Fillable Form 1: SAO 2 3 4 Self-Represented 5 (Family Law Self Help Center)

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Form 1: SAO 2 3 4 Self-Represented 5 (Family Law Self Help Center)

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© 2021 Family Law Self-Help Center 1 Stipulation & Order (No Children)
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SAO
Name: _________________________
Address: _______________________
City, State, Zip: __________________
Phone: _________________________
Email: _________________________
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
________________________________
Plaintiff,
vs.
________________________________
Defendant.
CASE NO.: ____________________
DEPT: ____________________
STIPULATION AND ORDER
The parties in this matter, (Plaintiff’s name) ______________________________________
and (Defendant’s name) ______________________________________, both in Proper Person,
hereby stipulate and agree to the following:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
© 2021 Family Law Self-Help Center 2 Stipulation & Order (No Children)
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(CHECK ONLY ONE BOX)
No hearing is currently scheduled.
OR
The hearing currently scheduled for (date) _____________________ at
(time) _____________ ( check one) a.m. p.m. should be taken off calendar.
DATED this (day) _______ day of (month) ___________________, 20_____.
Respectfully Submitted:
By:
(Plaintiff’s signature)
Plaintiff’s Name:
Address:
City, State, Zip:
Phone:
Email:
By:
(Defendant’s signature)
Defendant’s Name:
Address:
City, State, Zip:
Phone:
Email:
ACKNOWLEDGMENT (Plaintiff)
STATE OF NEVADA )
)
COUNTY OF CLARK )
On this (day) _______ day of (month) ___________________, 20_____, before me, the
undersigned Notary Public in and for the said County and State, personally appeared (Plaintiff’s
name) _____________________________________, known to me to be the person described in and
who executed the foregoing Stipulation and Order, and who acknowledged to me that he / she did so
freely and voluntarily and for the uses and purposes therein mentioned.
WITNESS my hand and official seal.
_______________________________________
Signature of notarial officer
© 2021 Family Law Self-Help Center 3 Stipulation & Order (No Children)
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ACKNOWLEDGMENT (Defendant)
STATE OF NEVADA )
)
COUNTY OF CLARK )
On this (day) _______ day of (month) ___________________, 20_____, before me, the
undersigned Notary Public in and for the said County and State, personally appeared (Defendant’s
name) _____________________________________, known to me to be the person described in and
who executed the foregoing Stipulation and Order, and who acknowledged to me that he / she did so
freely and voluntarily and for the uses and purposes therein mentioned.
WITNESS my hand and official seal.
_______________________________________
Signature of notarial officer
ORDER
UPON A READING of the foregoing Stipulation of the parties and good cause appearing,
IT IS HEREBY ORDERED that the parties’ stipulation is adopted and made an Order of
this Court.
IT IS FURTHER ORDERED that hearing presently scheduled for (date) ______________ at
(time) ____________ ( check one) a.m. p.m. shall be taken off calendar.
DATED this _____ day of _________________, 20_____.
________________________________________
DISTRICT COURT JUDGE
Respectfully Submitted:
(Your signature) ______________________________
(Your name) ______________________________
/s/
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Form 1: SAO 2 3 4 Self-Represented 5 (Family Law Self Help Center)

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Completed 15 January 2021

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