THIS IS A 2-SIDED FORM
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COMMONWEALTH OF MASSACHUSETTS
The Trial Court
Probate and Family Court Department
BARNSTABLE BERKSHIRE BRISTOL DUKES ESSEX FRANKLIN HAMPDEN HAMPSHIRE MIDDLESEX NANTUCKET NORFOLK PLYMOUTH SUFFOLK WORCESTER Division / Docket #Joint Petition for Divorce Under G.L. c. 208, §1A
andPetitioner/Wife, of / Petitioner/Husband, of
1. Now come Husband and Wife in a joint petition for divorce pursuant to G.L. c. 208, §1A.
2. The parties were lawfully married at , on , and last lived together at , on .
3. The minor of this marriage and :
None4. The parties certify that no previous action for divorce, annulling or affirming marriage, separate support, desertion, living apart for justifiable cause, or custody of child has been brought by either party against the other except: None.
5. On or about , an irretrievable breakdown of the marriage under G.L. c. 208, §1A did occur and to this day continues to exist.
6. Wherefore, the parties pray that the Court:
Grant a divorce on the ground of irretrievable breakdown of marriage.
Approve the separation agreement executed by the parties.
Incorporate and merge said agreement in the divorce judgment.
Incorporate but not merge said agreement, which shall survive and remain as an independent contract.
Allow Wife to resume her former name of .
Other.
Dated: / Dated:Petitioner/Wife / Petitioner/Husband
Attorney for Wife: / Attorney for Husband:
BBO #
Telephone: () / BBO #
Telephone: ( )
Joint Petition for Divorce
Under G.L. c. 208, §1A
For Wife: / Docket Number:Name: / Filing Date:
Address: / Agreement Approved:
Judgment:
BBO #
Telephone: / ( )
For Husband: / Documents filed:
Name: / Marriage Certificate
Address: / Wife’s Financial Statement
Husband’s Financial Statement
Separation Agreement
BBO # / Affidavit of Irretrievable Breakdown
Telephone: / ( ) /
Child Support Guidelines Worksheet
Affidavit Disclosing Care or
Custody ProceedingsCJ-D 101A (6/90) c.g.f. / LRAM