CJ-D 101B (4/07) C. G. F
COMPLAINT FOR DIVORCE PURSUANT TO G.L. c. 208 § 1B
Docket No.
Probate and Family Court Department
The Trial Court
Commonwealth of Massachusetts
on
(Street Address)
Division
V.
, Defendant, Plaintiff
was lawfully married to the defendant who now resides at
Plaintiff who resides at
(County)
(Zip)(State)(County)(City/Town)
(Zip)
(State)
(City/Town)(Street Address)
The parties were married at
onand last lived together at
(Date)
(Date)
The minor or dependent child(ren) of this marriage is/are:
(name of child and date of birth) (name of child and date of birth)
(name of child and date of birth)(name of child and date of birth)
Plaintiff certifies that no previous action for divorce, annulment or affirmation of marriage, separate support, desertion, living
apart for justifiable cause, or custody of child(ren) has been brought by either party against the other except:
(Date)
On or about
an irretrievable breakdown of the marriage under G.L. c. 208 § 1B
Wherefore, plaintiff requests that the Court:
grant a divorce on the ground of irretrievable breakdown.
prohibit defendant from imposing any restraint on plaintiff's personal liberty.
allow plaintiff to resume former name of
order conveyance of the real estate located at
order a suitable amount for support of
grant plaintiff defendant custody of the above-named child(ren).
standing in the name of
as recorded with the
Book
Page
(Signature of attorney or plaintiff, if pro se)
(Print name)
B.B.O. #
Tel. No.
(Zip)(State)(City/Town)
(Street address)
Date
1.
2.
3.
4.
5.
6.
occurred and continues to exist.
Registry of Deeds,
.
.
plaintiff
above-named child(ren)
and/or with suitable provision for health
insurance.
