Payment Amount:
$685.00 ( court fees are not included in this price)
$640.00 Low-Income/FIA benefits (filing fee is waved)
$375.00 Social Security Disability (filing fee is waved)
| Payment type: | |
| If paying by Visa/MasterCard please complete the following: |
| Card Number: | |
| Expiration Date: | / |
CVV Code:
(The 3-digit code on the back of the card) | |
| ZIP Code: | |
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| Some information about the marriage: |
| What County do you live in? | |
| Are you... |
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| How many children from the marriage? | |
| Is the Wife pregnant now? |
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| If yes, expected due date: | |
| Have you lived in Michigan for at least 6 months and in the County for at least 10 days? |
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| Date you were married: | |
| City and State you were married in: | |
| Some information about yourself: |
| Your full legal name: | |
| Your home street address: |
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| Your home city: |
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| Your home state: |
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| Your home ZIP code: |
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| Your email address: | |
| Home telephone: | |
| Work telephone: | |
| Cell telephone: | |
| Birthdate: | |
| Place of Birth: | |
| What was your LAST name BEFORE this marriage? | |
| How many times have you been married? | |
| Your Social Security number: | |
| Your Driver's License number: |
Issuing State: |
| Your Employer's name and address: | |
| Some information about your SPOUSE: |
| If you don't know all this information, just fill in as much as you can. |
| Spouse's full legal name: | |
| Spouse's home street address: | |
| Spouse's home city: |
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| Spouse's home state: |
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| Spouse's home ZIP code: |
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| Spouse's telephone number: | |
| Spouse's birthdate: | |
| Spouse's birth State: | |
| Spouse's Driver License number: |
Issuing State: |
| Spouse's Social Security number: | |
| Spouse's LAST name BEFORE this marriage: | |
| How many times has Spouse been married? | |
| Spouse's Employer name and address: | |
| Some information about the children: |
| If you don't know all this information, just fill in as much as you can. |
| Name and birthdate for each child:* | |
| Who will have PHYSICAL custody of the children? |
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| Who will have LEGAL custody of the children? |
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| Children's Health Care Provider: | |
| Policy number: | |
| The Health Insurance is provided by which parent? |
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| Are you or your spouse recieving FIA benefits? |
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| If yes, what is your Case Number? | |
| Is there a child-support Order in effect? |
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| If yes, what County and State? | |
| If yes, what is the FOC Case number? | |
| Friend of the Court (FOC) Options (check all that apply): |
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| Property Division: |
| We have NO property to be divided. |
| List all property to be divided in the space provided, (i.e. personal property and real estate property). State the agreement that you have or state how the property is be divided, or any specific information, instructions or questions. Including year and make of autos. | |
| Just a few more questions, then we're done!
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| WIFE's maiden name: | |
| Does WIFE want her maiden name back? |
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| Name other than maiden name that WIFE wants to change to: | |
| Date you separated: | |
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