF THE DISTRICT COURT

BY: ____________________________________

Copies to:

Plaintiff/Plaintiff’ s Attorney’s Name and Address

Defendant/Defendant’s Attorney’s Name and Address

Affidavit for Divorce with Children
Revised October 2012
Page 1 of 8
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)

AFFIDAVIT FOR DIVORCE WITHOUT APPEARANCE OF PARTIES
(With Minor Children)

(Only use if the parties have reached an agreement and both have signed the Decree of
Divorce or if either party defaulted and all default paperwork has been presented to the
court and an Entry of Default issued .)

STATE OF WYOMING )
) ss.
COUNTY OF _____________ )

_____________________________________, being first duly sworn, deposes and says:
(Print Name )

1. I am the Plaintiff Defendant in the case .

2. Plaintiff resided in the State of Wyoming for more than 60 days immediately prior
to filing the Complaint for Divorce in this case.

3. The Plaintiff Defendant and I were married to each other on the _____ day
of __________ _, ____________ in ____________ , ________________ ___ .
(Month) (Year) (City) (State)

4. Plaintiff is currently a re sident of County, State of _________ ____.

5. Defendant is currently a resident of County, State of _____________ _.

6. Plaintiff and Defendant are the parents, either natural or adoptive, of child(ren)
who are either under 18 years of age, between the ages of 18 and 20 years and still
in high school or a pr ogram equivalent to high school, or prevented from
supporting him/herself due to a mental, emotional or physical impairment.

Affidavit for Divorce with Children
Revised October 2012
Page 2 of 8
Child’s Initials : Year of Birth :
Child’s Initials : Year of Birth :
Child’s Initials : Year of Birth :
Chil d’s Initials : Year of Birth :
7. To the best of Plaintiff’s knowledge,
Wife is not pregnant, OR
Wife is pregnant (If pregnant, consult an attorney. 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 chil d, OR
Defendant is not the biological parent of the child.

8. Irreconcilable differences exist in the marriage .

9. The Wife
does not desire to have her former name restored ; OR
her former name restored to:
(list first, middle, and last name desired)

10. The Decree of Divorce equitably distributes the property and de bt
acquired during our marriage. In support of this assertion I am submitting the following
evide nce :

A. Debts (For Party Designation use : "P" = Plainti ff, "D " = Defendant , "J" = Joint)

PRINT CLEARLY OR TYPE
Party
Paying
Debt
Creditor and
Acct. #
Name(s) on
Account
Date of
Balance
Balance Main Purchase(s)
for Which Debt
Was Incurred
$
$
$
$
$
$
Add additional sheets, if necessary. Clearly identify any attached documents.
Total Debt of Plaintiff: $
Total Debt of Defendant: $

Affidavit for Divorce with Children
Revised October 2012
Page 3 of 8
B. Real Estate (For Party Designation use : "P" = Plainti ff, "D " = Defendant , "J" = Joint)

PRINT CLEARLY OR TYPE
Party Paying Debt
Property Type Owned and Address (residence, condo, rental, etc.)
Name(s) on Title
Fair Market Value
Basis of Fair Market Value (i.e., appra isal, estimate, purchase price, )
1st Mo rtgage 2nd Mortgage

Add additional sheets, if necessary. Clearly identify any attached documents.
Total Debt of Plaintiff: $
Total Debt of Defendant: $

C. Motor Vehicles (For Party Designation use : "P" = Pl ainti ff, "D " = Defendant , "J" = Joint)

PRINT CLEARLY OR TYPE
Party Keeping Vehicle
Year, Make, Model and VIN Name(s) on Title Name of Creditor Fair Market Value Amount of Debt

Add additional sheets, if neces sary. Clearly identify any attached documents.
Total Debt of Plaintiff: $
Total Debt of Defendant: $

D. Cash on Hand, Bank, Checking, or Saving Accounts, CD’s (For party designation
use: "P" = Plaintiff, "D" =Defendant or "J" = Joint)

PRINT C LEARLY OR TYPE
Party
Keeping
Property
Type of
Account
Name of Bank Account No.
(Last 4
Digits Only)
Date of
Balance
Balance

Affidavit for Divorce with Children
Revised October 2012
Page 4 of 8

Add additional sheets, if necessary. Clearly identify any attached documents.
Amount to Plaintiff: $
Amount to Defendant: $

E. Furniture and Household Goods ("Value" equals what you could sell it for in
its current condition, such as at auction, not what you paid for it or cost of replacement.)

PRINT CLEARLY OR TYPE
Descripti on of Items -
Household furnishings and
personal belongings (clothes,
jewelry, etc.)
Value of Plaintiff’s
Possessions
Value of Defendant’s
Possessions
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
TOTAL: $ $
Add additional sheets, if necessary. Clearly identify any attached documents.

F. Miscellaneous/Other Assets or Interests (not listed above) List all other assets,
including life insurance, stocks, bonds, retirement benefits, income tax refunds owing,
money owed to you, livestock, guns, etc. as distributed in the Decree.
PRINT CLEARLY OR TYPE (For party designation use: "P" = Plaintiff, "D" =Defendant or "J" =
Joint)
Party Keeping
Property
Description Account, serial or
other identi fying
number, if any - Last
4 Digits Only
Value

Affidavit for Divorce with Children
Revised October 2012
Page 5 of 8

Add additional sheets, if necessary. Clearly identify any attached documents.
Amount to Plaintiff: $
Amount to Defendant: $

11. Please list why the distribution of property and debts listed above is “equitable.”
The Wyoming Supreme Court has held that a just and equitable distribution does not
necessarily mean “equal.”

12. The Decree of Divorce sets forth provisions for child custody , visitation , parental
decision -making and child support that I believe is in our child(ren)’s best interest(s). In
support of this statement, I provide the following evidence, under oath and to the best of
my information and belief . Please address as many of the following factors as possible in
your explanation of why the Decree serves the child(ren)’s best interests:

(i) The quality of the relationship each child has with each parent:

(ii) The ability of each parent to provide adequate care for each child
throughout each period of responsibility, including arranging for each child's care by
others as needed:

(iii) The relative competency and fit ness of each parent:

(iv) Each parent's willingness to accept all responsibilities of parenting,
including a willingness to accept care for each child at specified times and to relinquish
care to the other parent a t specified times:

Affidavit for Divorce with Children
Revised October 2012
Page 6 of 8

(v) How the parents and each child can best maintain and strengthen a
relationship with each other:

(vi) How the paren ts and each child interact and communicate with each other
and how such interaction and communication may be improved :

(vii) The ability and willingness of each parent to allow the other to provide
care without in trusion, respect the other parent's rights and responsibilities, including the
right to privacy:

(viii) Geographic distance between the parents' residences:

(ix) The current physic al and mental ability of each paren t to care for each
child:

(x) Any other factors you want the court to consider necessary and relevant :

(xi) T he law requires the court to consider evidence of spousal abuse (domestic
violence) or child abuse as being contrary to the best interest of the children. Please state
whether or not there has been any domestic violence or abuse in the relationship and
whe ther the Decree adequately makes arrangements for visitation that best protects the
child(ren) and the abused party from further harm :

Affidavit for Divorce with Children
Revised October 2012
Page 7 of 8

I request the court grant me a divorce.

OATH

I affirm that this Affidavi t (including attached sheets, if relevant ) contains a
complete disclosure , to the best of my information and belief, of all items of property in
which my spouse and I have any current interest or expect to receive in the future based
upon the work or event s that took place during the marriage, and all liabilities for which I
am aware that either of us could be held personally responsible. I also affirm that the
representations made herein concerning my income and expenses , and that of my spouse,
are accura te to the best of my knowledge. I am aware that should the information
provided herein prove to be fraudulent or contain material misstatements or omissions,
whether inadvertent or intentional, or be found to be inaccurate, the court shall have
continuing jurisdiction to enter such orders as it considers necessary in equity and law to
determine the rights and duties with regard to that property right or obligation. I am also
aware the court may punish as perjury any materially false statements knowingly mad e
with intent to defraud or mislead.

Signature
Printed Name:
Address:

Phone Number:

Subscribed and sworn to before me by ____________________________ on this
_____ day of ____________________, 20____.

Wi tness my hand and official seal.
__ ____________________________
Notarial Officer / Court Clerk

My Commission Expires:

Affidavit for Divorce with Children
Revised October 2012
Page 8 of 8
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 tru e 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 fol lowing:

(Insert Defendant/Defendant’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 Plaintiff, ____________________ (name) requests a time and date for a
hearing /trial in the District Court. The hearing /trial wi ll take approximat ely ________
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 be fore 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 hearing 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 issue s:
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
Requi ring 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 se t 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 all civil matters including jury trials.

Request for Setting
Revised October 2012
Page 2 of 2
Payment of the statutory 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 t o the Wyoming State Treasurer. If a hearing is not
record ed by a n official co urt 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 docu ment
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 Uni ted States mail, postage pre -paid, and
addressed to the following:

(Insert Defendant/Defendant’s Attorney’s Name and Address)

TO: ______________________________________

______________________________________

___________________________ ___________

Your signature

Print name

Order Setting Hearing
Revised October 2012
Page 1 of 1
STATE OF WYOMING ) IN THE DISTRICT COURT
) ss
COUNTY OF ________________ ) _______________ JUDICIAL DISTRICT

Plaintiff:____________________________, ) Civil Action Case No. __________
(Print name of person filing) )
)
vs. )
)
Defen dant:__________________________. )
(Spouse) (Print name)

ORDER SETTING HEARING

THIS MATTER having come before the Court upon a Request for Setting , and the Court
being generally advised in the premises;
IT IS HEREBY ORDERED tha t a hearing on the Complaint for Divorce (or other items
indicated in the Request for Setting ) 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 asid e for
the trial of this matter. There will be no continuances or canceling of the hearing date based on
telephone calls.
DATED this ______ day of ___ ________ , 20____ .

___________________ ______________________
DISTRICT COURT JUDGE

Copies 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 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____ .

_______________ __________________________
DISTRICT 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 in cluded:
1. Personal data and history 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 identity 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, all
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 e mployability. 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 an d statement of present salability. (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 dete rmination
of the issues.

SECTION “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 di vorce," the reasons for that
position.
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 s pecific summary of expected testimony.
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

Plaintiff 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 time
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, toge ther 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 excused 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 Defendant/Defendant’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 need ed

Decree of Divorce (with Children) Revised October 2012 Page 1 of 18
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)

DECREE OF DIVORCE WITH MINOR CHILDREN

NOTE: ALL APPLICABLE BOXES MUST BE CHECKED OR THE JUDGE
WILL NOT SIGN YOUR DECREE.

This matter came before the Court by :
Default (and Entry of Default has been issued) ; OR
Agreement of the parties (b oth parties have signed this Decree ); OR
Trial

1. The Plaintiff lived in Wyoming sixty ( 60 ) days or more immediately before filing
the Complaint for Divorce .

2. The child(ren) lived in the State of Wyoming for a period of six (6) months or
more immediately before filing the Complaint for Divorce .

3. The Defendant was served :
Personally (by the sheriff) on ____________ __ ; OR
(Date)
Defendant accepted service ( Acknowledgement and Acceptance of Servic e
must be filed ); OR
By publication (Copy of Affidavit of Publication must be filed ); OR
By Registered or Ce rtified Mai l (R eturn receipt must be filed and Clerk must
have entered certificate of service .)

4. At least twenty (20) days have passed since the Complaint for Divorce was filed.

5. Defendant filed
an Answer
an Answe r and Counterclaim
no response (default must be entered , unless there is a waiver of right to
answer )

Decree of Divorce (with Children) Revised October 2012 Page 2 of 18
no response but both parties have signed and agreed to the entry of this
Decree of Divorce.

6. The parties were married to each other on the _____ day of _____________,
(month)
_______, in .
(year) (City, County and State)
7. The parties have irreconcilable differences constituting grounds for divorce.

8. The parties are the natu ral or adoptive parents of the following minor child(ren) :

Child’s Initials : Year of Birth :
Child’s Initials : Year of Birth :
Child’s Initials : Year of Birth :
Child’s Initials : Year of Birth :
Additional sheets of paper ar e attached if needed

9. This court has jurisdiction in all necessary particulars of this case .

10. Custody of the child(ren) should be as follows:

The parties have joint legal and joint physical custody; OR
The parti es have joint legal custody and Mother or Father has physical
custody; OR
Mother or Father has sole legal and physical custody; OR
Other (Please describe d esired legal and physical custody arrangement in
detail) __________________________________________________________________
________________________________________________________________________
___________________________________________________________ _____________

11 . The parties have an obligation to contribute to the support of the parties’ minor
child(ren).

12. To the best of Plaintiff’s knowledge,
Wife is not pregnant, OR
Wife is pregnant (If pregnant, consu lt an attorney. Your divorce may not
be able to be final until after the baby is born) and
Unless defined another way in this Decree, “Joint Legal Custody” means that both parties have access
to t he records of the child(ren) including school records, activities, teachers and teachers' conferences ,
as well as medical and dental treatment providers and mental health records . Both parties have these
rights unless the Court limits that access .

Decree of Divorce (with Children) Revised October 2012 Page 3 of 18
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.

13. The parties
have acquired property and debts during the marriage and th e division set
forth below in this Decree is just and equitable ; OR
did not acquire any property or debts during the marriage.

14. The Court should order that
No party is entitled to alimony/spousal support ; OR
The Wife shall pay to the H usband reasonable alimony ; OR
The Husband shall pay to the W ife reasonable alimony .

15. The Wife
does not desire to have her former name restored ; OR
wants her former name restored to: _________________________________
(list first, middle, and last name desired)

IT IS THEREFORE ORDERED:

1. That Plaintiff or Defendant is awarded a Decree of Divorce and a divorce
is granted .

2. CHILD CUSTODY, VISITATION AND SUPPORT:

A. Custody :

The parties shall have joint legal and physical custody. The parties shall
share physical custody of the minor children as described on the attached shee t of
paper.
Attach a schedule describing the sharing of physical custody.
Skip to Section C – Child Support; OR

The parties shall have joint legal custody and Mother or Father
shall have physical custody; OR

Mother OR Father shall have sole legal and physical custody . List
the reasons why joint legal custody is not appropriate :

Decree of Divorce (with Children) Revised October 2012 Page 4 of 18
Other (Please describe desired legal and physical custody arrangement
in detail): ___________________________________________________
___________________________________________________________
___________________________________________________________

B. Visit ation :

The child(ren) shall spend time with the non -custodial parent as the parties may
agree, but if they cannot agree, then time shall be spent with the child(ren) as follows:

B.1. WEEKENDS : The child(ren) shall spend time with M other OR
Father every weekend every other weekend when Friday is an even date
every other weekend when Friday is an odd date other (specific weekends
such as 1 st and 3rd):
from a.m./p.m. to a.m./p.m.

B.2. OTHER VISITATION : In addition to the Weekend visitation above, the
child(ren) shall also spend time with Mother OR Father as follows (specify
sp ecific da ys and times such as each Wednesday from 4:00 p.m. to 8:00 p.m.,
etc.):

Additional sh eets of paper are attached (if necessary).

B.3. SUMMER SCHEDULE : (Choose one)

Option 1: Mother OR Father shall have visitation with th e parties’
child(ren) beginning and continuing
until (i.e. ten days
after school lets out from 5:00 p.m. and continuing until ten days prior to school
starting up again at 5:00 p.m.).

The other parent shall have the same Weekend and Other Visitation as described
in paragraphs B.1 and B.2 above during the summer; OR

Option 2: The summer schedule will remain the same as during the
school year ; OR

Option 3: The summer schedule will be as follows:

Additional sh eets of paper are attached (if necessary).

Decree of Divorce (with Children) Revised October 2012 Page 5 of 18
B.4. HOLIDAY SCHEDULE : The following holiday schedule will take priority
over the regular weekday, weekend, and summer schedules described above. Fi ll
in the blanks below with Mother or Father to in dicate who the child(ren) will be
with for the holidays. Provide beginning and ending times. If a holiday is not
specified as even, odd, or every year with one parent, then the child(ren) will
remain with the parent they are normally scheduled to be with.

(Be very specific about the days, times, and location where exchanges will take place)

Holiday/Event Parent Spending Time with Child(ren) (Mother or Father)
Odd numbered years Even numbered years Every Year Time & Place of exchange
Mot her’s Day

Memorial Day

Father’s Day

July 4 th

Labor Day

Thanksgiving
Break
First Half Second Ha lf Entire Vacation None
First Half Second Half Entire Vacation None
First Half Second Half Entire Vac ation None

Christmas First Half Second Half Entire Vacation None
First Half Second Half Entire V acation None
First Half Second Half Entire Vacation None

Spring Break

First Half Second Half Enti re Vacation None
First Half Second Half Entire Vacation None
First Half Second Half Entire Vacation None

Child(ren)’s
Birthdays

Religious
Events

Other Holiday or
Event

Additional sh eets of paper are attached (if necessary).

B.5. OTHER (inc luding no visitation or supervised visitation) : If you
require a schedule that is difficul t to explain in the format above or if your
situation is unique such that visitation is not appropriate or requires supervision ,
please provide a detailed visitation schedule that fits your needs or an explanation
of why visitation is not appropriate on a separate sheet of paper and attach it.

Decree of Divorce (with Children) Revised October 2012 Page 6 of 18
B.6. TEMPORARY CHANGES TO THE SCHEDULE : Any schedule for
sharing time with the child(ren) may be changed as long as both pare nts agree to
the changes ahe ad of time, in writing.

B.7 . PERMANENT CHANGES TO THE SCHEDULE : Once the judge signs
the final Decree of Divorce in your case and approves this Visitation Plan, any
permanent changes must be agreed to by both parties or modi fied by the court.

B.8 . PARENT -CHILD COMMUNICATION : Both parents and child(ren)
shall have the right to communicate by telephone, in writing or by e -mailing
during reasonable hours without interference or monitoring by the other parent,
unless othe rwise ordered by the Court .

B.9 . MUTUAL RESPECT : Parents will not say things or knowingly allow
others to say things in the presence of their child(ren) that would take away the
child(ren)’s love and respect for the other parent such as saying negative th ings
about the other parent.

B.10 . OTHER TERMS : Add any other items regarding the child(ren) you
would like to include concerning visitation .

Additional sh eets of paper are attached (if necessary).

B.11 . EXCHANGE OF CHILD(REN)/ COST OF TRANSPORTATION :
Both parents shall have the child(ren) ready on time with sufficient clothing
packed and ready at the agreed -upon time of exchange. All clothing that
accompanied the child(ren) shall be returned to the other parent. All
transportation in connection with the visiting parent’s exercise of his/her visitation
shall be the responsibility of and/or paid for as follows:

Option 1: While both parents continue to reside within ____ miles of
each oth er, both parents shall be responsible for transportation costs for one -way
of the children’s transportation. Mother Father shall pick up the child(r en)
from ________________________________ _ at the beginning of the visit ation
(location)
and Mother Father shall pick up the child(ren) at the end of the visitation
from . If either party moves _________ miles or
(location)
more away, then the costs for transportatio n shall be as follows:

; OR

Option 2 : The visiting parent shall be responsible for all of the child(ren)’s
transportation costs; OR

Decree of Divorce (with Children) Revised October 2012 Page 7 of 18
Option 3 : Other: (provide details exchange and transportation cost s):

ONCE FILED, THE PART IES MAY ONLY MAKE SUBSTANTIAL, PE RMANENT
MODIFICATIONS TO THI S VISITATION PLAN BY WRITTEN AGRE EMENT SIGNED BY
BOTH PARTIES , APPROVED BY THE JU DGE AND FILED WITH THE C OURT. MINOR,
TEMPORARY CHANGES MAY BE MADE ANY TIME ONLY IF BOTH PARTIES AGRE E
TO THE CHANGES.

C. CHILD SUPPORT:

In accordance with W yo . Stat . § 20 -2-304, presumptive child s upport is calculated as
follows :
a. Number of children: _______
b. Father’s net monthly income is: $_______
actual (Father submitted a Confidential Financial Affidavit ); OR
imputed (Father did not submit a Confidential Financial Affidavit )
c. Mother’s net monthly income is: $_______
actual (Mother submitted a Confidential Financial Affidavit ); OR
imputed (Mother did not submit a Confidential Financial Affidavit )
d. Total child support obligation of both parents is: $_______
e. Father’s presumptive child support obligation is: $_______
f. Mother’s presumptive child support obligation is: $_______

C.1. Restriction on reducing amount of child support: No agreement which is
less than the presumed child support amount in the law shall be approved if public
Th e child support amount may depend on the custodial arrangement that is ordered by the court. If
each parent keeps the children overnight for more than forty percent (40%) of the year and both
parents contribute substantially to the expenses of the childre n in addition to the payment of child
support, a “joint presumptive support ” obligation shall be determined by use of the tables. Also, when
each parent has physical custody of at least one (1) of the children, a “shared presumptive support ”
obligation fo r all of the children shall be determined by use of the tables. See Wyo. Stat. §20 -2-304(c)
and (d) . For assistance in calculating child support, go to the following website :
http://www.laramiecounty.com/_departments/_district_court/calculator.aspx or call your local child
support enforcement agency .

Decree of Divorce (with Children) Revised October 2012 Page 8 of 18
support/benefits (such as aid under the personal opportunities with employment
responsibilities (POWER) program, Title 19, Kid Care , food stamps,
supplemental security income (SSI) or other similar benefits ) are being paid on
behalf of any of the child (ren ). CHECK ONE :
The child(ren) receive(s) public assistance ; OR
The child(ren) DO NOT receive(s) any public assistance .
C.2 . Amount of Child Support : M other OR Father shall pay
$_________ per month for child support. The amount of child support is based
upon:
The presumptive amount of child support determine d by Wyoming’s
Child Support Guidelines ; OR
There is a deviation (an adjustment) upwards or downwards from
the pr esumptive amount. (In order to deviate, t here must be a specific finding
that the application of the presumptive child support would be unjust or
inappropriate ). Th e reasons that the presumptive amount is unjust is because
(lis t the specific reasons) :

C.3 . Time of Payments : Child support payments shall begin:
On THE FIRST DAY OF THE MONTH beginning the month of
, 20 and shall continue to be paid on the first day of
the month thereafter, until further order of the court; OR
beginning on the ____ day of _____________, 20_______and continuing
as follows: .

C.4 . CONTINUATION OF CHILD SUPPORT: Child support shall continue
during the minor child’ s minority, and beyond if the child has a mental, emotional
or physical impairment preventing emancipation, or while the child is attending
high school or an equivalent program as a full -time student between the ages of
18 and 20. Child support shall terminate if, during the child’s minority, the child
marries, is emancipated, becomes self -supporting or dies.

C.5 . PLACE: All child support payments shall be paid to the Clerk of District
Court, whos e address i s:______________________________ (See Dist rict Court
Clerks’ Addresses in the packet) . The Clerk shall forward the support payments
to the receiving parent at the address provided by that parent to the Clerk. DO
NOT PAY WITH A PERSONAL CHECK. CASH ACCEPTED IN PERSON
ONLY. CASHIER’S CHECKS AND MO NEY ORDERS ACCEPTED.

C.6 . MODIFICATION: Either party may seek a modification of the child
support ordered herein pursuant to Wyo. Stat. §20 -2-311.

Decree of Divorce (with Children) Revised October 2012 Page 9 of 18
MO DIFICATION OF CHILD SUPPORT IS NOT EFFECTIVE UNLESS
IT IS APPROVED BY A WRITTEN ORDER SIGNED BY THE JUD GE.

C.7 . ABATEMENT OF CHILD SUPPORT (Temporary Reduction in
Child Support ): Wyo. Stat. §20 -2-305 says child s upport may abate or decrease
by one -half (1/2) of the daily support obligation for each day the noncustodial
parent has physical custody of the child for whom support is due, ONLY IF the
noncustodial parent has custody of the child for more than fifteen (15)
consecutive days and if approved by the Court.

REQUIREMENTS:
A. The non -custodial parent MUST FILE any claim for child support
abatem ent with the clerk o f the court within thirty (30) days after
the period for which abatement is clai med and must pay ten dollars
($10.00) to the clerk when filed.
B. The clerk will then mail a copy of the claim to the custodial parent.
C. The custodial parent can object or dispute any abatement claim by
filing an objection with the clerk of court within thirty (30) days of
the date the clerk mailed the notice to the custodial p arent and
paying ten dollars ($ 10.00) to the clerk.
D. The clerk will mail a copy of the objection to the noncustodial
parent.
E. Claims or objections not filed in a timely manner or not
accompanied by the ten dollar fee will be rejected .

C.8 . ENFORCEMENT: Wyoming law states that any payment of child
support not paid when due shall automatically become a judgment against the
parent who is supposed to pay on the due date. This judgment is subject to a 10%
late payment penalty if it is not paid within thirty -two (32) days.

3. MEDICAL INSURANCE :

The Mother or Father or Both parents shall provide health care insurance
coverage for the minor child (ren ) if insurance can be obtained at a reasonable cost and
the benefits under the insurance policy are accessible to the child (ren ).

3.A. Proof. The insuring parent shall provide to the Court written proof that
the insurance has been obtained within sixty (60) days after it became
available . Proof of insurance coverage shall contain, at a minimum:

i) The name of the insurer .
ii) The policy number .
iii) The address to which all claims should be mailed .

Decree of Divorce (with Children) Revised October 2012 Page 10 of 18
iv) A description of any restrictions on usage, such as pre -approval for
hospital admission, and the manner in which to obtain pre -
approval .
v) A description of all deductibles .
vi) Two (2) copies of claim forms.

3.B. Changes. The insuring parent shall provide written notice to the Clerk of
this Court and the other parent if insurance coverage for the child is
denied, revoked, or altered in any way that would affect the child's
coverage, including any change relating to the information required above.

3.C. Failure To Provide Insurance . The Court may hold a parent in contempt
for refusing to provide the ordered insurance or for failing or refusing to
provide the information req uired above. In addition, if either parent fails
to provide insurance or proof of insurance as required by this agreement,
the other parent may provide such insurance and the parent who was
supposed to shall be responsible to pay to the other parent the c ost of such
insurance plus the costs that parent had to pay for collection, including
reasonable attorney ’s fees.

3.D. Costs Not Paid For By Insurance . All deductibles, co -payments and other
expenses for health care that are not paid for by health insura nce shall be
paid by the parents as follows:

50% each by Mother and Father ; OR
% by Mother and % by Father.

i) If the insuring parent fails to pay the insurance premium, all health
care expenses of the children not covered by insurance shall be the
responsibility of that party.

ii) If the insuring parent fails to maintain insurance as required, that
party may be found in Contempt of Court and may be required to
pay or reimburse the expenses and costs set forth i n Wyo. Stat.
§20 -2-401(e).

4. CHANGES IN ADDRESS AND EMPLOYMENT:

Each parent shall inform the other parent and the clerk of court in writing of any
change of address, phone number, and employment:

4.A. CHANGE OF EMPLOYMENT STATUS : So long as there is a c hild
support obligation, each parent shall notify the other parent and the Clerk of this
Court, in writing, on forms available from the Court, within fifteen (15) days of
any change in employment, including second jobs, changed employers, starting or

Decree of Divorce (with Children) Revised October 2012 Page 11 of 18
endin g unemployment compensation, and starting or ending of worker’s
compensation, or any other change in income.

4.B. CHANGE OF ADDRESS : So long as there is a child support obligation, if
either parent plans to change his or her address, that parent must n otify the other
parent and the Clerk of this C ourt, in writing, on forms available from the Clerk
of this Court, no later than fifteen (15) days prior to the day of the move, the
destination of the move and the proposed move date.

4.C. CHANGE OF HOME CITY O R STATE OF RESIDENCE : Either
parent who plans to change their home city or state of residence, must give
written notice thirty (30) days prior to the move , both to the other parent and to
the clerk of district court stating the date and destination of th e move .

5. INCOME WITHHOLDING ORDER :

An income withholding order shall be entered and shall become effective as
follows:

Effective immediately (Recommended ); OR
Effective upon the date the Obligor (person who has to pay) requests
withholding commence; or the date the Obligor is at least one (1) month behind in child
support payments . L ist the reasons why good cause exists to delay the effective date for
withholding incom e:
; OR
OT HER (i.e. Military allotment) .

6. DIVISION OF PROPERTY:

The parties’ property shall be equitably divided as follows:

Wife’s Property:

6.A.1. The W ife shall have as her sole and separate property, free and clear of
any and all cla ims by the H usband, but subj ect to any debt owing on the
property , the following :
All personal property held in her name or in her possession, except as
otherwise specifically set forth in this Decree.
All bank a ccounts, investment accounts , and retirement accounts held
in her sole name, if any, except as otherwise specifically set forth in this
Decree.
The following motor vehicle(s) (list year, make, model and VIN):

Decree of Divorce (with Children) Revised October 2012 Page 12 of 18
Husband has OR does not have a retirement account. If Husband
has a retirement account, the account shall:
not be divided with W ife; OR
be divided as follows:
50% to each party; OR
$ to W ife; OR
Other described as follows: .

Husband’s Property:

6.A.2. The Husband shall have as h is sole and separate property, free and clear of
any and all claims thereto by the W ife , but subj ect to any indebtedness
thereon, the following:
All personal property held in his name or in his possession, except as
otherwise specifically set forth in this Decree.
All bank accounts, investment accounts , and retirement accounts, held
in his sole name, if any, except as otherwise specifically set forth in this
Decree.
The following motor vehicle(s) (list year, make, model and VIN):

Wife has OR does not have a retirement account. If Wife has a
retirement account, the account shall:
not be divided with Husband; OR
be divided as follows:
50% to each party; OR
$ to Husband; OR
Other described as follows: .

Other Property:

6.A.3. The parties have no other property which requires division; OR
The parties have the following property, which shall be awarded as
follows:

List all possessions valued at $100.00 or more. For any bank accounts, identify by using
the last 4 digits of the account number .

A qualified domestic relations order (QDRO) or similar order may be required in order for
retirement accounts to be divided. It is highly recommended that you get an attorney to draft
such an order. This Court retains jurisdiction to enter, correct, or modify such orders in order
to effectuate the terms of this Decree.

Decree of Divorce (with Children) Revised October 2012 Page 13 of 18
DESCRIPTION OF PROPERTY AWARDED TO:
1. WIFE HUSBAND
2. WIFE HUSBAND
3. WIFE HUSBAND
4. WIFE HUSBAND
5. WIFE HUSBAND
6. WIFE HUSBAND
7. WIFE HUSBAND
8. WIFE HUSBAND
9. WIFE HUSBAND
10. WIFE HUSBAND
11. WIFE HUSBAND
12. WIFE HUSBAND
13. WIFE HUSBAND
14. W IFE HUSBAND
15. WIFE HUSBAND
Additional sheets of paper are attached if needed

Real Property:

6.A.4. The parties do not own any real property (i.e. house or land) ; OR
The real property shall be divided as follows:

Option 1: Wife or Husband shall occupy the real property until sold.
The property shall be listed with a real estate agency for sale no later than
(date). Upon the sale, the net equity or loss from the sale shall be divided as
follows:
% to Wife
% to Husband

Until the property is sold, the mortgage (including taxes and insurance) shall be
paid by Wife or Husband and the utilities shall be paid by Wife or
Husband; OR

Other:

; OR

Option 2: Wife or Husband shall ow n the real property. The party
receiving the real property shall pay to the other the sum of $____________ for
his/her share of equity in the property. If applicable, t he party receiving the
property shall use his/her best efforts to re finance the debt o n the property and
remove the other party ’s name from any liability for the d ebt no later than
_____________ .
(Date )

Decree of Divorce (with Children) Revised October 2012 Page 14 of 18

Once the payment has been made and the other party’ s name has been removed
from the debt, if applicable, then the other party shall con vey by appropriate deed
his /her interest in the property .

If a joint debt encumbering the real property is not refinanced no later than
__________, the property shall be listed with a real estate agent and sold for no
(Date)
less than the appraised value; OR

Option 3: Other:

7. DIVISION OF DEBTS:

NOTICE: This decree does not necessarily affect the ability of a creditor to proceed
against a party or a party’s property, even though the party is not responsible under the
terms of the decree for an account, any debt associated with an account or any debt.

Each party shall pay the debts they have accumulated since the parties’
separation. The parties shall pay the following de bts acquired prior to the separation:

Type of Debt Name of Creditor and
Last 4 Digits of
Account No.
Amount
owed
Will Be Paid By: 100% by Wife;
100% by Husband ; or 50% by Both
1. WIFE HUSBAND BOTH
2. WIFE HUSBAND BOTH
3. WIFE HUSBAND BOTH
4. WIFE HUSBAND BOTH
5. WIFE HUSBAND BOTH
6. WIFE HUSBAND BOTH
7. WIFE HUSBAND BOTH
8. WIFE HUSBAND BOTH
9. WIFE HUSBAND BOTH
Additional sheets of paper are attached if needed
Other – If the debt will be paid by both parties other than 50/50, please list how much
each p arty will pay for each debt on a separate sheet of paper and attach it.

8. DEBTS OR LIABILITIES DISCOVERED AFTER THE DECREE IS
ENTERED : If any debts or liabilities not listed above exist or become known after entry
of this Decree, the person in possessio n of the merchandise purchased, or the person who
received the services , shall be responsible for the debt.

Decree of Divorce (with Children) Revised October 2012 Page 15 of 18
9. TITLE TRANSFER: Parties shall sign all documents necessary to complete all
transfer s of title ordered in this Decree, such as motor vehicles and bank accounts.
Otherwise, t his Decree can be used as a transfer of title and can be recorded.

10 . SPOUSAL SUPPORT/ALIMONY:

No party is entitled to spousal sup port/alimony ; OR
W ife OR Husband is ordered to pay the other spouse the sum of
$________ per month spousal support/alimony BEGINNING THE FIRST DAY
OF THE MONTH beginning , 20 , and continuing to be paid on
the same day each month until the receiving party is :
rema rried; OR
deceased; OR
until .
(Date or Event)

Unless stated otherwise, spousal support/alimony payments end if the receiving
party is remarried or deceased. Payments made shall be included in receiving
spouse’s taxable income and are tax deductible from the paying spouse’s income
as required by law.

11. FILING INCOME TAX : [If Decree entered between January 1 st and April 15 th]

For previous calendar years, p ursuant to IRS rules and regulations, the parties
will file joint federal and state income tax returns and hold the other harmless
(meaning other party won’t be responsible) from half of all additional income
taxes if any and other costs, and each will sha re equally in any refunds ; OR
Separate federal and state income tax returns ; OR
Other, explain:

For this calendar year and continuing thereafter, each party will file separate
federal and state income tax returns .

12. TAX EXEMPTION : The parties shall claim as income tax dependency
exemptions on federal and state tax returns as follows :

Initials of C hild (ren) Parent Entitled to Claim Year Allowed to Claim

M other Father every odd even
Other: ______

Decree of Divorce (with Children) Revised October 2012 Page 16 of 18

M other Father every odd even
Other: ______

provided that the party required to pay child support is only entitled to claim the
exemption(s) if he/she is current on his/her child support obligation as of December 31 st
of the year in which the exemption(s) is claimed. The parties shall sign all necessary tax
forms to allow the other party to claim the exemption(s) as stated above.

13. RESTORATION OF NAME : (This is wife’s sole decision).
The wife’s for mer n ame is restored to:
; OR
(List the first, middle and last name desired)
The wife does not desire to have her name changed.

14. ENFORCEMENT OF ORDER: Either party or, when appropriat e, the
department of family services has the right to petition to enforce an order pursuant to
W yo . Stat . §20 -2-201 through 20 -2-204, 20 -2-310 and 20 -2-311(d).

Contempt - Pursuant to W yo . Stat . §20 -2-204 and 20 -2-310, a court
having jurisdiction to enforc e or revise the decree may, upon
appropriate motion of either parent, require a parent to appear
before the court and show just cause why the parent should not be
held in contempt, upon a showing that the parent has willfully
violated the decree as to the care, custody, visitation and maintenance
of the children. The court may, in addition to any assessment it may
impose upon a finding that the parent is in contempt of court, award
attorney's fees, costs, and such other and further relief as the court
may deem necessary under the circumstances, to the parent aggrieved
by the violation of the decree, in order to enforce and require future
compliance with the decree.

15. DEFAULT: In the event that either party hereto shall fail to perform, in whole
or in p art, any obligation or duty imposed by the terms of this Decree, such defaulting
party shall be responsible for the payment of all reasonable attorney's fees, costs, and
expenses incurred by the other party as a result of such failure or default.

16. EXEC UTION OF INSTRUMENTS: Each party is ordered to take all steps
necessary to carry out the terms of the Decree, including but not limited to the
execution of documents.

Decree of Divorce (with Children) Revised October 2012 Page 17 of 18
17 . LIMITED REPRESENTATION : Following Rule 1.2(c) of the Wyoming
Rules of Profess ional Conduct, any attorney who has entered a limited appearance for the
purpose of obtaining a divorce decree is now discharged.

DONE this _________ day of ______________________, 20____.

BY THE COURT:

__________________________ ______
DISTRICT COURT JUDGE

CHECK ONLY O NE BOX, AND SIGN WHERE INDICATED IN THAT
SECTION ONLY :

If the parties have agreed (both sign and have signatures notarized) :

I certify that I have read the foregoing Decree of Divorce With Minor Children
and that I understand and agree to the terms and agree to the entry of this Decree.

_________________________ _____
Plaintiff’s signature

STATE OF ______________________ )
) ss
COUNTY OF ____________________ )

Subscribed and sworn to before me by _________________________________ _,
this ______ day of _____________________, 20______.

Witness my hand and official seal
______________________________
Notarial Officer
My Commission Expires:

I certify that I have read the for egoing Decree of Divorce With Minor Children
and that I understand and agree to the terms and agree to the entry of this Decree.

_____________________________ _
Defendant’s signature

Decree of Divorce (with Children) Revised October 2012 Page 18 of 18
STATE OF _____________________ )
) ss
COUNTY OF _________________ ___ )

Subscribed and sworn to before me by _________________________________ _,
this ______ day of _____________________, 20______.

Witness my hand and official seal:
______________________________
Notarial Officer

My Commission Expires:

If default has been entered and the Defendant did not respond:

The above is true and accurate and I want the court to approve:

______________________________
Plaintiff’s signature

If a court hearing was held :

APPROVED AS TO FORM:

_______________________________ ______________________________
Plaintiff’s signature Defendant’s signature

Copies sent to:

Plaintiff/Plaintiff’s Attorney’s Name and Address

Defendant/Defendant’ s Attorney’s Name and Address

Order for Income Withholding
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 FOR INCOME WITHHOLDING

THE COURT ORDERS any payor of
(name of Obligor, person owing child support), to pay child support to
_____ __________________ (name of Obligee, person owed child support) commencing on
__________________(date). Paymen ts are due on the __________ day of every
_________________ (specify time period, i.e. monthly). Total arrears (past due support) owed as
of ________________(date) for child support is $_____________ .
The Court orders the immediate activation of an order for income withholding
against the Obligor, pursuant to Wyo. Stat. § 20 -6-204.

Income withheld must be paid to the Clerk at the following address for
forwarding to the O blige e: Wyoming Child Support Enforcement, P .O. Box
1027, Cheyenne, WY 82003.
OR
Pursuant to Wyo. Stat. § 20 -6-204, t his order for inco me withholding is not subject to
immediate activation because either:
Both parties have agreed in writing to an alternative arrangement. (When the
parties agree to an alternative arrangement, the arrangement shall be in writing,
signed by the parties and reviewed and entered in the record by the court. )
OR
The Court finds there is good cause not to require the immediate ac tivation of
an order for income withholding because: ( The court shall include in the record its
findings of good cause, including a statement explaining why implementation of
imme diate income withholding would not be in the best interests of the child and, in
cases involving modification of child support, proof of timely payments. )

Order for Income Withholding
Revised October 2012
Page 2 of 3

Any order for income withholding not subject to immediate activation sh all become
effective upon the date the O bligor requests withholding commence; or the date the O bligor
becomes delinquent in payment of an amount equal to one (1) month's support obligation under
the support order as set forth in Wyo. Stat. § 20 -6-205.
IT I S FURTHER ORDERED that upon receipt of a notice of Income Withholding for
Support , every employer or other person now or in the future owing income to the Obligor shall
comply with all terms of the notice and shall withhold a portion of the Obligor’s incom e and
remit it to the Clerk at the address in the Income Withholding for Support form.
For purposes of this order: “INCOME ” means any form of periodic payment or
return in money to an individual, regardless of source. Income includes, but is not
limited to wages, earnings, salary, commission, compensation as an independent
contractor, temporary total disability and permanent partial disability , worker’s
compensation payments, unemployment compensation, disability, annuity and
retirement benefits, and any other payment made by any payor.

Furthermore, n o employer may discharge, discipline, refuse employmen t to, or otherwise
penalize an O bligor because of this Order for Income W ithholding or a subsequently issued
Income Withholding for Support form.
IT IS F URTHER ORDERED that the payor comply with all the terms of an issued
Income Withholding for Support form and a ll subsequent notices served upon the payor ;
The last known addresses of the Obligor and O bligee are as follows:
Obligor (person owing child supp ort) : __________________________
Address: __________________________
__________________________
Obligee (person to receive child support) : __________________________
Address: __________________________
__________________________

Order for Income Withholding
Revised October 2012
Page 3 of 3
IT IS, FURTHER, ORDERED that each party shall notify the Clerk of District C ourt,
in writin g, on forms available from the C lerk, within fifteen (15) days of any changes in address
or employment status.
At the time this Order for Income Withholding is enter ed, the C lerk shall mail a copy of
the order and the support order to the last known address of the O bligor and the Obligee as
listed below .*

DATED this ______ day of _ _______ _______________, 20_ ____ _.

BY THE COURT:

______ ________________ _____________
District Court Judge

Copies sent to:

Plaintiff/Plaintiff’s Attorney’s Name and Address

Defendant/Defendant’s Attorney’s Name and Address

* Be sure to i nclude addressed/ stamped envelopes for you and the defendant when filing this Order for Income
Withholding so that copies of this Order can be mailed by the Clerk as required by law.

Document Tracking Identifier____ _____________ ___ __ __ _____________ OMB 0970 -0154

INCOME WITHHOLDING FOR SUPPORT
 ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO)
 AMENDED IWO
 ONE -TIME ORDER/NOTICE FOR LUMP SUM PAYMENT
 TERMINATION of IWO Date: _____________________
 Child Support Enforcement (CSE) Agency  Court  Attorney  Private Individual/Entity (Check One)
NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the
sender (see IWO instructions http://www.acf.hhs.gov/programs/cse/newhire/employer/publication/publication.htm#forms ).
If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlyin g
order must be attached.

State/Tribe/Territory _________________________ Remittance Identifier (include w/payment) ____________________
City/County/Dist./Tribe _______________________ Order Identifier ________________________________ __________
Private Individual/Entity ______________________ CSE Agency Case Identifier _______________________________
________________________________ _____________ RE: ________________________________ _____________
Employer/Income Withholder’s Name Employee/Obligor’s Name (Last, First, Middle)
________________________________ _____________ ________________________________ _____________
Employer/Income Withholder’s Address Employee/Obligor’s Last 4 digits of SSN
________________________________ _____________ ________________________________ _____________
Custodial Party/Obligee’s Name (Last, First, Middle)
________________________________ _____________

Employer/Income Withholder’s FEIN ________________
Child(ren)’s Initials Child(ren)’s Year of Birth
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________

ORDER INFORMATION : This document is based on the support or withholding order from _____________ (State/Tribe).
You are required by law to deduct these amounts from the employee/obligor’s income until further notice.
$ ____________ Per ______________ curr ent child support
$ ____________ Per ______________ past -due child support - Arrears greater than 12 weeks?  Yes No
$ ____________ Per ______________ current cash medical support
$ ____________ Per ______________ past -due cash medical support
$ ____________ Per ______________ current spousal support
$ ____________ Per ______________ past -due spousal support
$ ____________ Per ______________ other (must sp ecify) ________________________________ ______________ .
for a Total Amount to Withhold of $ ____________ per __________________ .
AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information . If
your pay cycle does not match the ordered payment cycle, withhold one of the following amo unts:
$ _________ per weekly pay period $ __________ per semimonthly pay period (twice a month)
$ _________ per biweekly pay period (every two weeks) $ __________ per monthly pay period
$ _________ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order.

REMITTANCE INFORM ATION : If the employee/obligor’s principal place of employment is W yoming , you must begin
withholding no later than the first pay period that occurs after the date of service of this notice. Send payment withi n 7
working days of the pay date. If y ou cannot withhold the full amount of support for any or all orders for this
employee/obligor, withhold up to % of disposable income for all orders. If the employee/obligor’s principal place of
employment is not W yoming , obtain withholding limitat ions, time requirements, and any allowable employer fees at
http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact_map.htm for the employee/obligo r’s principal
place of employment.

OMB Expiration Date – 05/31/201 4. The OMB Expiration Date has no bearing on the termination date of the IWO ; it identifies the
version of the form currently in use.
For electronic payment requirements and centralized payment collection and disbursement facility information (S tate
Disbursement Unit [SDU ]), s ee http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact_map.htm .

Include the Remittance Identifier with the payment and if necessary this FIPS code: ___________________________ .

Remit payment to : Wyoming Child Support Enforcement , PO Box 1027, Cheyenne, WY 82003.
 Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in
accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below ). If payment is not directed
to an SDU /Tribal Payee or this IWO is not regular on its face , you must check this box and return the IWO to the sender.
Signature of Judge/Issuing Official (if required by State or Tribal law): ________________________________ __________
Print Name of Judge/Issuing Official: ________________________________ ________________________________ ____
Title of Judge/Issuing Official: ________________________________ ________________________________ _________
Date of Signature: ________________________________ ________________________________ __________________

If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a c opy
of this IWO must be provided to the employee/obligor.
 If checked, the employer/income withholder must pro vide a copy of this form to the employee/obligor.

ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS
State -specific contact and withholding information can be found on the Federal Employer Services website located at:
http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact_map.htm
Priority: W ithholding for support has priority over any other legal process under State law against the same income
(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender.
Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts
from more than one employee/obligor’s income in a sin gle payment. You must, however, separately identify each
employee/obligor’s portion of the payment.
Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a
Tribal CSE agency. If this IWO instruct s you to send a payment to an entity other than an SDU (e.g., payable to the
custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this
IWO was sent by a Court, Attorney , or Private Individu al/Entity and the initial order was entered before January 1, 1994 or
the order was issued by a Tribal CSE agency, you must follow the “Remit payment to” instructions on this form.

Reporting the Pay Date: You must report the pay date when sending the pay ment. The pay date is the date on which the
amount was withheld from the employee/obligor’s wages. You must comply with the law of the State (or Tribal law if
applicable) of the employee/obligor’s principal place of employment regarding time periods withi n which you must
implement the withholding and forward the support payments.
Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs
due to Federal, State, or Tribal withholding limits, you mus t honor all IWOs to the greatest extent possible, giving priority
to current support before payment of any past -due support. Follow the State or Tribal law/procedure of the
employee/obligor’s principal place of employment to determine the appropriate allo cation method.
Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to
this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are
required to rep ort and/or withhold lump sum payments .
Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the
employee/obligor’s income as the IWO directs, you are liable for both the accumulated amo unt you should have withheld
and any penalties set by State or Tribal law/procedure. ________________________________ _____________________
________________________________ ________________________________ ________________________________ _ ________________________________ ________________________________ ________________________________ _
Anti -discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor
from employment, refusing to employ, or takin g disciplinary action against an employee/obligor because of this IWO.
________________________________ ________________________________ ________________________________ _ ________________________________ ________________________________ ________________________________ _

Employer’s Name: ________________________________ __ Employer FEIN: ________________________________
Employee/Obligor’s Name: ________________________________ ________________________________ ___________
CSE Agency Case Identifier: _________________ Order Identifier : ________________________________ __________

IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor.

Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer
Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amount s allowed by the State or Tribe of the
employee/obligor’s principal place of employment (see REMITTANCE INFORMATION ). Disposable income is the net
income left after making mandatory deductions such as: State, Federal, local taxes ; Social Security taxes ; statutory
pension contributions ; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting
another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits
incre ase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe , you may
deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this
section.

For Tribal ord ers , you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal
employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the
law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section
303(d) of the CCPA (15 U.S.C. 1673 (b)).

Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums
in det ermining disposable income and applying appropriate withholding limits.

Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks,
then the Employer should calculate the CCPA limit using the l ower percentage.
Additional Information: ________________________________ ________________________________ _____________
________________________________ ________________________________ ________________________________ _
________________________________ ________________________________ ________________________________ _
NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for
you or you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency
and/or the sender by returning this form to the address listed in the Contact Information below :

 This person has never worked for this employer nor received periodic income.
 This person no longer works for this employer nor receives period ic income.
Please provide the following information for the employee/obligor:
Termination date: ________________________________ _____ Last known phone number: _____________________
Last known address: ________________________________ ________________________________ ________________
________________________________ ________________________________ ________________________________ _

Final payment date to SDU/ Tribal Payee: __________________ Final payment amount: _________________________

New employer’s name: ________________________________ ________________________________ _______________
New employer’s address: ________________________________ ________________________________ _____________ ________________________________ ________________________________ ________________________________ _

CONTACT INFORMATION:

To Employer/Income Withholder: If you have any questions, contact _____________________________ (Issuer name)
by phone at , by fax at , by email or website at: _____________________________ .

Send termination /income statu s notice and other correspondence to: ________________________________ __________
________________________________ ________________________________ ___________________ (Issuer address).

To Employee/Obligor: If the employee/obligor has questions, contact ______________________________ (Issuer name)
by phone at , by fax at , by email or website at ______________________________ .

Certificate of Mailing Decree of Divorce
Revised October 2012
Page 1 of 1

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)

CERTIFICATE OF MAILING DECREE OF DIVORCE

The undersigned certifies the mailing of: A Decree of Divorce to the following
whose name and address is as follows:

__________ _______________________________
Name

__________________________________________
Address

__________________________________________
City, State, Zip Code

DATED this ________ day of ______________________________, 20___.

CLERK OF THE DISTRICT COURT

By:_____________________________________
(Deputy Clerk of Court)

NOTE: You must bring the C lerk the envelope s pre -addressed with postage when you
present this form.

Laramie County Supplemental Order (to be submitted with Decree of Divorce)
Revised January 2011
Page 1 of 3
SUPPLEMENTAL ORDER
(Required in Laramie County, Wyoming)

STATE OF WYOMING ) IN THE DISTRICT COURT
) ss
COUNTY OF ________________ ) FIRST JUDICIAL DISTRICT

Plaintiff: ____________________________, ) Civil Action Case No. _________________
(Print name of person filing) )
)
vs. )
)
Defendant: __________________________ . ) (Spouse) (Print name) FILE ONLY IN LARAMIE COUNTY, WYOMING.
The provisions relating to custody, alimony, support, visitation and cond uct of the parties are subject to the
following terms and conditions, unless stated otherwise in the Decree of Divorce :

I. Care and Supervision

A. Physical Needs of the Children . The party who has custody of the children or the party
who is exercising vis itation with the children will provide the children:

1.1 with regular and nutritious food,
1.2 with clean and appropriate clothing,
1.3 with sanitary and reasonably private living and sleeping quarters,
1.4 with appropriate medical examinatio ns and treatments.

B. Training and Education . Both Parents:

2.1 will train the children to obey and respect their teachers and the law,
2.2 will require the children to attend all regular sessions of the school until
graduation unless excused absenc e,
2.3 will personally supervise the control and conduct and activities of the children
except when they are at school, or in known and usual recreational activities, or
in the immediate care of another competent person,
2.4 will provide guidance an d counsel in worldly and spiritual matters.

C. Prohibited Activities of the Parents . The Parents will not engage in or permit in the
presence of the children:

3.1 any excessive drinking, or use of illegal drugs or substances,
3.2 immoral condu ct,
3.3 obscenities,
3.4 violence,
3.5 disrespect for law and order.

II. Control of Visitation . Unless otherwise provided:

A. the p erson having visitation may take the children to such reasonable places for such
reasonable activities as such pers on may determine,

B. the children shall be ready and available promptly for all visits,

Laramie County Supplemental Order (to be submitt ed with Decree of Divorce)
Revised January 2011
Page 2 of 3
C. the children will have clean and appropriate clothing for visitation,

D. in the event a child is invited or desires to participate in other activities which may
interfere with a visit, a parent will not encourage, permit or consent thereto without
previous approval of the person whose visitation will be interfered with, and will not
deprecate the denial of such approval,

E. the person entitled to visitation may co rrespond with the children and the other parent
shall not censor such correspondence,

F. the person entitled to visitation may telephone each child for a time not to exceed 15
minutes between 7:00 P.M. and 9:30 P.M. on Wednesdays and Sundays and at such o ther
times as the parties may agree and the other parent shall not participate in such calls,

G. visitatio n may not be reduced or denied because support is not paid.

III. Interference . Neither parent will intrude upon the privacy of the other; nor falsely mak e or imply
mean or nasty or derogatory or deprecatory statements about the other to anyone; nor prevent or
restrict or in any way interfere with the other ’s rights granted by this Order.

IV. Injunction . The Plaintiff and Defendant and their agents and servant s are, and each is, enjoined
and restrained from doing, or attempting to do, or threatening to do, any act of injuring,
maltreating, vilifying or molesting the other party, or any of the children.

V. Child Support

A. In Decrees or Orders containing provis ions for the payment of support of children, all
such payments shall be delivered on or before the date ordered by means of cash,
certified check, postal money order or government allotment check, payable to the Clerk
of the District Court at the followin g address:

Clerk of the District Court
3rd Floor, Laramie County Governmental Complex
P.O. Box 787 or 309 West 20 th Street, Room 3100
Cheyenne, WY 82003 -0787

THE PARTY FILING THIS SUPPLEMENTAL ORDER SHALL COMPLETE
ALL THE INFORMATION BELOW

CHILD SUPPO RT: Amount Ordered $
Date(s) Due
Abate during visitation and
upon filing of Claim Yes No

Mother ’s name: _______________________________ __________________

Father ’s name: ____________________________________________________

Medical insurance is provided by: _____________________________________
Insurance company: _________________________________________________
Uninsured amount t o be paid by: _______________________________________

Laramie County Supplemental Order (to be submitt ed with Decree of Divorce)
Revised January 2011
Page 3 of 3
B. It is further ordered that the withholding of income shall commence as provided below:
Effective immediately upon entry of a Decree in this matter;

Except as otherwise provided by Wyo. Stat. 20 -6-204(a), an income withholding order which did
not become effective immediately upon entry, becomes effective upon the earliest of the
following:

The date the obligor requests withholding commence; or
The date the obligor becomes delin quent in payment of an amount equal to one (1) month's
support obligation under the support order.
Wyo. Stat. 20 -6-205.

IF NOT DESIGNATED, INCOME WITHHOLDING SHALL BE EFFECTIVE
IMMEDIATELY.

C. It is further ordered that both parents shall file in wri ting with the Clerk of this Court
any new address within fifteen days of change of address, and shall file in writing with the Clerk
of this Court, the name and address of his or her employer within 15 days of any change of
employment.

VI. Enforce ment . Either party, or, when appropriate, the department of family services, has the right to petition
to enforce an order pursuant to W.S. 20 -2-201 through 20 -2-204, 20 -2-310 and 20 -2-311(d).

A party moving for enforcement referred to in paragraph VII must be prepared to produce admissible
evidence in support of the motion. A frivolous motion will result in appropriate censure or sanctions.
VII. Contempt . Willful violation of any of the terms of this order may be punished as contempt of court. A
party may compel another ’s compliance with an order or decree by motion to the court, under oath, for an
order to show cause why sanctions should not be imposed. Such sanctions may result in a jail term.
Failure to allow visitation as ordered may be considere d contempt and could also constitute a change of
circumstance warranting change of custody.

This Supplemental Order for custody, etc., is incorporated into and made a part of that Decree or Order to
which it is attached and is enforceable to the same exte nt and in the same manner as said Decree or Order.

DATED:__________________________________________

_________________________________________________
DISTRICT JUDGE
Copies to:
Plainti ff:
(name and mailing address)
Defendant:
(name and mailing address)

List of Addresses for the Clerk of District Court O ffices

List of Addresses for Clerk of District Court Offices
Revised October 2012
Page 1 of 2
First Judicial District,
Laramie County
Clerk of District Court
P.O. Box 787
Cheyenne, Wyoming 82003
(307) 633 -4270

Second Judicial District,
Albany County
Clerk of District Court
P.O. Box 1106
Laramie, Wyoming 82070
(307) 721 -2508

Second Judicial Dist rict,
Carbon County
Clerk of District Court
P.O. Box 67
Rawlins, Wyoming 82301
(307) 328 -2628

Third Judicial District,
Lincoln County
Clerk of District Court
925 Sage Avenue
Kemmerer, Wyoming 83101
(307) 877 -3320

Third Judicial District,
Sweetwater Cou nty
Clerk of District Court
P.O. Box 430
Green River, W Y 82935
(307) 872 -6448

Third Judicial District,
Uinta County
Clerk of District Court
P.O. Box 1906
Evanston, Wyoming 82931
(307) 783 -0456

Fourth Judicial District,
Johnson County
Clerk of District Court
620 W. Fetterman, Ste. 208
Buffalo, Wyoming 82834
(307) 684 -7271

Fourth Judicial District,
Sheridan County
Clerk of District Court
224 S. Main Street, Suite B11
Sheridan, Wyoming 82801
(307) 674 -2960

Fifth Judicial District, Big
Horn County
Clerk of District Court
P.O. Box 670
Basin, Wyoming 82410 -0670
(307) 568 -2381

Fifth Judicial District, Hot
Springs County
Clerk of District Court
415 Arapahoe
Thermopolis, Wyoming
82443
(307) 864 -3323

Fifth Judicial District, Park
County
Clerk of Court
P.O . Box 1960
Cody, Wyoming 82414 -1960
(307) 527 -8690

Fifth Judicial District,
Washakie County
Clerk of District Court
P.O. Box 862
Worland, Wyoming 82401
(307) 347 -4821

Sixth Judicial District,
Campbell County
Clerk of District Court
P.O. Box 817
Gillet te, Wyoming 82717
(307) 682 -3424

Sixth Judicial District,
Crook County
Clerk of District Court
P.O. Box 406
Sundance, Wyoming 82729
(307) 283 -2523

Sixth Judicial District,
Weston County
Clerk of District Court
1 West Main
Newcastle, Wyoming 82701
(307 ) 746 -4778

Seventh Judicial District,
Natrona County
Clerk of District Court
P.O. Box 2510
Casper, Wyoming 82602
(307) 235 -9243

Eight Judicial District,
Converse County
Clerk of District Court
107 North 5th St
Douglas, Wyoming 82633
(307) 358 -3165

Eight Judicial District,
Goshen County
Clerk of District Court
P.O. B ox 818
Torrington, Wyoming
82240 -0818
(307) 532 -2155

Eight Judicial District,
Niobrara County
Clerk of District Court
P.O. Box 1318
Lusk, Wyoming 82225
(307) 334 -2736

Eight Judicial Dist rict,
Platte County
Clerk of District Court
P.O. Box 158
Wheatland, Wyoming 82201
(307) 322 -3857

Ninth Judicial District,
Fremont County
Clerk of District Court
P.O. Box 370
Lander, Wyoming 82520
(307) 332 -1134

List of Addresses for the Clerk of District Court O ffices

List of Addresses for Clerk of District Court Offices
Revised October 2012
Page 2 of 2
Ninth Judicial District,
Sublette County
Clerk of District Court
P.O. Box 764
Pinedale, Wyoming 82941
(307) 367 -4376

Ninth Judicial District,
Teton County
Clerk of District Court
P.O. Box 4460
Jackson, Wyoming 83001
(307) 733 -2533

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