Form Dhec PDF Details

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QuestionAnswer
Form NameForm Dhec
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesform dhec print, dhec form 2740, dhec form for special exemption for schools, sc dhec divorce form

Form Preview Example

State of South Carolina

Department of Health and Environmental Control

REPORT OF DIVORCE OR ANNULMENT OF MARRIAGE

 

 

 

 

 

 

 

State File No.

 

 

 

 

 

1.

PLAINTIFF (First, Middle, Last, Sufix)

 

2. LAST NAME ON BIRTH CERTIFICATE (If Different)

 

 

 

 

 

3. DATE OF BIRTH (Month, Day, Year)

 

4.

PLACE OF BIRTH (State or Foreign Country)

 

 

 

 

 

 

5.

RESIDENCE (County, State/Country)

 

6.

NUMBER OF THIS MARRIAGE - First, Second, etc. (Specify)

 

 

 

 

 

 

7.

DEFENDANT (First, Middle, Last, Sufix)

 

8.

LAST NAME ON BIRTH CERTIFICATE (If Different)

 

 

 

 

9. DATE OF BIRTH (Month, Day, Year)

 

10. PLACE OF BIRTH (State or Foreign Country)

 

 

 

 

11. RESIDENCE (County, State/Country)

 

12. NUMBER OF THIS MARRIAGE- First, Second, etc. (Specify)

 

 

 

 

 

13.

PLACE OF THIS MARRIAGE (County, State/Country)

14. DATE OF MARRIAGE (mm/dd/yyyy)

 

 

 

 

 

 

15. TYPE OF DECREE

 

16. COUNTY OF DECREE

 

17. DOCKET NUMBER

 

Absolute Divorce

Annulment

 

 

 

 

 

 

 

 

 

 

 

18.

DATE DECREE FILED (mm/dd/yyyy) - TO BE COMPLETED BY CLERK OF COURT.

 

 

 

 

 

 

19.

I CERTIFY THE MARRIAGE OF THE ABOVE NAMED PERSONS WAS DISSOLVED ON THE DATE DECREE FILED.

 

SIGNATURE OF CLERK OF COURT: _______________________________________________

DATE SIGNED: ______________________

 

 

 

 

(mm/dd/yyyy)

 

 

 

Conidential and statistical information (The information below will not appear on certiied copies of the report)

 

 

 

 

 

 

20. PLAINTIFF - SOCIAL SECURITY NUMBER (Last 4 Digits)

21. PLAINTIFF - RACE

 

22. PLAINTIFF - SEX

 

 

 

 

 

 

23. DEFENDANT - SOCIAL SECURITY NUMBER (Last 4 Digits)

24. DEFENDANT - RACE

 

25. DEFENDANT - SEX

 

 

 

 

 

26. ATTORNEY FOR PLAINTIFF

27. ATTORNEY BAR NUMBER

 

 

 

 

 

 

28. LEGAL GROUNDS

 

 

 

 

 

 

 

 

DHEC 0682 (09/2015)

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Step no. 1 for filling out how to form dhec

2. After the previous part is completed, it's time to put in the essential specifics in I CERTIFY THE MARRIAGE OF THE, SIGNATURE OF CLERK OF COURT DATE, mmddyyyy, Conidential and statistical, PLAINTIFF SOCIAL SECURITY NUMBER, PLAINTIFF RACE, PLAINTIFF SEX, DEFENDANT SOCIAL SECURITY NUMBER, DEFENDANT RACE, DEFENDANT SEX, ATTORNEY FOR PLAINTIFF, ATTORNEY BAR NUMBER, LEGAL GROUNDS, and DHEC allowing you to progress to the next part.

how to form dhec completion process explained (step 2)

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