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Wyoming Divorce Package For Petitioner With Children Form

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

Family Law Information	 and Instructions	 	
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.

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Page 	6 of 	14 	
 
 
 
 
 
 
 
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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	.

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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;

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Page 	8 of 	14 	
 	
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

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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	.

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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.

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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

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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

Checklist for Packet 1	 	
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:

Checklist for Packet 1	 	
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	;

Checklist for Packet 1	 	
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	.

Checklist for Packet 1	 	
Revised October 2012	 	
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.	 	
 	
 	Reply to Counterclaim	.  If the 	Defendant 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 thi	s form if the 	Defendant only filed an 	Answer	. 	
 	 	Take original and two copies to the 	Clerk	 for filing	 	
 	 	Mail copy to the 	Defendant	 and k	eep a copy for your records	 	
 	
 	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.

Checklist for Packet 1	 	
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	 	
 
v. 
 
______________________________	 	
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.)	 	
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
$ 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 
 
 
 
a. 
 
b. 
 
c. 
 
d. 
 
e. 
 
f. 
 
g. 
 
h. 
 
i. 
 
j. 
 
k. 
 
l. 
 
m. 
 
n. 
 
o. 
 
p. 
 
 	
 Attach additional sheets of paper if needed

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Confidential Financial Affidavit	 	
Approved by the Wyoming Supreme Court (2012)	 	
Page 	9 of 	9 	
C E R T I F I C A T E   O F   S E R V I C E	 	
 	
I certify that on 	 	 	 	 	 (date) the original of this 	Confidential 	
Financial Affidavit	 was filed with the 	Clerk of District 	Court; and, a true and accura	te copy of 	
this document 	was served on the other party by 	 Hand Delivery  OR 	 Faxed to this number	 	
  	 	 	 	   OR 	 by placing it in the United States mail, postage pre	-paid, 	
and addressed to the following:	 	
 
(P	rint 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 	
 	
3 	
 
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 	
 	
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	. 	
 
OR 	 	
 	
    	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	:   	 	 	
 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	 	 	 	
OR

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: 	______	 	
 
                            	         	 M	other  	 Father  	 	 every  	 odd 	 even	 	
 	 	 	 	 	 	 	 Other: 	______	 	
 
                            	         	 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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