IN THE COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION MEDINA COUNTY, OHIO Judge Mary R. Kovack DISSOLUTION CHECKLIST (without children) PETITIONER-1: Counsel: PETITIONER-2: Counsel: Case number: Marriage date: Pursuant to Loc. R. 7.01 (check off if needed and included) CASE DESIGNATION FORM PETITION FOR DISSOLUTION Includes both parties’ names, addresses, dates of birth, marriage date Statement regarding jurisdiction and venue Signed by attorneys/parties If applicable, the attorney’s address, telephone, and bar number executed by both parties WAIVER OF SERVICE SEPARATION AGREEMENT, original, executed by both parties Disclosure statement Personal property division addressed (including vehicles) Real property division addressed Financial division of property addressed (accounts, investments, life insurance, etc.) Pension division addressed If applicable, must address QDRO and jurisdiction over them Liabilities and debt division addressed Taxes Spousal support addressed - including jurisdiction Spousal support must have an effective date and must address duration Mandatory CSEA language, if spousal support will go through CSEA JUDGMENT ENTRY DECREE OF DISSOLUTION Includes both parties’ names, addresses, dates of birth, marriage date Jurisdiction and venue requirements met Contains date of hearing Signed by attorneys/parties Contains mandatory CSEA language if applicable Statement that wife (1) wishes to be restored to former name or (2) does not wish to be restored to a former name Payment of court costs and attorney fees (please acknowledge that court costs must be paid from any deposits first; then, indicate any additional formula for sharing them between the parties, as appropriate)
IN THE COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION MEDINA COUNTY, OHIO Judge Mary R. Kovack DISSOLUTION CHECKLIST (without children) PETITIONER-1: Counsel: PETITIONER-2: Counsel: Case number: Marriage date: Pursuant to Loc. R. 7.01 (check off if needed and included) CASE DESIGNATION FORM PETITION FOR DISSOLUTION Includes both parties’ names, addresses, dates of birth, marriage date Statement regarding jurisdiction and venue Signed by attorneys/parties If applicable, the attorney’s address, telephone, and bar number WAIVER OF SERVICE executed by both parties SEPARATION AGREEMENT, original, executed by both parties Disclosure statement Personal property division addressed (including vehicles) Real property division addressed Financial division of property addressed (accounts, investments, life insurance, etc.) Pension division addressed If applicable, must address QDRO and jurisdiction over them Liabilities and debt division addressed Taxes Spousal support addressed - including jurisdiction Spousal support must have an effective date and must address duration Mandatory CSEA language, if spousal support will go through CSEA JUDGMENT ENTRY DECREE OF DISSOLUTION Includes both parties’ names, addresses, dates of birth, marriage date Jurisdiction and venue requirements met Contains date of hearing Signed by attorneys/parties Contains mandatory CSEA language if applicable Statement that wife (1) wishes to be restored to former name or (2) does not wish to be restored to a former name Payment of court costs and attorney fees (please acknowledge that court costs must be paid from any deposits first; then, indicate any additional formula for sharing them between the parties, as appropriate)
Revised-DISSOLUTION-CHECKLIST-without-children-Form-7.01A.docx