Divorce Judgment and Corollary Relief Order (without oral evidence)

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COURT FILE NUMBER Clerk s Stamp COURT Court of Queen s Bench of Alberta JUDICIAL CENTRE PLAINTIFF DEFENDANT DOCUMENT Divorce Judgment and Corollary Relief Order (without oral evidence) ADDRESS FOR SERVICE AND CONTACT INFORMATION OF PARTY FILING THIS DOCUMENT Name Full address ( ) DATE ON WHICH JUDGMENT WAS PRONOUNCED: LOCATION OF HEARING OR TRIAL: NAME OF JUDGE WHO MADE THIS ORDER: THE COURT has reviewed the Statement of Claim for Divorce and the Affidavit of the Applicant and has been advised of the following: THE DEFENDANT has a guideline income of $ THE PLAINTIFF has a guideline income of $ THE NAME AND BIRTHDATE of each child of the marriage is as follows:

- 2 - THE PARTIES have agreed to depart from the Federal Child Support Guidelines for the following reasons: (List reasons, OR cross out if this does not apply) THE PARTIES have agreed to waive spousal support and each party has had independent legal advice with respect to that agreement. (Cross out if this does not apply.) IT IS ADJUDGED: 1. THAT the Court grants a Judgment of Divorce between the Plaintiff and the Defendant, who were married on at (Date of marriage) (Place of marriage City and Province or Country) the divorce to be effective on the 31 st day after the date this Judgment is made, unless this Judgment is appealed before the 31 st day. IT IS ORDERED THAT: 2. (Check off the boxes that apply. Cross off words that do not apply. Write in the details) The Plaintiff and Defendant shall have joint custody of the children of the marriage, namely, The children shall reside primarily with the Plaintiff / Defendant approximately equal time with each party. The Plaintiff / Defendant shall have sole custody of the children of the marriage, namely, 3. The Plaintiff and/or the Defendant shall have parenting time with the children as follows:

- 3-4. The shall pay to the the sum of $ (Plaintiff or Defendant) (Plaintiff or Defendant) (base amount) per month for the support of the children of the marriage, payable on the day of each month, commencing, 20 (Date of first payment). The shall pay to the the sum of $ (Plaintiff or Defendant) (Plaintiff or Defendant) (s. 7 amount) Per month for additional expenses for the children of the marriage, payable on the day of each month commencing, 20, allocated as follows: (Date of first payment) NAME OF CHILD NATURE OF ADD-ON AMOUNT OR PERCENTAGE.. Each party shall provide the other party with a complete copy of his or her income tax return and any notices of assessment and reassessment issued to him or her by the Canada Customs and Revenue Agency on an annual basis, on or before June 30th of each year, as long as there is a child of the marriage as defined by the Divorce Act (Canada). In the event that a party has not filed an income tax return for the previous year, he or she shall provide the other party with copies of his or her T4, T4A and all other relevant tax slips and statements disclosing any and all sources of income, including self-employment income., The amounts owing under this Order shall be paid to the Director of Maintenance Enforcement ( MEP ) at 7 th floor North, 10365 97 Street, Edmonton, Alberta, T5J 3W7, (telephone 780-422- 5555, website www.albertamep.gov.ab.ca), and shall be enforced by MEP on the filing of the Order with MEP by the creditor (recipient of support) or debtor (payor of support). The amounts owing shall continue to be enforced by MEP until the party who filed this Order gives MEP a notice in writing withdrawing this Order from filing in accordance with section 9 of the Maintenance Enforcement Act. Justice of the Court of Queen s Bench of Alberta

- 4 - (Remove this page if not consent signatures are not required) Consent provided for matter to proceed without oral evidence and consent to all matters of corollary relief by: Plaintiff s signature (Attach an Affidavit of Execution) Signature of Witness Consent provided for matter to proceed without oral evidence and consent to all matters of corollary relief by: Defendant s signature (Attach an Affidavit of Execution) Signature of Witness THE SPOUSES ARE NOT FREE TO REMARRY UNTIL THIS JUDGMENT TAKES EFFECT, AT WHICH TIME EITHER SPOUSE MAY OBTAIN A CERTIFICATE OF DIVORCE FROM THIS COURT. IF AN APPEAL IS TAKEN FROM THIS JUDGMENT, IT MAY DELAY THIS JUDGMENT TAKING EFFECT.

AFFIDAVIT OF EXECUTION I of, Alberta (Name of Witness for Plaintiff s signature) (City / Town) SWEAR / AFFIRM AND SAY THAT: 1. I was personally present and did see (Name of Plainitff) named in the within document, who is personally known to me to be the person named therein OR who identified himself / herself to me by means of photographic identification duly sign and execute the same for the purposes named therein 2. The document was executed at, Alberta, and I am the subscribing witness thereto. Sworn (OR Affirmed) before me on, 20 at, Alberta. (Signature of witness) Commissioner for Oaths in and for the Province of Alberta, Justice of the Peace or Notary Public ID Verified AFFIDAVIT OF EXECUTION I of, Alberta (Name of Witness for Defendant s signature) (City / Town) SWEAR / AFFIRM AND SAY THAT: 3. I was personally present and did see (Name of Defendant) named in the within document, who is personally known to me to be the person named therein OR who identified himself / herself to me by means of photographic identification duly sign and execute the same for the purposes named therein 4. The document was executed at, Alberta, and I am the subscribing witness thereto. Sworn (OR Affirmed) before me on, 20 at, Alberta. (Signature of witness) Commissioner for Oaths in and for the Province of Alberta, Justice of the Peace or Notary Public ID Verified Affidavit of Execution Divorce Judgment Revised December, 2011