Vs 4 Form PDF Details

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QuestionAnswer
Form NameVs 4 Form
Form Length1 pages
Fillable?Yes
Fillable fields48
Avg. time to fill out9 min 55 sec
Other namesvs 4 virginia, virginia vs4 form, va tax form pdf, report of divorce or annulment vs 4 form

Form Preview Example

NOTE:

ITEMS 1-30 ON THIS FORM TO BE COMPLETED BY PETITIONER OR ATTORNEY AND FILED WITH CLERK OF COURT WITH PETITION OR DECREE

PLEASE PREPARE BY TYPEWRITER OR PRINT IN BLACK UNFADING INK. THIS IS A PERMANENT RECORD

CLERK OF COURT WILL CERTIFY AND FORWARD TO STATE REGISTRAR BY 10TH DAY OF MONTH FOLLOWING DATE FINAL DECREE IS GRANTED

Section 32.1-268

CODE OF VIRGINIA

VS4 7/15

 

 

COMMONWEALTH OF VIRGINIA- REPORT OF DIVORCE OR ANNULMENT

 

 

 

 

Department of Health- Division of Vital Records- Richmond

 

1. CIRCUIT COURT FOR CITYOR COUNTYOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I STATE FILE NUMBER

 

2. FULL NAME

 

 

PARTYA

(check one)

 

0 HUSBAND

 

 

 

 

0 WIFE

D SPOUSE

 

 

(first. middle, last, suffix)

 

 

I 5. DATE OF BIRTH

 

 

 

 

 

 

 

 

 

(maiden name, if any)

 

I

 

3. SOCIAL SECURITYNUMBER

4. PLACE OF BIRTH

(state or foreign country)

 

 

 

 

 

 

 

16. RACE

 

 

 

 

 

17. SEX

 

8. NUMBER OF THIS MARRIAGE (first, second, etc.)

 

 

 

 

I 9. EDUCATION (specify only highest grade

completed)

 

10. USUAL RESIDENCE

 

 

 

 

 

 

 

 

 

 

 

 

Elementary or Secondary (0-12)

 

College (1-4 or 5+)

 

(street number or rural route number)

 

 

 

(city or

town)

 

 

 

(county if not independent city)

(state)

11. FULL NAME

 

 

PARTYB

(check one)

 

0 HUSBAND

 

 

 

 

D

WIFE

D SPOUSE

 

 

(first, middle, last, suffix)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(maiden name, if any)

 

112. SOCIAL SECURITYNUMBER

13. PLACE OF BIRTH (state or foreign country)

 

114. DATE OF BIRTH

 

 

 

 

 

 

1

15. RACE

 

 

116. SEX

 

17. NUMBER OF THIS MARRIAGE (first, second, etc.)

 

 

 

 

1

18. EDUCATION (specify only highest grade completed)

 

19. USUAL RESIDENCE

 

 

 

 

 

 

 

 

 

 

Elementary or Secondary (0-12)

 

 

College (1-4 or 5+)

 

(street number or rural route number)

 

 

 

(city or town)

 

 

 

(county if not independent city)

(state)

20. PLACE OF MARRIAGE

(city or town)

 

 

(county)

 

 

(state or foreign country)

121. DATE OF MARRIAGE

 

122. DATE OF SEPARATION

23. NUMBER OF CHILDREN UNDER 18

24. NUMBER OF CHILDREN UNDER 18 IN THIS FAMILYWHOSE PHYSICAL CUSTODY\/VAS

AWARDED TO:

 

IN THIS FAMILY

 

 

 

Party A

Party B

 

Joint (Party A/Party B)

 

 

 

Other

 

 

 

DNo Children

 

25. PLAINTIFF

OPARTYB

OBOTH

26. DIVORCE GRANTED TO

0BOTH

 

I

 

27. LEGAL GROUND OR

CAUSE OF DIVORCE (if annulment- so state)

 

OPARTYA

 

DPARTYA

D PARTYB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28. INFORMANT'S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D PETITIONER

 

 

 

SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29. NAME OF INFORMANT (Type or Print)

 

 

 

I

30. ADDRESS OF

 

 

 

 

 

 

 

 

D ATTORNEYFOR PETITIONER

 

 

 

 

 

(street number or rural route number)

 

(city or town)

(state)

I CERTIFYTHAT A FINAL DECREE OF

 

 

 

 

INFORMANT

 

 

 

 

 

 

 

 

 

 

 

 

CONCERNING THE ABOVE

 

 

 

WAS ENTERED

 

 

 

 

 

 

 

 

 

 

 

(divorce or annulment)

 

 

 

 

(date of divorce or annulment)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MARRIAGE ANO WAS NUMBERED

 

(court file number)

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF CLERK OF COURT OR DEPUTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF CLERK OR DEPUTY

(Type or Print)

 

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step 1 to writing vs4 form virginia

Add the essential information in the SectionCODEOFVIRGINIA, PartyADPARTYADPARTYBBOTH, DPETITIONERDATTORNEYFORPETITIONER, numberorruralroutenumbercityortown, JointPartyAParty, PartyB, Other, DNoChildrensostate, stateDATEOFMARRIAGEDATEOFSEPARATION, ADDRESSOFstreetINFORMANTIWASENTERED, divorce, orannulment, state, dateofdivorce, and orannulment part.

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