Kentucky Deposition of Petitioner Form

Kentucky Deposition of Petitioner.doc This form must be filled in and submitted to the county court clerk’s office by the spouse that filed for the divorce. States the reason for divorce as a few othe

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NO. (A)____________________                                ___________________ CIRCUIT COURT

FAMILY DIVISION _________

 

 

(B)__________________________                                                                           PETITIONER

(print name of Petitioner)

SELF-HELP FORM #4

v.                                               DEPOSITION OF PETITIONER

 

(C)__________________________                                                                        RESPONDENT

(print name of Respondent)

 

* * *   * * *   * * *

 

The Petitioner, being duly sworn, states:

I.          I am the Petitioner in this matter.

II.        I had been a resident of Kentucky for more than 180 days when I filed my Petition.

III.       My age is ________.

IV.       My employment status is:  ¨ unemployed ¨ disabled ¨ retired ¨ employed as ____________________________.

(type of occupation)

 

V.        My spouse’s age is ________.

 

VI.       My spouse’s employment status is:  ¨ unemployed ¨ disabled ¨ retired ¨ employed as ____________________________

(type of occupation)

 

VII.      We were married on ____________________________ in ____________________

(date of marriage)              (county)

County, ___________________.

(state)

 

VIII.    We separated on (D)__________________________ and have not lived together as

(date of separation)

husband and wife since then.

 

IX.       ¨ We have no minor children of our marriage.

 

OR

 

¨ (E)We have the following minor child(ren) of our marriage:

 

Initials Age

 

X.        ¨ I am not ¨ the wife is not pregnant.

XI.       Our marriage is irretrievably broken.  There is no reasonable hope of reconciliation and a conciliation conference would serve no useful purpose.

XII.     Neither of us is in the military.

XIII.    ¨ The Respondent is in default.

OR

¨ We have entered a marital separation agreement that has been filed with the Court.

XIV.(F)I am the wife.  I ¨want ¨ do not want my former name of___________________

(former name)

to be restored.

 

 

(G)

(signature of Petitioner)

 

(H)

(Print name of Petitioner)

 

(address)

 

 

 

(I)

(telephone)

 

 

 

COMMONWEALTH OF KENTUCKY      )

)

COUNTY OF ___________________)

 

Subscribed and sworn to before me by the above-named Petitioner on this ______  day of  ___________________, 200____.

 

My commission expires: _______________________.

 

 

NOTARY PUBLIC

STATE AT LARGE, KENTUCKY