Form DCH-0838 at a glance
What it is: This is the Record of Divorce or Annulment of the Michigan Department of Health and Human Services.
Who signs: The Certifying Official enters the Signature, Title and Date Signed.
A filled-in Form DCH-0838 example: a first marriage with two minor children
How to fill out Form DCH-0838, box by box
Court Case Number, State File Number and County
Enter the Court Case Number, the State File Number and the County.
Plaintiff's name, birthdate, residence and birthplace
Enter the Plaintiff's Full Name (First, Middle, Last) and Birthdate (Month, Day, Year), and mark Male, Female or Other.
In 3, enter the Last Name Before First Married (if different).
Enter the Plaintiff's Residence by City, Village, or Township, County and State.
Enter the Plaintiff's Birthplace (State or Foreign Country) and the Number of this Marriage (First, Second, etc. - Specify).
Defendant's name, birthdate, residence and birthplace
Enter the Defendant's Full Name (First, Middle, Last) and Birthdate (Month, Day, Year), and mark Male, Female or Other.
In 9, enter the Last Name Before First Married (if different).
Enter the Defendant's Residence by City, Village, or Township, County and State.
Enter the Defendant's Birthplace (State or Foreign Country) and the Number of this Marriage (First, Second, etc. - Specify).
Place and Date of this Marriage, and the household at separation
Enter the Place of this Marriage by City, Village, or Township, County and State or Foreign Country.
Enter the Date of this Marriage (Month, Day, Year).
Enter the Date Couple Last Resided in Same Household (Month, Day, Year), or Check if Not Separated.
Enter the Number of Minor Children in Household at Separation Date (Filing Date if Not Separated), or mark Check If None.
Plaintiff's Attorney and Attorney's Address
Enter the Plaintiff's Attorney (Name - Type or Print) and the Bar Number.
Enter the Attorney's Address: Number and Street, City, State and Zip Code.
Judgment of Divorce or Annulment and Physical Custody
Enter the Judgment of (Specify if Divorce or Annulment), and the Number of Minor Children Whose Physical Custody was Awarded to: Plaintiff, Defendant, Joint or Other, or No Children or Unknown.
Enter Judgment Recorded on (Month, Day, Year) and, after I certify that this Divorce was granted on, the Month, Day, Year.
Certifying Official
The Certifying Official enters the Signature, Title and Date Signed.
More rules for Form DCH-0838
By authority of MCL 333.2813.
Sources
[1] Form DCH-0838 (Rev. 2-26), Record of Divorce or Annulment, Michigan Department of Health and Human Services (the Official source link on this page).
