Form Cafc001 – Fill Out and Use This PDF

IN THE CIRCUIT COURT OF

, MISSOURI

(County where court is located. City of Saint Louis is considered a county.)

In re the Marriage of:

Case

(First Name)

(Middle Name) (Last Name)

(Jr./Sr./III)

Number

Petitioner, (Enter your full legal name above)

(Will be assigned when case is filed)

-and-

Division

(First Name)

(Middle Name) (Last Name)

(Jr./Sr./III)

Number

Respondent. (Enter your spouse’s full legal name above)

(Will be assigned when case is filed)

Petition for Dissolution of Marriage

Throughout this entire case, you,

,

(First Name)

(Middle Name)

(Last Name)

(Jr./Sr./III)

will always be the Petitioner.

Your spouse,

, will always be the

(First Name) (Middle Name)

(Last Name)

(Jr./Sr./III)

Respondent.

Information about Petitioner

(Enter your name on the lines)
	(First Name)			(Middle Name)		(Last Name)	(Jr./Sr./III)

1.How many petitions have you filed in this case? (Check one of the three boxes)

This is the first petition I have filed in this case. (Original petition)

This is the second petition I have filed in this case.

This is the third petition I have filed in this case.

2.What is your mailing address?

This is the address the court will use to send information about your case to you. If you move during the time this case is pending, you must send a letter to the court notifying it of your new address. This address is not necessarily the same as the address at which you live. Even if you do not wish to give the address at which you live, you must still give the court a mailing address. Because court actions are a matter of public record, the address you list will be available to the public.

(Street)

(City)

(State)

(Zip)

()

(Telephone Number with Area Code) (E-mail Address - Optional)

3.What are the last four numbers of your social security number?

The last four digits of your social security number are required by §452.312, RSMo.

XXX-XX-

Petition for Dissolution of Marriage

Page 1 of 14

Form CAFC001 01/01/2018

This form is available for free at www.selfrepresent.mo.gov

4.Are you over the age of eighteen? (Check one of the two boxes) Yes

No

Missouri law requires that one party to a dissolution of marriage proceeding must have been a resident of the State of Missouri for at least 90 days. If the time is less than four months, state the number of days you have lived in the state.

Years Months Days

(Length of time you have lived in this state)

7.In what county do you currently live and for what length of time have you lived there?

City of Saint Louis is considered a county. If you live in the city of Saint Louis, you should enter “Saint Louis city” in the blank.

(County)	Years Months Days
	(Length of time you have lived in this county)

8.What is your current employment status? (Check one of the three boxes)

Employed

Unemployed

Self-employed

9.If you are employed or self-employed, where do you currently work?

If you are self-employed, enter a brief description of the type of work you perform such as “Landscaping” or “Day care” on the line for the name of your employer. If you are self-employed, you should also enter the address information for your self-employment.

(Employer’s name or type of self-employment)

(Street)

(City)

(State)

(Zip)

10. What is your total monthly gross income from all sources?

Gross income is the amount of money a person earns before anything such as taxes is deducted. For a more detailed definition of “gross income” see Supreme Court Form No. 14.

(Total monthly gross income)

11.Can you support yourself through the combined income from your employment and income from property that you will receive in the dissolution? (Check one of the two boxes)

This does not include supporting any minor children.

Yes

No

Petition for Dissolution of Marriage

Page 2 of 14

Form CAFC001 01/01/2018

This form is available for free at www.selfrepresent.mo.gov

Information about Respondent

(Enter your spouse’s name on the lines)

(First Name)

(Middle Name) (Last Name)

(Jr./Sr./III)

12. What is your spouse’s mailing address?

This is the address that the court will use to send information about your case to your spouse. If you do not know your spouse’s current address, you should enter the last known address of your spouse.

(Street)

(City)

(State)

(Zip)

()

(Telephone Number with Area Code) (E-mail Address - Optional)

13. What are the last four numbers of your spouse’s social security number?

The last four digits of your spouse’s social security number are required by §452.312, RSMo. Do not leave this field blank. If you do not know your spouse’s social security number, enter “Unknown” in this field.

XXX-XX-

14. Is your spouse over the age of eighteen? (Check one of the two boxes)

Yes

No

15.	My spouse lives in	the United States		another country, which is		.
16.	My spouse lives in	Missouri	another state, which is				.

If the time is less than four months, state the number of days your spouse has lived in the state.

Years Months Days

(Length of time they have lived in this state)

17. In what county does your spouse currently live and for how long has your spouse lived there?

If you do not know in which county your spouse lives and cannot find out this information, then you should enter “Unknown.” City of Saint Louis is considered a county.

(County)	Years Months Days
	(Length of time they have lived in this county)

18.If your spouse does not now live in Missouri, did you and your spouse live together in Missouri during your marriage? (Check one of the three boxes)

If you and your spouse have never lived together in the State of Missouri during your marriage and they do not voluntarily enter their appearance in this proceeding, the court will lack personal jurisdiction over your spouse. This means that the court cannot award any money judgment to you. It may be better to file this case in the state where your spouse lives. You should consult a lawyer for further information.

Yes

No

Not Applicable (My spouse currently lives in Missouri)

19. What is your spouse’s current employment status? (Check one of the four boxes)

Employed Unemployed Self-employed Unknown

Petition for Dissolution of Marriage

Page 3 of 14

Form CAFC001 01/01/2018

This form is available for free at www.selfrepresent.mo.gov

20. If your spouse is employed or self-employed, where do they currently work?

If your spouse is self-employed, enter a brief description of the type of work they perform, such as “Landscaping” or “Day care,” on the line for the name of the employer. If your spouse is self-employed you should also enter the address information for their self-employment.

(Employer’s name or type of self-employment)

(Street)

(City)

(State)

(Zip)

21. What is your spouse’s total monthly gross income from all sources?

Gross income is the amount of money a person earns before anything such as taxes is deducted. If you do not know the exact amount of monthly gross income for your spouse, you should enter your best estimate here.

(Total monthly gross income)

22.Can your spouse support themselves through the combined income from their employment and income from property that they will receive in the dissolution? (Check one of the three boxes)

This does not include supporting any minor children born of the marriage.

Yes

No

Unknown

23. Is your spouse on active duty in the military? (Check one of the two boxes)

If your spouse is on active duty in the armed forces of the United States, the Servicemembers Civil Relief Act (SCRA) may prevent you from getting a dissolution of marriage without your spouse’s consent. You should contact a lawyer about this situation prior to filing this Petition for Dissolution of Marriage.

Yes

No

Information about the Marriage

24. What date were you married?	/	/
	(mm/dd/yyyy)

25. Where did you get your marriage license? (Check one of the two boxes)

Enter the state, county and country where your marriage is registered. This is not necessarily the same as the county where you were married. City of Saint Louis is considered a county. If your marriage is registered in the city of Saint Louis, enter “Saint Louis city.”

In the United States, in the State of				, County of				.
In another country, which is						.
26. What date did you and your spouse separate?			/	/
			(mm/dd/yyyy)

Petition for Dissolution of Marriage

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Form CAFC001 01/01/2018

This form is available for free at www.selfrepresent.mo.gov

27.Is there any reasonable likelihood that your marriage can be preserved? (Check one of the two boxes)

Yes

No

28.Is your marriage irretrievably broken? (Check one of the two boxes)

Yes

No

29.Are you or your spouse pregnant? (Check all that apply)

Yes, I am pregnant.

Yes, my spouse is pregnant.

No, neither me nor my spouse are pregnant.

You must enter a number on each line below, even if it is 0. Include children no matter how old they are. Do not include deceased children.

30.	How many living children do you and your spouse have together that were
	born after the date of this marriage?
	Include in this number all living children born to you and your spouse during this marriage
	as a result of sexual intercourse or artificial insemination.		(Number of Children)
31.	How many living children did you and your spouse adopt?
	If you have already accounted for this child in paragraph 30, do not count them in this
	paragraph. Include in this number all living children who were: (a) born to you or your
	spouse and later adopted by the other spouse; or (b) adopted by both parties.		(Number of Children)
32.	How many living children do you and your spouse have together that were
	born before the date of this marriage?
	Include in this number all living children born to you and your spouse before this marriage
	as a result of sexual intercourse or artificial insemination. You should attach a copy of
	the birth certificate(s) for these children to your Petition.		(Number of Children)

33.A. How many living children were born to you (if you are female) with someone other than your spouse during this marriage? (This number includes children born after the parties separated.)

Additional information may be required before the court proceeds with your case.		(Number of Children)

B.How many living children were born to your spouse (if they are female) with someone other than you during this marriage? (This number includes children born after the parties separated.)

Additional information may be required before the court proceeds with your case.	(Number of Children)

34. Enter the total number of children from lines 30, 31, 32 and 33 A and B.

(Total Number of Children)

Petition for Dissolution of Marriage

Page 5 of 14

Form CAFC001 01/01/2018

This form is available for free at www.selfrepresent.mo.gov