Michigan Form Dch 0838 PDF Details

Michigan Form Dch 0838 is a Declaration of Domicile for Michigan Income Tax Purposes. This form is used to declare your domicile status for Michigan income tax purposes. A person's domicile is their permanent home, the place where they intend to return to whenever they are away. There are a number of factors that can be considered when determining your domicile, including your residency, presence in Michigan, and ties to the state. To complete this form, you will need to provide information about your residency and presence in Michigan, as well as any ties you have to the state. Once you have completed the form, it must be signed and dated. You should keep a copy of this form for your records.

In the listing, there is some information relating to the michigan form dch 0838. It may be helpful to know its length, the average time to complete the form, the fields you should fill in, and so on.

QuestionAnswer
Form NameMichigan Form Dch 0838
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdch 0838 fillable, michigan record divorce, dch 0838, record of divorce michigan

Form Preview Example

__________________________________

State File Number

RECORD OF

DIVORCE OR ANNULMENT

MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES

By authority of MCL 333.2813.

_________________________________

Court Case Number

_________________________________

County

1. Plaintiff’s Full Name _______________________________________________________ 2.

Plaintiff’s Birthdate ______________

Male

Female

(First, Middle, Last)

(Month, Day, Year)

 

 

3.Last Name Before First Married (if different) _____________________________________________________________________

4.Plaintiff’s Residence _______________________________________________________________________________________

(City, Village, or Township)(County)(State)

5.

Plaintiff’s Birthplace ______________________________________________________ 6. Number of this Marriage __________

 

 

 

 

 

(State or Foreign Country)

(First, Second, etc. - Specify)

7.

Defendant’s Full Name ____________________________________________________ 8. Defendant’s Birthdate ____________

 

Male

Female

(First, Middle, Last)

(Month, Day, Year)

9.Last Name Before First Married (if different) _____________________________________________________________________

10.Defendant’s Residence _____________________________________________________________________________________

(City, Village, or Township)(County)(State)

11. Defendant’s Birthplace ___________________________________________________ 12. Number of this Marriage __________

 

 

(State or Foreign Country)

 

(First, Second, etc. - Specify)

13.

Place of this Marriage ______________________________________________________________________________________

 

(City, Village, or Township)

(County)

(State or Foreign Country)

 

 

 

 

 

14.

Date of this Marriage _____________________

15. Date Couple Last Resided

Check if Not

 

 

Separated

______________

in Same Household

 

(Month, Day, Year)

(Month, Day, Year)

 

 

 

 

 

 

 

 

Check If

 

 

16.

Number of Minor Children in Household at Separation Date (Filing Date if Not Separated)

None

______________

 

 

 

 

(Number)

 

17.

Plaintiff’s Attorney _________________________________________________________________________________________

 

 

(Name - Type or Print)

(Bar Number)

 

18.

Attorney’s Address _________________________________________________________________________________________

 

(Number and Street)

(City)

(State)

(Zip Code)

 

 

20. Number of Minor Children Whose

 

 

 

19.

Judgment of ____________________ Physical Custody was Awarded to: Plaintiff____ Defendant____ Joint____ Other____

 

(Divorce/Annulment - Specify)

(Number)

(Number)

(Number)

(Number)

 

 

No Children

Unknown

 

 

21.

Judgment Recorded on _______________________ 22. I certify that this Divorce was granted on ________________________

 

(Month, Day, Year)

 

(Month, Day, Year)

 

23.

Certifying Oficial _________________________________________________________________________________________

 

(Signature)

(Title)

(Date Signed)

 

Failure to provide the required information is a misdemeanor punishable by imprisonment

of not more than 1 year or a ine of not more than $1,000.00 or both.

DCH-0838 (Rev. 08/2015)

Watch Michigan Form Dch 0838 Video Instruction

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