Free STATE OF MINNESOTA - Minnesota

State of Minnesota
County
Select County

District Court
Judicial District: Court File Number: Case Type: Dissolution

In Re the Marriage of:

Name of Petitioner

and
Name of Respondent

Affidavit in Support of Motion For Temporary Relief Without Children

STATE OF MINNESOTA COUNTY OF My name is 1.

) ) SS ) and I state under oath that:

I am the (check one): Petitioner/Plaintiff Respondent/Defendant in this case, and I make this Affidavit in support of my Motion For Temporary Relief Without Children.

2. I AM NOT asking for temporary spousal maintenance. I AM asking the Court to decide temporary spousal maintenance LATER. I AM asking the Court for spousal maintenance. I do not have enough income to meet my needs. My spouse has income to meet his or her needs and is able to help me. My income and expenses are in my Application for Temporary Relief. I need $ per month. I cannot support myself because

3.

I am asking the Court to order my spouse to pay my attorney's fees: YES NO. YES, I need attorney's fees because

If

DIV603

State

ENG

Rev 5/08-D

www.mncourts.gov/forms

Page 1 of 5

4. I am asking the Court to order that I have sole use and possession of our home located at (full address)

I am asking the Court to order that my spouse have sole use and possession of our home located at (full address)

I am asking the Court to order that my spouse and I stay in the home located at (full address)

I am asking the Court for the relief checked above because

5.

My spouse and I have already divided our personal belongings, household goods and furniture: (check one): YES NO. If NO, I am asking for the temporary use and possession of the following personal property, household goods and furniture (list the specific items):

because

I am asking that my spouse have the temporary use and possession of the following household goods and furniture (list the specific items):

because

6.

My spouse and I own motor vehicle(s): YES NO. If YES, I want the temporary use and possession of the following motor vehicle(s): (list year/make/model for each vehicle)

DIV603

State

ENG

Rev 5/08-D

www.mncourts.gov/forms

Page 2 of 5

because

I want my spouse to have the temporary use and possession of the following motor vehicle(s): (list year/make/model for each vehicle)

because

I will make the payments and insurance costs for my vehicle(s): YES NO. NO, I want my spouse to make these payments because

If

My spouse should make the payments and insurance costs for his/her vehicle(s): YES NO. If NO, I do not want my spouse to make these payments because

7.

My spouse and I have debts: YES NO. If YES, I am asking the Court to order the debts to be paid temporarily as I asked in my Motion because

8.

I want to change certain medical, dental, automobile or life insurance policies: YES NO. If YES, I want to make the following changes:

because

9.

I am asking for insurance to be reinstated: YES NO.

If YES, explain:

DIV603

State

ENG

Rev 5/08-D

www.mncourts.gov/forms

Page 3 of 5

a. b. c. d.

What insurance has lapsed or been cancelled: The date that the insurance lapsed or was cancelled: Who let the insurance lapse or cancelled it: Why should the insurance be reinstated:

10.

I believe that my spouse's income will increase: YES NO.

If YES, this income

is (check all that apply): salary or wage increases; overtime pay; bonuses; or other (specify: I want the Court to order my spouse to immediately notify me of any changes in his or her income: YES NO because (s)he might not tell me and I want to know because

11.

I want the Court to order that my spouse shall not spend or otherwise use income raises, income tax refunds, bonuses or other extra income: YES NO. If YES, because

12.

I am asking the Court for permission to sell or otherwise dispose of property: YES NO. specific): If YES, I want to sell or otherwise dispose of the following property (be

because

13.

I asked the Court for additional relief: YES NO.

I asked for this relief because

DIV603

State

ENG

Rev 5/08-D

www.mncourts.gov/forms

Page 4 of 5

Dated:
Signature (Sign only in front of notary public or court administrator.)

Name: Subscribed and sworn to before me this day of , . Address: City/State/Zip: Telephone:
Notary Public \ Deputy Court Administrator

DIV603

State

ENG

Rev 5/08-D

www.mncourts.gov/forms

Page 5 of 5