NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.

Cause Number: 0F ' 2H ' 07’53I

Print cause number and other court information exactly as the court assigned.

In the Matter of the Marriage of

a»
2 i) 6
N 171“) maaflTB’ml 0050949
In the
Petitioner:
(court Number)
Print first. middle and last name of the spouse filing for divorce.

And E’bistrict Court

D County Court at Law
Respmden“ VAsmdn Fmzemraml BHwesW on LL93 County.
Print first, middle and last name of other spouse. Texas

Final Decree of Divorce

A hearing took place on
Date

There was no jury. Neither the husband nor wife asked for a jury.

1. Appearances
Petitioner
The Petitioner's name is: N111 'J PMBRTB H M O DEDA'IQA
First Middle Last
The Petitioner is the: (Check one box.) Z’husband. D wife.
(Check one box.)
B’The Petitioner was present, self-represented, and announced ready for trial.
D The Petitioner was present, self-represented, and agreed to the terms of this Final Decree of Divorce
(called “Decree" throughout this document).
D The Petitioner was not present but has signed on page 9 agreeing to the terms of this Decree.

Respondent
The Respondent’s name is: V9 59"]71 PHRBM ennl (3‘1an; R “a
First Middle Last
The Respondent is the: (Check one box.) Dhusband. Erwife.
(Check one box.)
The Respondent was present, self-represented, and announced ready for trial.
The Respondent was present, self-represented, and agreed to the terms of this Decree.
DDDDD

The Respondent was not present, but filed an Answer or Waiver of Service and has signed on page
9 agreeing to the terms of this Decree.
The Respondent was not present, but filed a Global Waiver that waived Respondent's right to notice
of this hearing and did not otherwise appear.
The Respondent was not present, but was served and has defaulted. The Petitioner has filed a
Certificate of Last Known Address and a Military Status Affidavit.

FM-DivA-201 Final Decree of Divorce [Divorce Set A] (Rev. 11—2021) Page 1 of 9

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2. Record (The Court fills out this section.)

D A Court reporter recorded today’s hearing.

D A Court reporter did not record today’s hearing because the parties agreed not to make a record.
U A Statement of the Evidence was signed by the Court.

3. Jurisdiction

The Court heard evidence and finds that it has jurisdiction over this case and the parties, that the
residency and notice requirements have been met, and the Petition for Divorce meets all legal
requirements. The Court further finds that: (Check one box.)
has been at least 60 days since the Petition for Divorce was filed.
it

D the 60 day waiting period is not required because: (Check one box.)
D Petitioner has an active Protective Order under Title 4 of the Texas Family Code. or an active
magistrate's order for emergency protection under Article 17.292 of the Texas Code of Criminal
Procedure against Respondent because Respondent committed family violence during the
marriage.
D Respondent has a final conviction or has received deferred adjudication for a crime involving
family violence against Petitioner or a member of Petitioner's household.

4. Family Violence Statement

It has been represented to the Court that: (Check ONLY the option that applies to the situation.)

Z’, There has been no pattern of child neglect or family violence by any party to this case within two
years preceding the filing of this case or during the pendency of this case.
Or

D There has been family violence (Check all that apply.):

E while the divorce was pending
D during the two years prior to the filing of this lawsuit.

5. Dates of Marriage and Separation (Check ONLY the option that applies to the situation):

E’The date of marriage was on or about: 0&1 Q ' I &°13

Month Day Year
D This was an informal (common law) marriage.
6. Divorce

IT lS ORDERED that the Petitioner and the Respondent are divorced.

7. Children

7A.No Children Together

The Court finds that the spouses do not have any biological or adopted children together who are under
18 years old, or over 18 years old and still in high school.

FM-DivA-201 Final Decree of Divorce [Divorce Set A] (Rev. 11-2021) Page 2 of 9

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7B.Wife Not Pregnant
The Court finds that the wife is not pregnant.

7C.Did the wife have a child with another man while married to the husband?
(Check one box.)
The Court finds that the wife did not have children with another man while married to the husband.
D The Court finds that the wife did have a child or children with another man while married to the
husband. All of the children born during the marriage that are not the husband’s adepted or biological
children are named below:
Child’s name Sex Date of Birth

check one box below and attach

If the wife had a child with another man while married to the husband,
copy of court order or Acknowledgement and Denial of Paternity for each child.
The Court further finds that paternity of each child listed above has been established,
D A court order has established that another man is the biological father and/or the husband is not
the biological father of the child(ren) listed above. A copy of the court order is attached to this
Decree as Exhibit ___.
D An Acknowledgement of Paternity was signed by the biological father and a Denial of Paternity
was signed by the husband for the child(ren) listed above. A copy of each Acknowledgment and
Denial of Paternity is attached to this Decree as Exhibit(s)

8. Property and Debt

(Fill in all lines. If there is no property to declare in a particular category, write “none”.
The Court finds that the following is a just and right division of the parties' property and debt.

8A. Husband’s Separate Property

The Court confirms that the husband owns the following property as his separate property:
1. House or Land located at:
Street Address City State Zip
D Husband owned this property before marriage.
D Husband received this property as a gift or inheritance.
2. Cars, trucks, motorcycles or other vehicles Husband owned these vehicles before marriage or
received them as a gift or inheritance during the marriage:
Vehicle Identification No. [VlN]
Year Make Model _
eoie emw 3.2a. NBME5¢586<NMMH

3. Other Money or Property Confirmed as Husband’s Separate Property

Husband owned the following money or property before the marriage or inherited or received the
money or property as a gift during the marriage:

FM-DivA-201 Final Decree of Divorce [Divorce Set A] (Rev. 11-2021) Page 3 of 9

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 $QH.200 inVcsmwk ha swam", 5 3‘100 in chase, bum “may,
$ 6. 500 in WC bum acmw.
Husband received the following money recovery for personal injuries that occurred during the
marriage that is not for lost wages or medical expenses:

8B. Husband’s Community Property

The Court ORDERS that the husband is awarded the following community property as his sole and
separate property and wife is divested of (loses) all right, title, interest and claim in and to that property.
wife is ORDERED to sign any deeds or documents needed to transfer any pr0perty listed below to the
husband. Husband is responsible for preparing the documents.
1. All property in husband’s care, custody or control, or in husband’s name, that this Decree does not
give to the wife.
2. House or land located at:
Street Address City State Zip

Legal Description:

Note: The legal description is on the deed you received when you became an owner of the house or land.
It is also available at the county clerk’s office in the county where the house or land is located. Do NOT
use the legal description listed on your property tax bill because it is usually incomplete. lT IS VERY
IMPORTANT THAT THIS INFORMATION IS CORRECT. If you are not absolutely sure, talk to a lawyer.

All cash and money in any bank or other financial institution listed in husband’s name alone.

Any insurance policy that covers husband‘s life.

Husband's cars, trucks, motorcycles or other vehicles listed below:
Year Make Model Vehicle Identification No. [VIN]

6. Husband will also keep the following property:

8C. Wife’s Separate Property

The Court confirms that wife owns the following property as her separate property:
1. House or Land located at:
Street Address City State Zip
D Wife owned this property before marriage.
D Wife received this property as a gift or inheritance.

2. Cars, trucks, motorcycles or other vehicles Wife owned these vehicles before marriage or
received them as a gift or inheritance during the marriage:
Year Make Model Vehicle Identification No. [VIN]

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3. Other Money or Property Confirmed as Wife’s Separate Property
Wife owned the following money or personal property before the marriage or inherited or received the
money or property as a gift during the marriage:

Wife received the following money recovery for personal injuries that occurred during the marriage
that was not for lost wages or medical expenses:

SD. Wife’s Community Property

The Court ORDERS that the wife is awarded the following property as her sole and separate property and
Husband is divested of (loses) all right. title, interest and claim in and to that property. Husband is
ORDERED to sign any deeds or documents needed to transfer any property listed below to the wife.
Wife is reSponsible for preparing the documents.
1. All property in wife's care, custody or control, or in wife's name, that this Decree does not give to the
Husband.
2. House or land located at:
Street Address City State Zip

Legal Description:

Note: The legal description is on the deed you received when you became an owner of the house or land.
It is also available at the county clerk’s office in the county where the house or land is located.
Do NOT
use the legal description listed on your property tax bill because it is usually incomplete. IT IS VERY
IMPORTANT THAT THlS INFORMATION IS CORRECT. If you are not absolutely sure, talk to a lawyer.

3. All cash and money in any bank or other financial institution listed in wife's name alone.

4. Any insurance policy that covers wife's life.

5. Wife's cars, trucks, motorcycles, or other vehicles listed below:

Year Make Model Vehicle Identification No. [VIN]

6. Wife will also keep the following property:

FM-DivA-201 Final Decree of Divorce [Divorce Set A] (Rev. 11-2021) Page 5 of 9

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8E. Retirement Funds in Husband’s Name
stock ownership, profit sharing, thrift,
(For example: pension, retirement. 401(k), 403(b), employee
and stock option plans, as well as individual retirement accounts (IRAs), annuities and variable
Keogh,
annuity life insurance benefits.)

The Court makes the following orders regarding retirement funds in husband’s name.

(Check 85(1) or 85(2).)

8E(1) D Husband is awarded 100% of all retirement funds in husband’s name alone, including but not
limited to all rights to any pension, retirement, military retirement, 401(k), 403(b), employee
stock ownership, profit sharing, thrift, Keogh, and stock option plans in husband‘s name
and variable
alone, along with 100% of any individual retirement accounts (IRAs), annuities,
annuity life insurance in husband’s name alone.

8E(2') D The following retirement funds in husband’s name are divided between husband and wife:
(It is very important to list the exact name and
account number of any retirement fund the Court is dividing.)

Formal Name of Retirement Fund Account Number

The Court ORDERS that the portion of each retirement fund listed above accrued between
the date of the marriage I I and the date this Final Decree of Divorce is

signed by the Court: (Check one.)

specifically described
D is awarded 50% to husband and 50% to wife and as moreCourt. in

the Qualified Domestic Relations Order signed by the

D is awarded % to husband and % to wife and as more specifically

described in the Qualified Domestic Relations Order signed by the Court.

D is awarded $ to wife and the remainder to husband and as

more specifically described in the Qualified Domestic Relations Order signed by
the Court.

D other:

The Court ORDERS that husband is awarded all retirement funds in husband’s name alone
that are not specifically awarded to wife above.

The Court checks this box. if applicable.

D A Qualified Domestic Relations Order was signed by the Court on the same day this
Final Decree of Divorce was signed by the Court.

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 8F. Retirement Funds in Wife’s Name
(For example: pension, retirement, 401(k), 403(b), employee stock ownership, profit sharing, thrift,
Keogh, and stock option plans, as well as individual retirement accounts (IRAs), annuities and variable
annuity life insurance benefits.)

The Court makes the following orders regarding retirement funds in wife’s name.
(Check 8F(1) or 8F(2).)

8F(1) D Wife is awarded 100% of all retirement funds in wife's name alone, including all rights to any
pension, retirement, military retirement, 401(k), 403(b), employee stock ownership, profit
sharing, thrift, Keogh, and stock option plans in wife‘s name alone, along with 100% of any
individual retirement accounts (IRAs), annuities, and variable annuity life insurance in wife's
name alone.

8F(2) D The following retirement funds in wife‘s name are divided between husband and wife:
(It is very important to list the exact name and account number of any retirement fund the Court is dividing.)

Formal Name of Retirement Fund Account Number

The Court ORDERS that the portion of each retirement fund listed above accrued between
the date of the marriage / I and the date this Final Decree of Divorce is

signed by the Court: (Check one.)

D is awarded 50% to wife and 50% to husband and as more specifically described in
the Qualified Domestic Relations Order signed by the Court.

D is awarded % to wife and % to husband and as more specifically

described in the Qualified Domestic Relations Order signed by the Court.
D is awarded $ to husband and the remainder to wife and as
more specifically described in the Qualified Domestic Relations Order signed by
the Court.

D other:

The Court ORDERS that wife is awarded all retirement funds in wife's name alone that are
not specifically awarded to husband above.

The Court checks this box. if applicable.

D A Qualified Domestic Relations Order was signed by the Court on the same day this Final
Decree of Divorce was signed by the Court.

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8G. Debts to Husband
The Court ORDERS husband to pay the debts listed below:
1. All debts, taxes, bills, liens. and other charges, past, present and future, that are in husband‘s name
alone unless this Decree requires otherwise.
2. Any debt husband incurred after separation. Date of separation:
Month Day Year
3. The balance due on any loan or mortgage for the real property (house or land) that this Decree gives
to husband alone.
4. The balance due on any loan for any vehicles that this Decree gives to husband alone.
5. All other debts listed below, which are not in husband's name alone: (such as credit cards, student
loans, medical bills, income taxes)

8H. Debts to Wife

The Court ORDERS wife to pay the debts listed below:
1. All debts, taxes, bills, liens, and other charges, present and future, that are in wife's name alone
unless this Decree requires otherwise.
2. Any debt wife incurred after separation. Date of separation:
Month Day Year
3. The balance due on any loan or mortgage for the real property that this Decree gives to wife alone.
4. The balance due on any loan for any vehicles that this Decree gives to wife alone.
5. All other debts listed below, which are not in wife’s name alone:
(such as credit cards, student loans, medical bills, income taxes)

9. Muniment of Title
This Decree shall serve as a muniment of title to transfer ownership of all property awarded to any party
in this Final Decree of Divorce. (A “muniment of title" creates an official record of ownership transfer.)

10. Name Change

The Court ORDERS the name of the: (Check all boxes that apply.)
D Husband changed back to a name used before marriage, as it appears below:

First Middle Last

D Wife changed back to a name used before marriage, as it appears below:

First Middle Last

FM-DivA-201 Final Decree of Divorce [Divorce Set A] (Rev. 11-2021) Page 8 of 9

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11. Court Costs
The costs of court shall be paid by the spouse who incurred them to the extent the party is required pay
to

such costs. A spouse who filed a Statement of Inability to Afford Payment of Court Costs or Affidavit of
or Declaration of that was not successfully contested is not required to pay court
lndigency lndigency
costs.

12. Other Orders

The court has the right to make other orders, if needed. to clarify or enforce the orders above.

13.Fina| Orders
denied.
Any orders requested that do not appear above are

This Decree is a final judgment that disposes of all claims and all parties and is appealable.

Date of Judgment Judge’s Signature

Judge’s Printed Name

of Divorce in form and substance.

By signing below, the Petitioner agrees to this Final Decree

PM ' 343' Firm?

Phone number
Petitioner’s Signature

N1 11 M page man n1 one 0mm Date

Petitioner’s Name (print)

Maili (.255 mmdov) ('6ch drivc.m’t-3'Pr, 1M”), 7F T5031

Address:

ema‘"
’hodeduru wgmuil. Lam
Fax (if available)

Decree of Divorce in form and substance.

By signing below, the Respondent agrees to this Final

Phone number
Respondent's Signature

vrwwn Pears M 6H m steamer/0e Date

Respondent’s Name (print)

Mailing
Address:

Email:

Fax: (if available)

FM—DivA-201 Final Decree of Divorce [Divorce Set A] (Rev. 11-2021)

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