Statement in support of an application for a divorce, dissolution or (judicial) separation on the ground of 5 years’ separation

Published date21 March 2018
Subject MatterDivorce and civil partnership dissolution forms
Statement in support of
divorce / dissolution /
(judicial) separation
5 years’ separation
Section 1(2)(e) Matrimonial Causes Act 1973
Section 44(5)(c) Civil Partnership Act 200 4
To be completed by the Petitioner
Name of court Case No.
Name of Petitioner
Name of Respondent
If completing this form by hand, please use black ink a nd BLOCK CAPITAL LETTERS and tick the boxes that apply.
About the petition
1. Have you read the petition for divorce dissolution (judicial) separation in this case?
Yes N o
2. Do you wish to alter or add to any statement in the divorce / dissolution / ( judicial) separation petition?
If Yes, please state the alterations or additions to be made.
Yes N o
3. Subject to these alterations or additions (if any) is everything stated in your divorce / dissolution /
(judicial) separation petition true?
If any statement is not within your own knowledge, please indicate this and state whether it is true to the
best of your information and belief.
Yes N o
4. State the date on which you and the Respondent separated.
D D /M M /YYYY
5. State the date on which you came to the decision that the marriage/civil partnership was at an end.
D D /M M /YYYY
D80E Statement in support - 5 years’ separation (04.14) © Crown Copyright 2014
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