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Form 10

You cannot obtain a 3301(d) divorce against an unrepresented Defendant if he/she is in the military. Therefore, you only need to file this form if your spouse is not represented by counsel, and you are seeking a divorce under Section 3301(d) of the Divorce Code.

The numbers on these instructions correspond with the numbers in the boxes on the form. Use the form with the boxes to guide you through filling out the blank form.

Box 1: Print the name of the county you are filing in exactly as it appears on Form 1.

Box 2: Print the name of the Plaintiff exactly as it appears on Form 1.

Box 3: Print the docket number. This is the number that the Prothonotary's Office wrote on Form 1 at the time of filing.

Box 4: Print the name of the Defendant exactly as it appears on Form 1.

Box 5: Print your full name.

Box 6: Print the date.

Box 7: Sign your name.

AFFIDAVIT OF NON-MILITARY SERVICE PURSUANT TO PA.R.C.P. 1920.46.

I, ___ (your full name), say that I am the Plaintiff in the above-captioned matter; that I personally know that the Defendant is over the age of eighteen years, and that Defendant is not in the military service or in any branch of the armed forces of the United States or its allies or otherwise within the provisions of the Servicemember's Civil Relief Act, formally the Soldiers' and Sailors' Civil Relief Act of Congress of 1940, and the amendments thereto. I verify that the statements in this document are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904, relating to unsworn falsification to authorities.

I verify that the statements in this document are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904, relating to unsworn falsification to authorities.

Plaintiff's Signature

PLAINTIFF VS. DFFFNDANT Case No. ___

Case No.

IN DIVORCE

I, ___ (your full name), say that I am the Plaintiff in the above-captioned matter; that I personally know that the Defendant is over the age of eighteen years, and that Defendant is not in the military service or in any branch of the armed forces of the United States or its allies or otherwise within the provisions of the Servicemember's Civil Relief Act, formally the Soldiers' and Sailors' Civil Relief Act of Congress of 1940, and the amendments thereto.

I verify that the statements in this document are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904, relating to unsworn falsification to authorities.

Date:_____

Plaintiff's Signature

CASE NO. _____

I certify that this filing complies with the provisions of the Case Record Public Access Policy of the Unified Judicial System of Pennsylvania: Case Records of the Appellate and Trial Courts that require filing confidential information and documents differently than non-confidential information and documents.

Signature: _____

Petitioner Date: _____

Print Name: _____

Date: