SCA-FC-108: Answer to Divorce Petition
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 2 of 5
During the last five years, if any of the children have lived at addresses other than their current address, use
the following space to list where they lived, and for how long. If there is not enough room in the following
space, use an additional sheet of paper.
I have attached additional sheet(s).
Child's Name Address Dates of Residence
Who provides health insurance for the children?
Another person, whose name and address is:
The children DO NOT have health insurance coverage.
The West Virginia Children's Health Insurance Program (WV CHIP) can help parents obtain free
or low cost health care for their children. For more information, call 1-877-982-2447, or ask the
Family Court staff about WV CHIP.
a. Has the Respondent been a party or witness in any other proceeding, in any state,
concerning the allocation of custodial responsibility for the children?
b. Is the Respondent aware of any other proceeding, past or present, in any state,
concerning allocation of custodial responsibility for the children?
c. Is the Respondent aware of any person, other than the Petitioner and Respondent, who
has physical custody of, or claims any custodial right concerning the children?
Answer all of the following questions.