July 2011 (Form 1) Request for Divorce Page 1 of 4
Approved by the Tennessee Supreme Court
Thi
s form is
only for spouses who:
Have no children together who are under 18, in high school, or disabled.
Agree how to divide their property and debt, and have no land, or businesses, or retirement
benefits.
One or both spouses lived in Tennessee for at least 6 months and/or they lived in Tennessee
when they decided to divorce.
If you do not meet these rules, you
cannot use these forms. Please talk to a lawyer.
BOTH
SPOUSES SIGNED AND NOTARIZED THE DIVORCE AGREEMENT
A
NSWER EACH QUESTION.
Residency - (CHECK ALL THAT APPLY):
My spouse or I have lived in Tennessee for at least 6 months.
I was living in Tennessee when the reason for this divorce happened.
Our differences arose in Tennessee.
Venue – (CHECK ONE) I am filing for divorce in this County because:
My spouse and I lived in this County when we separated.
Address:
Street Address City State Zip
My spouse lives in this County.
I live in this County and my spouse does not live in Tennessee, or is in jail.
Reason for Divorce - (you must both sign and notarize the Divorce Agreement to use this form):
My spouse and I can no longer get along, and we have irreconcilable differences.
Children - My spouse and I have no children together who are under 18, in high school, or disabled.
Children together means children you had together, born before your marriage,
AND any and all
children born during your marriage or adopted.
The Wife - (CHECK ONE):
is
is not pregnant. (If the Wife is pregnant, you cannot use this
form.)
Date of Separation -
My spouse and I decided to divorce on (C
HECK ONE):
The date of filing this paper (REQUEST FOR DIVORCE); or
The date we started living apart: (MM/DD/YYYY):
We were married on (MM/DD/YYYY): in:
(City, County, State or Foreign Country)
State of Tennessee
Circuit Court Sumner County
Request for Divorce (Complaint)
File No.
(Must Be Completed)
Plaintiff
(Name: First, Middle, Last) of Spouse Filing the Divorce)
Defendant
(Name: First, Middle, Last of the Other Spouse)
July 2011 (Form 1) Request for Divorce Page 2 of 4
Approved by the Tennessee Supreme Court
Orders of Protection and Injunctions:
If you have an Order of Protection, it will stay in effect until the divorce judge changes it. Or it
has already expired (
CHECK THE BOX TO DESCRIBE YOUR POSITION):
No Order of Protection has been in effect during this case.
The Order of Protection is ended (expired).
The Order of Protection is active when I file this paper (Request for Divorce) and so will stay in
effect until the divorce judge changes it.
(ATTACH A COPY OF ORDER OF PROTECTION)
Restraining Order (CHECK ONE):
No Restraining Order other than the Statutory Injunction, which applies in every divorce case,
has been in effect during this case.
Other (DESCRIBE):
Wife’s Information
Name:
First Name Middle Name Maiden Name Last Name (now)
Address:
Street Address City State Zip
Birthplace
City and State or Foreign Country
Birth Date (MM/DD/YYYY):
Race: White Hispanic Black Native American Other:
How many marriages before this
one?
How long has she lived in
Tennessee?
years months
Active-duty U.S. Armed
Services?
Ye s No
Husband’s Information
Name:
First Name Middle Name Maiden name Last name (Now)
Address:
Street address City State Zip
Birthplace
City and State or Foreign Country
Birth date (MM/DD/YYYY):
Race: White Hispanic Black Native American Other:
How many marriages before this
one?
How long has he lived in
Tennessee?
years months
Active-duty U.S. Armed
Services?
Ye s No
V
ICTIMS OF
D
OMESTIC
V
IOLENCE
You do not have to list a home address below. You may list a P.O. Box instead.
The local domestic violence agency can help you.
Call 1-800-356-6767 or go to www.tcadsv.org
July 2011 (Form 1) Request for Divorce Page 3 of 4
Approved by the Tennessee Supreme Court
Financial Information
Real Property (House, Land, or Mobile Homes that are permanently attached to the ground)
My spouse and I:
Do NOT own Real Property. If either of you have REAL Property, please see a lawyer first.
Personal Property (such as Cars, Mobile Homes (not permanently attached to the ground), Bank
Accounts)
Own property and have filed the Divorce Agreement that lists how our property is divided.
Do not own Personal Property (such as Cars, Mobile Homes, Bank Accounts)
(If either of you has a Pension or Retirement Account or own a Business, you cannot use these
forms.
Please see a lawyer first.)
Debts My spouse and I (check one):
Do NOT have debts.
Have debts and have filed a Divorce Agreement that lists how our debts are divided.
One or both of us has filed for a Bankruptcy and it is still active.
Alimony (check one):
Neither spouse wants alimony.
One of the spouses wants alimony, as agreed to in our Divorce Agreement.
Name Change (check below to change a spouse’s name back to the name used before this marriage)
Wife requests
First Name Middle Name Last Name
Husband requests
First Name Middle Name Last Name
Court Costs (check one):
Who will pay the court costs for this divorce?
Spouses will each pay 50% of the costs.
Husband will pay all costs.
Wife will pay all costs.
Other agreement: __________________________________________________________.
Divorce Agreement
Our signed Divorce Agreement (Form 5) is attached, and we ask the Court to approve it.
I ask the Court to grant this divorce, make the other orders I have asked for above, and to make any
other orders I am entitled to.
July 2011 (Form 1) Request for Divorce Page 4 of 4
Approved by the Tennessee Supreme Court
READ THE TEXT BELOW THEN SIGN ONLY IN FRONT OF A NOTARY
Signed at (City): on (Date):
(MM/DD/YYYY)
State of Tennessee, County of
(Name of County Where Notarized)
I know that Tennessee has laws against lying on purpose (perjury). I swear that:
As far as I know, the information on this form is true.
My request for divorce is serious.
My spouse and I have
not agreed to lie about the information in this divorce.
SWORN to and SUBSCRIBED before me, on (date):
Signed at (City):
State of Tennessee, County of
By (Name of Person Filing for Divorce):
(Signature of Person Filing for Divorce):
Signature of Notary Public, State of Tennessee
My commission expires: ___________
MM/DD/YYYY
(N
OTARYS SEAL)