Uniform Domestic Relations Form 17 – (Petition for dissolution of Marriage and Waiver of Service of Summons)

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Supreme Court of Ohio Uniform Domestic Relations Form 17 PETITION FOR DISSOLUTION OF MARRIAGE AND WAIVER OF SERVICE OF SUMMONS Approved under Ohio Civil Rule 84 Amended: June 1,2021 Page 1 of 3 IN THE COURT OF COMMON PLEAS ______________________________ DIVISION ______________________________ COUNTY, OHIO Case No. Name Judge Street Address Magistrate City, State and Zip Code Petitioner 1 and Name Street Address City, State and Zip Code Petitioner 2 WARNING: This form is not a substitute for the benefit of the advice of legal counsel. It is highly recommended that you consult an attorney. Instructions: This form is used to request ending the marriage when the parties have agreed on all aspects of the termination, including the division of real estate, personal property, debts, spousal support, and, if there is/are (a) child(ren), allocation of parental rights and responsibilities (custody), parenting time (companionship and visitation) and child support. A Separation Agreement (Uniform Domestic Relations Form 19) must be filed with this Petition. If there is/are child(ren), a Parenting Proceeding Affidavit (Uniform Domestic Relations Form 3) and either a Shared Parenting Plan (Uniform Domestic Relations Form 20) or a Parenting Plan (Uniform Domestic Relations Form 21) must be filed with this Petition. The Court may require additional forms to accompany this document. You must check the requirements of the county in which you file. YOU MUST UPDATE THE CLERK OF COURTS IF ANY OF THE ABOVE CONTACT INFORMATION CHANGES. PETITION FOR DISSOLUTION OF MARRIAGE AND WAIVER OF SERVICE OF SUMMONS WITH CHILDREN WITHOUT CHILDREN Now come Petitioners and state as follows: 1. Petitioner 1 Petitioner 2 Both parties has/have been (a) resident(s) of the State of Ohio for at least six (6) months immediately before the filing of this Petition. 2. Petitioners consent to venue.

Supreme Court of Ohio Uniform Domestic Relations Form 17 PETITION FOR DISSOLUTION OF MARRIAGE AND WAIVER OF SERVICE OF SUMMONS Approved under Ohio Civil Rule 84 Amended: June 1,2021 Page 2 of 3 3. Petitioners were married on (date of marriage) in (city or county, and state). 4. Neither party is pregnant OR a party is pregnant. 5. Check all that apply: (If more space is needed, add additional pages) There is/are no minor child(ren) born from or adopted during this marriage or relationship. The following child(ren) was/were born of the parties’ relationship prior to the marriage: Name of Child Date of Birth The following child(ren) was/were born from or adopted during this marriage: Name of Child Date of Birth The following child(ren) was/were born from or adopted during this marriage or relationship and is/are mentally or physically disabled and will be incapable of supporting or maintaining themselves: Name of Child Date of Birth The following child(ren) is/are subject to an existing order of parenting or support of another Court or agency: Name of Child Date of Birth Name of Court or Agency One party is not the parent of the following child(ren) who was/were born during the marriage: Name of Child Date of Birth 6. Military Service: Neither Petitioner 1 nor Petitioner 2 is an active-duty servicemember of the United States military. Petitioner 1 and/or Petitioner 2 is an active-duty servicemember of the United States military.

Supreme Court of Ohio Uniform Domestic Relations Form 17 PETITION FOR DISSOLUTION OF MARRIAGE AND WAIVER OF SERVICE OF SUMMONS Approved under Ohio Civil Rule 84 Amended: June 1,2021 Page 3 of 3 7. Petitioners entered into a Separation Agreement which is attached and incorporated herein as if fully written. 8. If Petitioners have (a) minor child(ren): (select one) Petitioners agreed to a Shared Parenting Plan which is attached and incorporated herein as if fully written. Petitioners agreed to a Parenting Plan which is attached and incorporated herein as if fully written. 9. Petitioners are both over eighteen (18) years of age, are not under any disability, and waive all rights to receive Summons for the dissolution action through the Clerk of Courts. 10. _________________________________________________, requests to be restored to the former name of . Petitioners request that the Court dissolve their marriage and issue a Judgment Entry-Decree of Dissolution of Marriage adopting the terms of the Separation Agreement and the Shared Parenting Plan or Parenting Plan, if there is/are (a) child(ren). Petitioner 1 Signature ___________________________________________ Printed Name ___________________________________________ Address ___________________________________________ City, State, Zip ______________________________________________________ Phone Number ___________________________________________ Fax Number ___________________________________________ E-mail Petitioner 2 Signature _____________________________________________ Printed Name _____________________________________________ Address _____________________________________________ City, State, Zip ________________________________________________________ Phone Number _____________________________________________ Fax Number _____________________________________________ E-mail Petitioner 1 Attorney Signature ___________________________________________ Printed Name ___________________________________________ Address ___________________________________________ City, State, Zip ______________________________________________________ Phone Number ___________________________________________ Fax Number ___________________________________________ E-mail ___________________________________________ Supreme Court Reg No. Petitioner 2 Attorney Signature _____________________________________________ Printed Name _____________________________________________ Address _____________________________________________ City, State, Zip ________________________________________________________ Phone Number _____________________________________________ Fax Number _____________________________________________ E-mail _____________________________________________ Supreme Court Reg No.