Certificate Of Divorce

TYPE VIRGIN ISLANDS OF THE UNITED STATES CERTIFICATE OF DIVORCE, DISSOLUTION OF MARRIAGE, OR ANNULMENT COURT FILE NUMBER STATE FILE NUMBER SEE HANDBOOK FOR INSTRUCTIONS 1. HUSBAND'S NAME (First, Middle, Last) 2a. RESIDENCE-CITY, TOWN OR LOCATION 210. COUNTY OR ISLAND 2c. STATE 3a. BIRTHPLACE (State or Foreign Country) 3b. DATE OF BIRTH (Month, Day, Year) 4. SOC. SEC. NO. 5a. WIFE'S NAME (First, Middle, Last) 5b. MAIDEN SURNAME 6a. RESIDENCE-CITY, TOWN OR LOCATION 6b. COUNTY OR ISLAND 6c. STATE 7a. BIRTHPLACE (State or Foreign Country) 7b. DATE OF BIRTH (Month, Day, Year) 8. SOC. SEC. NO. 9a. PLACE OF THIS MARRIAGE-CITY, TOWN OR LOCATION 9b. COUNTY OR ISLAND 9b. STATE OR FOREIGN COUNTRY 10. DATE OF THIS MARRIAGE (Month,Day, Yr) 11. DATE COUPLE LAST RESIDED IN SAME HOUSEHOLD (Month Day, Year) 12. NUMBER OF CHILDREN UNDER 18 IN THIS HOUSEHOLD AS OF THE DATE IN ITEM 11 Number None 13. PETITIONER HUSBAND Other (Specify) WIFE BOTH a. NAME OF PETITIONER'S ATTORNEY (TypelPrint) 14b. ADDRESS (Street and Number or Rural Route Number, City or Town, State, Zip Code) 15. 1 CERTIFY THAT THE MARRIAGE OF THE ABOVE NAMED PERSONS WAS DISSOLVED ON: (Month,Day, Year) 16. TYPE OF DECREE-Divorce, Dissolution, or Annulment (Specify) 17. DATE RECORDED (Month, Day, Year) , 18. NUMBER OF CHILDREN UNDER 18 WHOSE PHYSICAL CUSTODY WAS AWARDED TO: Husband Joint (Husband/Wife) No Children 21. SIGNATURE OF CERTIFYING OFFICIAL 22. TITLE OF CERTIFYING OFFICIAL Wife Other 1 9. ISLAND OF DECREE , 20. TITLE OF COURT 23. DATE SIGNED (Month. Day, Year) , CONFIDENTIAL INFORMATION. THE INFORMATION BELOW WILL NOT APPEAR ON CERTIFIED COPIES OF THE RECORD. 24. NUMBER OF THIS MARRIAGE First, Second, etc. (Specify below) 25. IF PREVIOUSLY MARRIED, LAST MARRIAGE ENDED I By Death, Divorce, Dissolution, Date (Month, Day, Year) I or Annulment (Specify below) I 27. EDUCATION 26. RACE-American Indian, Black, White, etc. (Specify below) (Specify only highest grade completed Elementary/Secondary I I (0-12) I college (1-4 or 5+) 25a. 25b. 26a. 27a. , 24b 25c. 25d. 26b. 27b. I I I I I I i i , American LegalNet, Inc. www.FormsWorkflow.com