Form DC6:5(1) "Complaint for Dissolution of Marriage (With Child(Ren))" - Nebraska

What Is Form DC6:5(1)?

This is a legal form that was released by the United States District Court for the District of Nebraska - a government authority operating within Nebraska. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on February 1, 2015;
  • The latest edition provided by the United States District Court for the District of Nebraska;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DC6:5(1) by clicking the link below or browse more documents and templates provided by the United States District Court for the District of Nebraska.

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Download Form DC6:5(1) "Complaint for Dissolution of Marriage (With Child(Ren))" - Nebraska

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Nebraska State Court Form
COMPLAINT FOR
DISSOLUTION OF
Do NOT complete form without reading instructions. Click HERE for Nebraska Self-Help Center instructions.
DC 6:5(1) Rev. 02/15
MARRIAGE (With Child(ren))
Neb. Rev. Stat. § 42-353
IN THE DISTRICT COURT OF _______________________ COUNTY, NEBRASKA
(county where Complaint filed)
____________________________,
Case No. CI _____________
Plaintiff,
(your full name)
(case number assigned by clerk of court)
COMPLAINT FOR
vs.
DISSOLUTION OF MARRIAGE
(WITH CHILD(REN))
____________________________,
Defendant.
(spouse’s full name)
I ______________________________________, without assistance of an
(your full name)
attorney, ask this court for a Dissolution of Marriage. In support of my complaint, I state
that the following items are true:
1.
I live at ___________________________________________________,
(your street address: if confidential under Nebraska or Federal law, enter county and state only and provide an
alternative address for mailing of notice)
in ___________________________________________________________________,
(city, county, and state where you live)
2.
My spouse’s address is _______________________________________,
(spouse’s street address)
in __________________________________________________________________.
(city, county and state where spouse lives)
3.
Either my spouse or I have lived in the state of Nebraska for more than one year
prior to the filing of this complaint, with the intention of making this state a permanent home.
4.
At the time I filed this action, either my spouse or I was living in
______________________ County, Nebraska.
(county where Complaint filed)
5.
We were married on ___________________________________,
(date of marriage)
in _________________________________.
(city and state of marriage)
Page 1 of 7
Complaint for Dissolution of Marriage (with Child(ren))
DC 6:5(1) Rev. 02/15
Pro Se Committee
Nebraska State Court Form
COMPLAINT FOR
DISSOLUTION OF
Do NOT complete form without reading instructions. Click HERE for Nebraska Self-Help Center instructions.
DC 6:5(1) Rev. 02/15
MARRIAGE (With Child(ren))
Neb. Rev. Stat. § 42-353
IN THE DISTRICT COURT OF _______________________ COUNTY, NEBRASKA
(county where Complaint filed)
____________________________,
Case No. CI _____________
Plaintiff,
(your full name)
(case number assigned by clerk of court)
COMPLAINT FOR
vs.
DISSOLUTION OF MARRIAGE
(WITH CHILD(REN))
____________________________,
Defendant.
(spouse’s full name)
I ______________________________________, without assistance of an
(your full name)
attorney, ask this court for a Dissolution of Marriage. In support of my complaint, I state
that the following items are true:
1.
I live at ___________________________________________________,
(your street address: if confidential under Nebraska or Federal law, enter county and state only and provide an
alternative address for mailing of notice)
in ___________________________________________________________________,
(city, county, and state where you live)
2.
My spouse’s address is _______________________________________,
(spouse’s street address)
in __________________________________________________________________.
(city, county and state where spouse lives)
3.
Either my spouse or I have lived in the state of Nebraska for more than one year
prior to the filing of this complaint, with the intention of making this state a permanent home.
4.
At the time I filed this action, either my spouse or I was living in
______________________ County, Nebraska.
(county where Complaint filed)
5.
We were married on ___________________________________,
(date of marriage)
in _________________________________.
(city and state of marriage)
Page 1 of 7
Complaint for Dissolution of Marriage (with Child(ren))
DC 6:5(1) Rev. 02/15
Pro Se Committee
6.
Neither my spouse nor I am a party to any other pending actions for
divorce, separation, or dissolution of marriage in this state or in any other state.
7.
My spouse is not a member of the Armed Forces of the United States or its
allies.
8.
My marriage is irretrievably broken.
9.
My spouse and I have ______________ child(ren) whose custody or
(number of children)
welfare may be affected by this divorce. Their names and years of birth are:
_____________________________________
_____________
(name of child)
(child’s year of birth)
_____________________________________
_____________
(name of child)
(child’s year of birth)
_____________________________________
_____________
(name of child)
(child’s year of birth)
____________________________________
_____________
(name of child)
(child’s year of birth)
10.
______________________________ fit to have the care, custody, and
(“I am,” “My spouse is,” or “Both my spouse and I are”)
control of our minor child(ren).
11.
The following information is provided because of the requirements of the
Uniform Child Custody Jurisdiction and Enforcement Act:
(a)
For the last five years, the child(ren)’s addresses and the persons
they have lived with are:
DATES:
ADDRESS:
NAME and CURRENT ADDRESS
OF PERSON(S) WITH WHOM
THE CHILD(REN) HAVE LIVED:
______________
___________________
________________________________
______________
___________________
________________________________
______________
___________________
________________________________
______________
___________________
________________________________
______________
___________________
________________________________
Page 2 of 7
Complaint for Dissolution of Marriage (with Child(ren))
DC 6:5(1) Rev. 02/15
Pro Se Committee
(b)
Check the box that applies:
I have not been a party or a witness in any other proceeding
concerning the custody of or parenting time with the
child(ren).
OR
I have been a party or a witness in another proceeding
concerning the custody of or parenting time with the
child(ren), as follows:
(name of court)
(case number)
(date of child custody determination, if any)
(c)
Check the box that applies:
I know of no other actions or proceedings that could affect
this action. This includes actions or proceedings about
domestic violence, protection orders, termination of parental
rights, and adoptions.
OR
There is currently a proceeding which could affect this action.
(name of court)
(case number)
(date of child custody determination, if any)
Page 3 of 7
Complaint for Dissolution of Marriage (with Child(ren))
DC 6:5(1) Rev. 02/15
Pro Se Committee
(d)
Check the box that applies:
I do not know the names and addresses of any persons other
than my spouse and myself who have physical custody of the
child(ren) or claim to have custody or parenting time rights
with the child(ren).
OR
The following is a list of the names and addresses of persons
other than my spouse and myself who have physical custody
of the child(ren) or claim to have custody or parenting time
rights with the child(ren):
NAME:
ADDRESS:
_________________________
_____________________________________
_________________________
_____________________________________
12.
_________________________ able to provide support for the child(ren).
(“I am” or “My spouse is”)
13.
During the course of the marriage, my spouse and I have accumulated
certain items of property, which should be fairly divided between us.
14.
My spouse and I owe certain marital debts and obligations and the
responsibility for payment of these debts and obligations should be fairly divided
between us.
15.
I wish my former name, _______________________________________,
(former or maiden name, including first, middle and last names)
to be restored to me.
16.
I want this dissolution of marriage proceeding heard by a district court judge.
Page 4 of 7
Complaint for Dissolution of Marriage (with Child(ren))
DC 6:5(1) Rev. 02/15
Pro Se Committee
17.
Check the box that applies:
There are no existing restraining orders, protection orders, or
criminal no-contact orders regarding either party.
OR
There are one or more existing restraining orders, protection
orders, or criminal no-contact orders regarding one or more of the
parties. Details are as follows:
(a)
Type(s) of order(s):
restraining;
protection;
criminal no-contact.
(b)
Name of court, case number, and date of order for each
order:
________________________________________________
(name of court, case number and date of each order)
________________________________________________
________________________________________________
A Parenting Plan
has
has not (check one) been developed.
18.
19.
Child custody, parenting time, or other access, and child support are not
contested.
I request the Court:
A.
Dissolve my marriage.
B.
Fairly divide the property and debts between my spouse and me.
Page 5 of 7
Complaint for Dissolution of Marriage (with Child(ren))
DC 6:5(1) Rev. 02/15
Pro Se Committee
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