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Summons And Complaint For Civil Union Dissolution-Notice Of Appearance-And Affidavit Of Child Custody 836CU - Vermont
| Summons And Complaint For Civil Union Dissolution-Notice Of Appearance-And Affidavit Of Child Custody Form. This is a Vermont form and can be used in Family Court Statewide . |
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Form 836 CU Vermont County Docket Number Family Court SUMMONS, COMPLAINT FOR CIVIL UNION DISSOLUTION NOTICE OF APPEARANCE AND AFFIDAVIT OF CHILD CUSTODY Plaintiffs Name Dendants Nameef Street Address Street Address V. Town/City State Zip Code Town/City State Zip Code SUMMONS To the above-named Defendant: You are hereby summoned and required to serve upon the Plaintiff at the address listed above an Answer to the attached Complaint that has been served upon you. You must also file a copy of your Answer Name and Address of the Court with the Court at the following address: You must answer this summons within (20) days of the date of service. If you fail to answer the Complaint within twenty days, a Default Judgment may be entered against you and the Court may grant the relief demanded by the plaintiff in the Complaint. Under most circumstances, your answer must state as a counterclaim any related claim which you may have against the plaintiff, or you will thereafter be barred from making such claim in any other action. Court Clerk Date COMPLAINT FOR CIVIL UNION DISSOLUTION Town/City County State 1. (a) Plaintiff resides in Date (b) ___ Plaintiff has resided in Vermont continuously until the present day since Town/City County State 2. (a) Defendant resides in Date (b) ___ Defendant has resided in Vermont continuously until the present day since Date 3. Plaintiff and Defendant received a Certificate of civil union on at Town/City State 4. The following are the biological or adoptive children of said civil union: Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth Form 836 CU 10/00 <<<<<<<<<********>>>>>>>>>>>>> 25. The parties own the following property singly or jointly: 6. The following actions for divorce, annulment, civil union dissolution, abuse prevention or separate supporthave been brought by either party against the other: ____ None, or: ( ___ A certified copy of the complaint and docket entries in the previous action is attached.) 7. Defendant has/will have lived separate and apart from the plaintiff for six consecutive months and the resumptionof the civil union relationship is not reasonably probable. The parties separated on Date8. ___ Plaintiff ___ Defendant is or has been a recipient of public assistance from the VT Department ofSocial Welfare. PLAINTIFF REQUESTS THE FOLLOWING RELIEF: ___ 1. Dissolution of civil union. ___ 2. That the Court award ___ the plaintiff ___ the defendant legal rights and responsibilities for the minor children. ___ 3. That the Court award ___ the plaintiff ___ the defendant physical rights and responsibilities for the minor children. ___ 4. That the Court award ___ the plaintiff ___ the defendant suitable parent/child contact. ___ 5. That the Court award payment of suitable child support money. ___ 6. That the Court award ___ the plaintiff ___ the defendant suitable maintenance supplement. ___ 7. That the Court award ___ the plaintiff ___ the defendant suitable maintenance. ___ 8. That the Court award ___ the plaintiff ___ the defendant a suitable portion of the property of the civil union. ___ 9. That the Court award the plaintiff costs and attorneys fees. ___10. Such other relief as is just and equitable. <<<<<<<<<********>>>>>>>>>>>>> 3 NOTICE OF APPEARANCE I, the Plaintiff in this case, enter my pro se appearance; I will represent myself. Unless I or an attorney notify you otherwise, no attorney will represent me in this case. All court papers may be mailed to me by first class mail at the address listed above. I understand that it is my responsibility to notify the Court of any change in my mailing address. I understand that if I send anything to the Court, I must send copies to Defendant or Defendants attorney. I can be reached by telephone at the following numbers. Telephone Number (day) Telephone Number (evening) AFFIDAVIT OF CHILD CUSTODY I.With regard to each child named in the above complaint, the child: (use an additional page if you need more space) A. now lives: at ___ my address ___ the address listed below: B. has lived in the places listed below within the last five years: C. has lived with the following people during the past five years (give current address): II A. Have you participated as a party, witness, or in any other capacity in any litigation concerning the custody of the child(ren) named above, in Vermont or in any other state? ___ yes** ___ no B. Do you have information of any custody proceeding concerning the child(ren) named above pending in a court in Vermont or in any other state? ___ yes** ___ no C. Do you know of any person not a party to these proceedings who has physical custody of the child(ren) named above or claims to have custody or visitation rights with respect to the child(ren)? ___ yes** ___ no (** If you answered yes, please explain on another page) Notice: During this proceeding, you must inform the court if you learn of any other custody proceeding concerning the child(ren). Date Signature of Plaintiff Subscribed and sworn to before me: Date Signature of Notary Public Expiration Date Form 836 CU 10/00
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