Provide your Information

Name:
Address:
City:    County:
State: Zip:

Provide your Spouse's Information (We will not contact your spouse)

Name:
Address:
City:    County:
State: Zip:


Provide Marriage Information

Date of Marriage:
Location of Marriage (City and State):
Date of Separation:


Provide Statutory Information

Have you resided in the State of Michigan for at least 180 days: SelectYesNo

Have you resided in your County of residence for at least 10 days: SelectYesNo

Has there been a breakdown in the marital relationship, such that the objects of matrimony have been destroyed and there is no likelihood of reconciliation: SelectYesNo


Provide Debt and Property Information

List all property and assets:
(Indicate ownership next to each item; type in H for property owned by Husband, W for property owned by Wife, and J for jointly-owned property)


List property/assets Wife will transfer to Husband:



List property/assets Husband will transfer to Wife:



List all debts:
(Please specify credit cards by the name of the issuing bank)



List debts which Wife will pay:



List debts which Husband will pay:



Wife's Former Name

Wife wishes to restore former name:SelectYesNo

Wife's Former Name:

Provide Minor Children Information

List the name and birthdate of each minor child in common with your spouse (Indicate M for male and F for female):




Indicate whether there has ever been any prior court proceeding involving the custody or support of the minor child(ren). Please include the court and case number of any such proceeding:



Indicate which spouse will have physical custody of the child(ren):Select OneWifeHusbandJoint

Indicate the type of visitation schedule:Select OneReasonableSpecificSupervised

Specify the terms of the visitation schedule:


Provide Child Support/Spousal Support Information

Indicate Wife's annual income:

Indicate Husband's annual income:

Indicate which spouse will provide medical coverage for children:Select OneWifeHusbandBoth parents

Indicate whether spousal support will be paid:SelectYesNo

If yes, please enter the amount:

Indicate which spouse will pay support:Select OneWifeHusband


 ACKNOWLEDGMENT: Speedy Legal Docs did not provide me with any advice, explanation or representation about any legal rights, remedies, defenses or options: