Eff. 1/07 Rev. 1/31/07 DECREE OF DISSOLUTION WITH CHILDREN NO SHARED PARENTING PLAN Case Caption [DR 49(B)] Parties' names Parties' addresses Parties' date of birth The name of the assigned Judge The words "Final Appealable Order" Statement of Hearing The name of the hearing officer who heard the case. The date the hearing was held. If a magistrate heard the hearing, a waiver of findings of fact and conclusions of law and objection period, unless a Form DR18 is filed. Statement of Arrears A statement of the child support arrears due and the date the arrears are owed through, if applicable. A statement of the spousal support arrears due and the date the arrears are owed through, if applicable. OR If support is current, a statement to that affect. Statement regarding Separation Agreement A statement incorporating the Separation Agreement by reference into the Decree was provided. Counsel Identification 1. Counsel for First Petitioner provided their name, Supreme Court Registration Number, address and telephone number. 2. Counsel for Second Petitioner provided their name, Supreme Court Registration Number, address and telephone number. Payment of Court Costs Every Decree shall contain a provision for the payment of court costs. Signatures on Decree 1. If both petitioners are represented by counsel, the Decree is signed by both attorneys. 2. If one party is represented by counsel, the Decree is signed by the attorney and the pro se litigant. 3. If neither party is represented by counsel, the Decree is signed by both pro se litigants. 4. A signature line for hearing officer. (If a magistrate heard the final hearing, a signature line for the magistrate and assigned case judge must be present.) Number of Copies Six (6) copies, plus the original, of the Decree were provided. Required Documents to be submitted with the Decree If child support or spousal support is ordered and paid through CSEA, a Form DR 201 was provided. If child support or spousal support is ordered, an original IV-D application was provided.