Forms For Authorized Attorney’s Only

Form For Authorized Users Only (BETA)

Security



Today's Date:

Party Information

The Wife is the:
The Wife's maiden name is:

Plaintiff's Information





Plaintiffs Address:

Plaintiff's City:

Plaintiff's State:

Plaintiff's Zip Code:

Plaintiff's County:

Plaintiff's Phone:

Plaintiff a member of military.
Plaintiff's Social Security Number is:
Plaintiff's Sex:
Plaintiff's Date of Birth:

Plaintiff's Date of Birth Alternate Syntax:
Plaintiff's Place of Birth:

Defendant Information





Defendant's Address:

Defendant's City:

Defendant's State:

Defendant's Zip Code:

Defendant's County:

Defendant's Phone:

Defendant a member of military.
Defendant's Social Security Number is:
Defendant's Sex:
Defendant's Date of Birth:

Defendant's Date of Birth Alternate Syntax:
Defendant's Place of Birth:

Venue Information

Index Number:
Date Index Issued:
Summons Filed:
YesNo
Date Summons Filed:

Summons Served:
YesNo
Date Summons Served:

Children under 18:
YesNo
County of Venue
Court Type
Basis of Venue
Address upon which venue based

Representation

Is Plaintiff Pro Se or Represented by Attorney:

Attorney Information

Attorney Name:


Attorney Address:

Attorney City:

Attorney State:

Attorney Zip:

Attorney Email:

Attorney Phone:

Attorney Fax:

Representation

Is Defendant Pro Se or Represented by Attorney:
Issue Joined:YesNo

Defendant's Attorney:

Defendant's Attorney Phone Number:

Defendant's Attorney Email:

Information From Parties Separation Agrreement

Date of Parties Separation Agreement (Accurate Date Required):

Reason New York has Jurisdiction over this Divorce proceeding
The Plaintiff has resided in New York State for a continuous period of at least two years immediately preceding the commencement of this divorce action.The Defendant has resided in New York State for a continuous period of at least two years immediately preceding the commencement of this divorce action.The Plaintiff has resided in New York State on the date of commencement of this divorce action and for a continuous period of one year immediately preceding the commencement of this divorce action and the parties were married in New York State.The Defendant has resided in New York State on the date of commencement of this divorce action and for a continuous period of one year immediately preceding the commencement of this divorce action and the parties were married in New York State.The Plaintiff has resided in New York State on the date of commencement of this divorce action and for a continuous period of one year immediately preceding the commencement of this divorce action and the parties have resided as married people in New York State.The Defendant has resided in New York State on the date of commencement of this divorce action and for a continuous period of one year immediately preceding the commencement of this divorce action and the parties have resided as married people in New York State.The cause of action occurred in New York State and Plaintiff resided in New York State for a continuous period of at least one year immediately preceding the commencement of this divorce action.The cause of action occurred in New York State and Defendant resided in New York State for a continuous period of at least one year immediately preceding the commencement of this divorce action.The cause of action occurred in New York State and both parties were residents at the time of commencement of this divorce action.

Marriage

Date of the Parties Marriage:
City/Town/Village where Parties Marriage
State of the Parties Marriage
Type of ceremony

Children

There are no children off the marriage and none are expected.
Name Soc. Sec. #, DOB, and Address. (One Per Line)





















The parties have agreed that: be designated as the custodial parent of the child(ren) of the marriage.
The parties have agreed that: be designated the primary residential parent of the child(ren) of the marriage.
Pursuant to a written agreement the parties have agreed that the:

Shall pay support to the:

Support shall be in the amount of (or "NA):

Support shall be paid:

directlythrough the Support Collection UnitNA
The parties agree that the PlaintiffDefendant shall maintain health insurance for the parrties child(ren). Uninsured medical expenses shall be divided:
Plaintiff's percentage responsibility:

Defendant's percentage responsibility:

The parties have agreed that the presumptively correct amount of child support to be paid by the non-custodial parent is:
- WeeklyBi-WeeklyMonthly
The amount ConformsDeviates from CSSA guidelines.
Reason for deivation if any:

Maintenance

Is maintenance being paid:

No maintenance is being paid as per the parties agreement.
The parties have agreed that the shall pay maintenance to the in the amount of:

Maintenance shall be paid:

The duration of maintenance shall be:

Health Insurance Information

Plaintiff





Defendant