James E.Smith, ESQ.

Name, address, phone number, e-mail and date of birth for husband

Name *

Address *

Phone Number *

Email Address *

Date of Birth for husband *

Name, address, phone number, e-mail and date of birth for wife

Name *

Address *

Phone Number *

Email Address *

Date of Birth for wife *

Name and birthdates of any children between husband and wife

Name *

Date of Birth for children *

Name

Date of Birth for children

Date and place of marriage

Date *

Place *

Are you married outside Nevada?

Yes

Has your resident agent seen you in Nevada every week for the last 6 weeks?

Yes

Date of separation between husband and wife

Date *

Do you have a pre or post-nuptial or separation agreement?

Yes

What name wife wants after marriage

Name *

Is wife pregnant?

Yes

Who gets custody and what is the proposed visitation

Name *

Proposed visitation *

Name and address of your resident witness

Name *

Address *

What is the reason for your annulment

Reason *

What evidence do you have for your reason

Evidence *