Printable Divorce Certificate PDF Details

When individuals go through the emotional and legal process of ending a marriage, the completion of a Divorce Certificate form stands as a crucial final step. Issued by the State of Utah Department of Health, this comprehensive document records the key details of the dissolution of a marriage, annulment, or marriage dissolution. It encompasses personal information of both parties involved, such as full names before and after marriage, sex, places of birth, dates of birth, and the number of marriages previously entered into. Moreover, it delves into the couple's last place of residence together, the education level of each spouse, and the racial background. Critical to the process, it documents the place and date of the marriage being dissolved, specifics about children under 18 within the household, and the marriage's ending. Responsibility for children's custody is highlighted, ensuring clarity in post-divorce arrangements. Additionally, the form includes details of the legal representation for the petitioner and finalizes with the certification of the decree type—be it divorce, dissolution, or annulment—authenticated by the signature of a certifying official. This form, in essence, encapsulates the legal termination of a marital union, serving as an essential record for both the involved parties and the state.

QuestionAnswer
Form NamePrintable Divorce Certificate
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesprintable divorce certificate, udoh form, divorce certificate template, divorce certificate online

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STATE OF UTAH - DEPARTMENT OF HEALTH CERTIFICATE OF DIVORCE, DISSOLUTION OF MARRIAGE, OR ANNULMENT

SPOUSE 1

1a. First Name

 

1b. Middle Name

1c. Last name before first marriage,

 

1d. Last Name

 

 

 

 

 

 

 

 

 

 

 

if applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1e. Sex

 

2a. RESIDENCE - CITY, TOWN OR LOCATION

 

 

2b. COUNTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

 

F

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2c. STATE

 

 

 

 

3. BIRTHPLACE (State or Foreign Country)

 

4. BIRTHDATE (MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. NUMBER OF THIS

6. IF NOT FIRST MARRIAGE, LAST MARRIAGE ENDED:

 

7. RACE: White, Black, American

 

8. EDUCATION: (Specify only highest

 

MARRIAGE - First,

 

Indian, etc. (Specify)

 

 

 

 

grade completed)

 

 

 

 

 

 

 

 

 

 

Second, etc. (Specify)

By Death, Divorce, Dissolution,

Date (MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

 

or annulment (Specify)

 

 

 

 

Elementary/Secondary

College

 

 

 

 

 

 

 

 

 

 

(0 - 12)

(13-16 or 17+)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPOUSE 2

9a. First Name

 

9b. Middle Name

9c. Last name before first marriage,

 

9d. Last Name

 

 

 

 

 

 

 

 

 

 

 

 

if applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9e. Sex

 

10a. RESIDENCE - CITY, TOWN OR LOCATION

 

 

 

10b. COUNTY

 

 

 

 

F

 

 

 

 

 

 

 

 

 

 

 

 

 

M

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10c. STATE

 

 

 

 

11. BIRTHPLACE (State or Foreign Country)

 

12. BIRTHDATE (MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. NUMBER OF THIS

14. IF NOT FIRST MARRIAGE, LAST MARRIAGE ENDED:

 

15. RACE: White, Black, American

16. EDUCATION: (Specify only highest

 

 

MARRIAGE - First,

 

Indian, etc. (Specify)

 

grade completed)

 

 

 

 

 

 

 

 

 

 

 

 

Second, etc. (Specify)

By Death, Divorce, Dissolution,

Date (MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

 

 

or annulment (Specify)

 

 

 

 

 

Elementary/Secondary

College

 

 

 

 

 

 

 

 

 

 

 

(0 - 12)

(13-16 or 17+)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MARRIAGE

17a. PLACE OF THIS MARRIAGE - CITY TOWN, OR LOCATION

 

17b. COUNTY

17c. STATE OR FOREIGN COUNTRY

18. DATE OF THIS MARRIAGE

 

 

 

 

 

 

 

 

 

 

(MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19. DATE COUPLE LAST RESIDED IN SAME HOUSEHOLD

20. NUMBER OF CHILDREN UNDER 18 IN THIS

21. PETITIONER

 

 

 

 

 

(MM/DD/YY)

 

HOUSEHOLD AS OF THE DATE IN ITEM 19

 

 

Spouse 1

 

 

Spouse 2

 

Both

 

 

 

 

 

 

 

 

Number_________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

None

 

 

Other, Specify ____________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ATTORNEY

22a. NAME OF PETITIONER'S ATTORNEY (Type/Print)

22b. ADDRESS (Street and Number or Rural Route Number, City, or Town, State, Zip Code)

DECREE

23. I CERTIFY THAT THE MARRIAGE OF THE ABOVE NAMED PERSONS

24. TYPE OF DECREE, Divorce, Dissolution,

25. DATE RECORDED (MM/DD/YY)

 

WAS DISSOLVED ON (MM/DD/YY)

or Annulment (Specify)

 

 

 

 

 

 

 

 

 

 

 

26. NUMBER OF CHILDREN UNDER 18 WHOSE PHYSICAL CUSTODY WAS AWARDED TO:

27. COUNTY OF DECREE

28. TITLE OF COURT

 

Spouse 1_______

Spouse 2_______ Joint__________ Other _________

 

 

 

 

 

No Children

 

Not Determined Yet

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29. SIGNATURE OF CERTIFYING OFFICIAL

 

30. TITLE OF CERTIFYING OFFICIAL

 

25. DATE SIGNED (MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

UDOH OVRS Form 404 Rev. 01/16

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Provide the expected details in the DATE COUPLE LAST RESIDED IN SAME, NUMBER OF CHILDREN UNDER IN THIS, None, PETITIONER, Spouse Spouse Other Specify, Both, a NAME OF PETITIONERS ATTORNEY, b ADDRESS Street and Number or, I CERTIFY THAT THE MARRIAGE OF, TYPE OF DECREE Divorce, DATE RECORDED MMDDYY, NUMBER OF CHILDREN UNDER WHOSE, COUNTY OF DECREE, TITLE OF COURT, and No Children box.

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