Instructions for Completing Forms for Joint Simplified Dissolution of Marriage There are five (5) forms which must be completed for obtaining a joint simplified dissolution of marriage. All of these forms have been drafted to be self-explanatory and as easy to complete as possible. The first three forms listed below (numbers 1-3) must be signed by both spouses in the presence of a Notary Public. A Notary Public is available at the Circuit Clerk’s office in the Family section, Room 118. Until you have a Notary Public present to attest to your signature in writing, do not sign the Joint Affidavit regarding Separation of the Parties, Division of Property and Waiver of Bifurcated Hearing; Joint Petition for Simplified Dissolution of Marriage; and Agreement as to Assets and Debts.

Forms: 1. Joint Petition for Simplified Dissolution of Marriage 2. Joint Affidavit regarding Separation of the Parties, Division of Property and Waiver of Bifurcated Hearing 3. Agreement as to Assets and Debts 4. Judgment for Dissolution of Marriage 5. Certificate of Dissolution of Marriage (available at the Circuit Clerk’s office, once the above four forms

have been filed). The above-listed forms appear below this page. You may access the forms by scrolling down, but please read the following before scrolling down.

With all five forms, you should either type, or neatly print with black ink, the necessary information. If you complete the forms by hand, be sure your printing is legible, or you may be required to start over and complete the forms again. Fill out all forms completely. Even though this is a “joint” petition, one of the parties must be designated as a “Petitioner” and the other must be designated as a “Respondent.” Traditionally, the party seeking the dissolution is the petitioner.

The Judgment for Dissolution of Marriage need not be signed in front of a Notary, but should be completed and signed by both parties, below the words “Approved as to Form and Content,” before your hearing. The judge will complete the “Entered” line and sign the Judgment if the dissolution is granted.

If a spouse wishes to return to her maiden or former name, she should complete paragraphs 11 and C of the Petition form and paragraphs 11 and D of the Judgment form.

You must also complete the Certificate of Dissolution of Marriage and submit it when the judge grants the dissolution, along with a copy of your most recent income tax return.

Other than providing this brochure and accompanying forms, employees of the Circuit Clerk are prohibited by law from giving any legal advice.

IN THE CIRCUIT COURT OF THE THIRD JUDICIAL CIRCUIT Madison County, Illinois

IN RE THE MARRIAGE OF:

) Petitioner; )

) NO. vs. )

) )

Respondent.

JOINT PETITION FOR SIMPLIFIED DISSOLUTION OF MARRIAGE

Now comes Petitioner, , without counsel, and Respondent, , without

counsel, and hereby petition this Honorable Court for a dissolution of the marriage between Petitioner and Respondent. In support

of this petition for dissolution of marriage, the parties state as follows:

1. The Petitioner is presently years of age; Petitioner’s occupation is ; Petitioner resides at

, Illinois; and has/ has not resided in the State of

Illinois for at least ninety (90) days immediately preceding the filing of this Petition for Dissolution of Marriage.

2. The Respondent is presently years of age; Respondent’s occupation is ; Respondent

resides at , Illinois; and has/ has not

resided in the State of Illinois for at least ninety (90) days immediately preceding the filing of this Petition for Dissolution of

Marriage.

3. The Petitioner and Respondent have been married for less than eight (8) years prior to the filing of this petition; they were

married on (date) ; and the marriage was registered in the County of , State of

.

4. No children were born to the Petitioner and Respondent during their relationship; no children were adopted by Parties; and

neither party, to their knowledge, is pregnant.

5. The parties have lived separate and apart for a continuous period in excess of six (6) months and irreconcilable differences

have caused the irretrievable breakdown of their marriage; efforts at reconciliation have failed and future attempts at

reconciliation would be impracticable and not in the best interests of the parties. The parties have lived

separate and apart since (date) .

Page 1 of 3

6. Neither party is dependent on the other party for spousal support (also known as alimony or maintenance), or each party is

willing to waive the right to spousal support. Both parties understand that consulting with attorneys may help determine

eligibility for spousal support. Both Petitioner and Respondent waive any rights to maintenance.

7. Neither Petitioner nor Respondent has any interest in real property (real estate) or retirement benefits unless the retirementbenefits are exclusively held in individual retirement accounts and the combined value of the accounts is less than $10,000.00.

8. The parties have disclosed to each other all assets and their tax returns for all years of the marriage.

9. Neither party has a gross annualized income in excess of $30,000; the Petitioner’s gross annual income from all sources is

$ ; the Respondent’s gross annual income from all sources is $ ; and the total

annual income of the parties is less than $60,000.00.

10. The total fair market value of all marital property, after deducting all encumbrances, is less than $50,000.00 and the

parties have executed a written agreement dividing all assets in excess of $100.00 in value and allocating responsibility for

debts and liabilities between the parties. A copy of the written agreement, signed by both parties, is filed with this

petition.

11. (Optional) ‘s former/maiden name was .

WHEREFORE, the parties pray as follows:

A. That the parties be awarded a Judgment of Dissolution of Marriage dissolving the bonds of matrimony existing between them.

B. That the written agreement of the parties dividing marital assets, debts and liabilities, a copy of which is filed with this

petition, be incorporated into the final order and judgment of this Court granting the petition for dissolution of marriage.

C. (Optional) That (wife’s name) be restored to her former/maiden name,

.

D. That this Court grant the parties such other and further relief as may be just.

Petitioner (signature) Respondent (signature)

Page 2 of 3

Case No

VERIFICATION – JOINT PETITION

STATE OF ILLINOIS ) ) SS

COUNTY OF MADISON )

, Petitioner, being first duly sworn upon oath, depose and say that I have read the foregoing Joint

Petition for Simplified Dissolution of Marriage, understand the contents thereof, and believe the same to be true and correct to the

best of may knowledge and belief.

Petitioner (signature)

Subscribed and sworn before me, a Notary Public, this day of , 20 .

NOTARY PUBLIC

STATE OF ILLINOIS ) ) SS

COUNTY OF MADISON )

, Respondent, being first duly sworn upon oath, depose and say that I have read the foregoing

Joint Petition for Simplified Dissolution of Marriage, understand the contents thereof, and believe the same to be true and correct

to the best of may knowledge and belief.

Respondent (signature)

Subscribed and sworn before me, a Notary Public, this day of , 20 .

NOTARY PUBLIC

Page 3 of 3 Case No

IN THE CIRCUIT COURT OF THE THIRD JUDICIAL CIRCUIT Madison County, Illinois

IN RE THE MARRIAGE OF:

)

Petitioner; ) ) NO.

vs. ) )

) Respondent.

JOINT AFFIDAVIT REGARDING SEPARATION OF THE PARTIES, DIVISION OF PROPERTY AND WAIVER OF BIFURCATED HEARING

NOW COME , Petitioner, and , Respondent, and

being first sworn on their oaths, depose and state as follows:

1. That irreconcilable differences have caused the irretrievable breakdown of their marriage.

2. That all efforts at reconciliation of the differences between the parties have heretofore failed and future attempts at reconciliation would be impracticable and not in the best interest of the parties.

3. That the parties have lived separate and apart for a continuous period of more than six (6) months prior to the date of this

affidavit, having separated on or about and having remained living separate for all times thereafter.

4. That the marital property belonging to the parties has been divided according to the terms of the written agreement of the parties filed with the Petition for Dissolution of Marriage in this cause, and that the parties have executed all documents required to carry out the agreement.

5. That the parties waive any right either may have to a bifurcated hearing in this cause.

6. That each of the parties represents that their signing of this Affidavit is their individual, sole, and voluntary act.

Petitioner (signature) Respondent (signature)

Page 1 of 2 Case No

VERIFICATION – JOINT AFFIDAVIT

STATE OF ILLINOIS ) ) SS

COUNTY OF MADISON )

, Petitioner, being first duly sworn upon oath, depose and say that I have read the foregoing Joint

Affidavit, understand the contents thereof, and believe the same to be true and correct to the best of may knowledge and belief.

Petitioner (signature)

Subscribed and sworn before me, a Notary Public, this day of , 20 .

NOTARY PUBLIC

STATE OF ILLINOIS ) ) SS

COUNTY OF MADISON )

, Respondent, being first duly sworn upon oath, depose and say that I have read the foregoing

Joint Affidavit, understand the contents thereof, and believe the same to be true and correct to the best of may knowledge and

belief.

Respondent (signature)

Subscribed and sworn before me, a Notary Public, this day of , 20 .

NOTARY PUBLIC

Page 2 of 2 Case No

IN THE CIRCUIT COURT OF THE THIRD JUDICIAL CIRCUIT Madison County, Illinois

IN RE THE MARRIAGE OF:

) Petitioner; )

) NO. vs. )

) )

Respondent.

JUDGMENT FOR DISSOLUTION OF MARRIAGE

This cause having come on for hearing on the Joint Petition for Simplified Dissolution of Marriage filed by the parties hereto; the Court having examined and considered the Petition, the Affidavit of the parties, and all other pleadings and exhibits filed in this matter; the Court having heard the testimony presented herein; and the Court being otherwise fully advised in the premises, find as follows:

1. This Court has Jurisdiction over the subject matter and the parties hereto.

2. and/or (Petitioner and/or Respondent, or both) now, and for ninety (90) days continuously and immediately preceding this date, have been residents of the State of Illinois.

3. The parties have been married for less than eight (8) years prior to the filing of this petition; the parties weremarried on (mo/day/year) ; and the marriage was registered inCounty, State of .

4. The parties have lived separate and apart for a continuing period of six (6) months; irreconcilable differences have caused theirretrievable breakdown of the marriage; efforts at reconciliation have failed; and, further efforts at reconciliation would notbe in the best interests of the parties.

5. The parties have each signed an affidavit regarding separation.

6. The parties have each signed a waiver of any right to a bifurcated hearing in this case.

7. No children were born to or adopted by the parties during their relationship and neither party is pregnant at this time.

8. Both the Petitioner and Respondent have waived any right to maintenance.

9. Neither Petitioner nor Respondent has any interest in real property. The parties have disclosed to each other all assets andtheir tax returns for all years of marriage. Neither party has a gross annualized income in excess of $30,000, and the totalannualized income of the parties is less than $60,000.

10. The total fair market value of all marital property owned by the parties, after deducting all encumbrances, is less than$50,000.00. The parties have executed a written agreement, which the Court finds is not unconscionable, dividing all assetsin excess of $100.00 in value and allocating responsibility for all debts and liabilities between the parties. A copy of thewritten agreement, signed by both parties, was filed with the petition in this cause and is hereby incorporated by reference asif fully set forth herein.

Page 1 of 2

11. (Optional) ‘s former/maiden name was . (wife’s name) (wife’s maiden OR former name)

WHEREFORE, IT IS HEREBY ORDERED, ADJUDGED AND DECREED:

A. The marriage between the parties is hereby dissolved, and Petitioner and Respondent are each hereby awarded a

Judgment of Dissolution of Marriage dissolving their bonds of matrimony. B. This Court adopts as a part of this Judgment, as if it were fully set forth herein, the agreement of the parties concerning the

distribution of assets, debts and liabilities. Petitioner and Respondent are hereby ordered to dispose of all claims each may have against the other, and to dispose of all assets, debts and liabilities, in accordance with and pursuant to the agreement entered into by the parties and presented to this Court. Petitioner and Respondent are each ordered to timely execute any, and all titles, certificates and other documents of any kind or nature whatsoever, necessary to carry out the terms and condition of this Judgment of Dissolution of Marriage as to the division of assets, debts and liabilities ordered herein.

C. Each of the parties is hereby denied any right or claim to maintenance.

D. (Optional) is hereby restored to her former/maiden name, .

(wife’s name) E. Except for the provisions contained in this Judgment of Dissolution of Marriage, each of the parties is hereby barred and

foreclosed from making any and all claims against the other whether for alimony or maintenance, homestead rights, dower rights, rights of inheritance or any and all other property rights, whether real, personal or mixed, which either of them may now have or may hereafter acquire arising out of the marital relationship heretofore existing between them.

F. This Court retains jurisdiction of this cause for the purpose of enforcing the provisions of this Judgment of Dissolution of

Marriage. ENTERED:

JUDGE APPROVED AS TO FORM AND CONTENT:

Petitioner (signature)

Respondent (signature)

Page 2 of 2

Case No

Description of Asset and Estimated Value (List all marital assets in excess of One Hundred Dollars [$100] in value – assets of lower value may be listed)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

Page 1 of 2

IN THE CIRCUIT COURT OF THE THIRD JUDICIAL CIRCUIT Madison County, Illinois

IN RE THE MARRIAGE OF:

) Petitioner; )

) NO. vs. )

) )

Respondent.

AGREEMENT AS TO ASSETS AND DEBTS

Now come , Petitioner, and , Respondent, (Petitioner’s Name) (Respondent’s Name)

and hereby agree to the following distribution of all marital assets in excess of One Hundred Dollars ($100.00) in value and the following division of all marital debts and liabilities.

Marital Assets

Party to Receive Asset (Enter name of Party [Petitioner or Respondent]

who will receive asset)

15.

Marital Debts and Liabilities

Description of Debt or Liability Amount Account Number Party to Pay Debt (List last 4 digits of Account (Enter name of Party [Petitioner

(List all Marital Debts and Liabilities) (list total balance due) Number where applicable) or Respondent] who will be responsible paying the debt or liability)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Petitioner’s Signature Respondent’s Signature

Subscribed and Sworn before me this day of Subscribed and Sworn before me this day of , 20 . , 20 .

Notary Public Notary Public

(Seal) (Seal)

Page 2 of 2 Case No

AFFIDAVIT AS TO MILITARY SERVICE

(Petitioner)

vs

Case Number

(Respondent)

AFFIDAVIT AS TO MILITARY SERVICE OF RESPONDENT

I, , make oath and say as follows:

1.

2. I am the petitioner in the above-entitled action and as such have full knowledge of the

facts relating thereto.

(Check A., B. or C.)

A. Said respondent is in the military service of the United States.

B. Said respondent is not in the military service of the United States.

C. I am not able to determine whether or not respondent is in such service.

D. I further state that

(In D., set forth the fact upon which affidavit is based. The Soldiers and

Sailors Civil Relief Act requires facts be stated showing respondent is not in the military service. Stating conclusion only is not sufficient. If respondent is in the military service, file date of induction, unit, and length of service, if known.)

(Petitioner)

SUBSCRIBED AND SWORN TO ME THIS DAY OF , A.D.,

20 .

NOTARY PUBLIC

and My age is years, my residence is at .my occupation is

IN RE THE MARRIAGE OF:

ENTRY OF APPEARANCE – WAIVER AND CONSENT

STATE OF ILLINOIS )

) SS. IN THE CIRCUIT COURT

COUNTY OF MADISON )

IN RE THE MARRIAGE OF:

CASE NUMBER

PETITIONER

AND

RESPONDENT

I HEREBY ENTER MY APPEARANCE IN THE ABOVE-ENTITLED CAUSE AS RESPONDENT HEREIN, AND

EXPRESSLY WAIVE THE NECESSITY OF PROCESS OF SUMMONS AND CONSENT THAT THE SAME

PROCEEDINGS MAY BE HAD HEREIN, AS FULLY AND WITH THE SAME FORCE AND EFFECT AS THOUGH I HAD

BEEN DULY AND REGULARLY SERVED WITH PROCESS OF SUMMONS THEREIN IN THE STATE OF ILLINOIS,

AT LEAST THIRTY DAYS PRIOR TO ANY RETURN DAY DESIGNATED BY THE PETITIONER HEREIN OR AS

PROVIDED BY LAW.

I FURTHER CONSENT THAT IMMEDIATE DEFAULT MAY BE TAKEN AND ENTERED HEREIN AGAINST ME

UPON THE FILING OF THIS APPEARANCE OR AT ANY TIME THEREAFTER AND THAT AN IMMEDIATE HEARING

OF SAID CAUSE MAY BE HAD WITHOUT FURTHER NOTICE.

DATED AT , ILLINOIS THIS DAY OF ,

A.D.,20 .

STATE OF ILLINOIS )

) SS.

COUNTY OF MADISON )

I, A NOTARY PUBLIC IN AND FOR SAID COUNTY IN THE

STATE AFORESAID, DO HEREBY CERTIFY THAT PERSONALLY KNOWN

TO ME TO BE THE SAME PERSON WHOSE NAME IS SUBSCRIBED TO THE WITHIN INSTRUMENT OF WRITING,

APPEARED BEFORE ME THIS DAY IN PERSON, AND ACKNOWLEDGED THAT SIGNED THE SAME AS

FREE AND VOLUNTARY ACT, FOR THE USES AND PURPOSES THEREIN SET FORTH.

DAY OF GIVEN UNDER MY HAND AND NOTARIAL SEAL,

THIS , A.D., 20____.

NOTARY PUBLIC

Case No