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Brad Kurlancheek, Attorney at Law,
19 Darling St., Wilkes-Barre PA 18702
OFF: (800) 324-9748 or (570) 825-5252 FAX: (800) 374-6145 >
?'s: email@example.com (put "DIVORCE" in subject)>
USE THIS PAGE TO APPLY BY-MAIL or FAX ONLY>
BY MAIL. Either (1) type in the information asked for, below, on your computer screen, then print the form using File/Print on your browser, or (2) print this page first, then fill it in freehand. Then: Mail this form to my office with check or money order for $295.00. There are no extra costs.
BY FAX. You may also fax THIS form, but only if you are using a credit card, which payment information you may fill in below on the bottom of this page. There are no extra costs.
You can also apply by ONLINE CREDIT CARD. You may use the Secured Online No Fault Divorce Application instead of this form, if you wish to pay by credit card online. There are no extra costs. Click here now if you wish to apply and pay online. Otherwise, stay here, and use THIS application for Mail-in or Fax purposes.
Either way, once I receive your application and payment, I'll mail you divorce papers for your review, signature & return mailing. You will receive the divorce papers within 10 to 15 days after you mail me your application and payment. When you receive the divorce papers from me, please do not fax them back, as the court requires on file your original signature.
NO FAULT DIVORCE APPLICATION
you are separated (approximate): You do not have to be
You may still file for and obtain a legal divorce even if you are still cohabitating with your spouse; however, if you do not live in the same residence as your spouse, then you are technically considered "separated." If you are separated, please indicate below the approximate date separation began. If you have been separated for at least two years, your divorce will take approximately 65 to 80 days. If you have been separated less than 2 years, your divorce will take approximately 4 1/2 to 6 months.
Mth/ Day/ Year
Approximate Date of Separation:
What is your name and full address:
Your E-Mail Address:
Maiden name if applicable:
Date of birth:
State where you were born:
County where you reside:
Phone Numbers - (Optional, but sometimes a problem can be fixed quickly if I can call you instead of writing.)
Date since you have lived at present address: Month/Year
Your spouse's name and full address (must be exact & completely accurate; otherwise, if I do not have a correct address, I will not be able to accomplish your divorce, since service of the divorce papers to your spouse will THEN not be possible.)
Spouse's Maiden name if applicable:
County where he/she presently resides:
Date married: (If unsure, please guesstimate):
Month Day Year
Where married (County (or city if don't know county) and State):
Date since your spouse has lived at present address:
That's it; it's that simple. You're ALMOST done.
YOUR INITIALS ARE REQUIRED IN ONE (1) PLACE BELOW.
I caution you NOT to do this, unless you're absolutely sure of each of the following:
(1) MUTUAL CONSENT: Your spouse also wants to be divorced.
(2) PROPERTY: You have no property disputes and do not need a Property Settlement Agreement (i.e., you do not have extensive pension, stock, real estate, or other assets of significant value which you and your spouse are requiring to have definitively divided up between the two of you by a Property Settlement Agreement, which Agreement you want made a condition of, and a part of, your divorce. If you do require a Property Settlement Agreement, please email me first, at firstname.lastname@example.org .
(3) CORRECT ADDRESS OR EMAIL OF YOUR SPOUSE: You know where your spouse lives or you have a valid email address for him/her.
(4) CHILDREN: If you have children, AND you and your spouse CANNOT agree on such issues as Custody, Visitation, or Support, you will make arrangements, either on your own or through an attorney, to settle and resolve such matters through the Domestic Relations Section (DRS) of the county where your children reside, either before, during, or after your divorce. By filling out this form and initialing here you acknowledge that this divorce will not resolve nor effect any issues concerning children between you and your spouse. You may still obtain a no fault divorce without resolving these issues. You are not required by law to resolve these issues through your no fault divorce action. You can either resolve them independently of your divorce, resolve them after your divorce (or before), or determine that such issues will be resolved privately between you and the other parent of your children, without resorting to litigation through Domestic Relations and/or the county court system.
(5) RESIDENCE: One of you has resided in Pennsylvania for the past 6 months.
Please review your form for accuracy, then print and mail the form w/check or money order for $295.00 to my office address below. You will receive divorce papers for your review and signature within 10 to 15 days. There are no extra or hidden costs. The total fee is $295.00 providing your spouse consents, and you have a good mailing address for your spouse.
If you wish to FAX OR MAIL IN YOUR CREDIT CARD NUMBER:
If you prefer to pay by FAXED or MAILED-IN CREDIT CARD NO., please complete the following:
Visa , Mastercard , American Express or Discover (place an "X")
Name on Credit Card
Address of Credit Card Holder (Street) City, State, Zip
Credit Card Number Expiration Date
The 3 Digit Code on the Back of your Credit Card:
DATE YOU SIGNED THIS FORM: YOUR SIGNATURE:
If you are using your credit card, you may either fax or mail your application. Fax Number is (570) 300-1864
If you are using your check or money order, please mail your application and payment to the address below.
Please feel free to call or e-mail if any questions or concerns. (Put "DIVORCE" in subject.)
BRAD KURLANCHEEK, ATTORNEY AT LAW
19 DARLING ST., WILKES-BARRE PA 18702-2510
OFF: (570) 825-5252 or (800) 324-9748 Fax (800) 374-6145