A dissolution is a termination of a marriage by agreement. The forms listed below are required. Failure to provide all forms listed, or filing incomplete forms,  may result in your case not being filed or being dismissed.  

Pro se (unrepresented) Litigants MUST use the forms specified below. 

Click here for Information from the Ohio State Bar Association on Divorce and Dissolution Related Issues

Click Here for Information about Visitation, Custody, Parenting Time, and Child Support from Southeastern Ohio Legal Services

FAILURE TO ATTEND THE MANDATORY PARENTING SEMINAR MAY RESULT IN THE HEARING BEING CONTINUED  UNTIL THE SEMINAR IS COMPLETED. 

NOTICE: The Supreme Court no longer provides forms in Microsoft Word Format. Only PDF versions are available. Comments or concerns should be directed to CFC@sc.ohio.gov 

If any of the Supreme Court Form links do not work - you may find the forms here: https://www.supremecourt.ohio.gov/courts/services-to-courts/children-families/dom-rel-juvenile-forms/ 

Remember to fill out the County Name (Adams) and the Division of the Court (Domestic Relations). The name of the Judge to be used on the forms is Brett M. Spencer. The name of the Magistrate to be used on all forms is David M. Hunter.

1. Form AC-001 - Notice of Appearance (Word | PDF) Required for Attorneys and any spouse not represented by an attorney

2. Form AC-002 - Waiver of Counsel (Word | PDF) Required for any spouse not  represented by an attorney

3. Form AC-003- Waiver of Service of Summons (Word | PDF) One Form for each spouse - both spouses required to sign

4. Form SC-17 - Petition for Dissolution (PDF ) 

5. Uniform Domestic Relations Form - Affidavit 3 (Parenting Proceeding Affidavit) (PDF ) 

6. Uniform Domestic Relations Form - Affidavit 4 (Health Insurance Affidavit) (PDF  )

7. Form SC-1 - Affidavit of Income and Expenses ( PDF) CANNOT BE WAIVED IF CHILDREN ARE INVOLVED

8. Form SC-2 - Affidavit of Property ( PDF) -OR-

   • Form AC-201 - Waiver of Affidavit of Property (Word | PDF)  Must be signed by both spouses

9. Form SC-19 - Separation Agreement ( PDF ) If no shared parenting, the child support and parenting forms below are attached.

10. Parenting Seminar Required - See Local Rules (One for each spouse) MUST COMPLETE SEMINAR BEFORE HEARING WILL BE SCHEDULED

    • Form AC-203 Notice of Helping Children Cope With Family Separation Seminar ( Word | PDF)

    • Form AC-204 Helping Children Cope With Family Separation Registration Packet   ( Word | PDF)

11. SHARED PARENTING DO NOT USE THE SUPREME COURT SHARED PARENTING PLAN  OR PARENTING PLAN AS IT DOES NOT COMPLY WITH OUR LOCAL RULES. 

    • Form AC-216 Shared Parenting Plan (Word | PDF)

    • *Form AC - 205- Miscellaneous Motion - Motion for Shared Parenting  (Word | PDF) 

    • Form AC - 206 - Adams County Standard Parenting Orders (Word | PDF)  - will be attached to shared parenting plan or separation agreement. 

    • Form AC - 207 - Adams County Standard Parenting Schedule (Word | PDF)   - will be attached to shared parenting plan or separation agreement. 

    • Form AC - 208 - Adams County Standard Child Support and Medical Support Order (Word | PDF)  - to be attached to shared parenting plan. EVEN IF CHILD SUPPORT IS BEING DEVIATED TO ZERO

      • *Child Support Worksheet (Ohio Child Support Guidelines Calculator) - Must be signed by both spouses

    • Form AC - 202 - Adams County CSEA Account Setup Sheet (Word | PDF) Do NOT file with the Clerk - Bring to final hearing.

    • Form JFS 07076  Application for Child Support Services Do NOT file with the Clerk - Bring to final hearing.

12. Parenting Related DO NOT USE THE SUPREME COURT SHARED PARENTING PLAN AS IT DOES NOT COMPLY WITH OUR LOCAL RULES. 

    • • Form AC-217 - Parenting plan (to be attached to agreed entry or separation agreement)  (Word | PDF)

      • Form AC - 206 - Adams County Standard Parenting Orders (Word | PDF)  - will be attached to separation agreement. 

      • Form AC - 207 - Adams County Standard Parenting Schedule (Word | PDF)   - will be attached to separation agreement. 

      • Form AC - 208 - Adams County Standard Child Support and Medical Support Order (Word | PDF)  - to be attached to parenting order agreement,  or separation agreement.  EVEN IF CHILD SUPPORT IS BEING DEVIATED TO ZERO

        • *Child Support Worksheet (Ohio Child Support Guidelines Calculator) - Must be signed by both spouses 

      • Form AC - 202 - Adams County CSEA Account Setup Sheet (Word | PDF) Do NOT file with the Clerk - Bring to final hearing.

      • Form JFS 07076  Application for Child Support Services Do NOT file with the Clerk - Bring to final hearing.

13. Form AC-005 - Praecipe for Service (Word | PDF) 

14. Decree of Dissolution - Only required for Attorneys at final hearing - use own form. Do NOT file with the Clerk - Bring to final hearing.

15. Decree of Shared Parenting (If applicable)- Only required for Attorneys at final hearing - use own form. Do NOT file with the Clerk - Bring to final hearing.

16. Form AC-006 - Waiver of Magistrate's Decision and 14 Day Waiver (Word | PDF) Do NOT file with the Clerk - Bring to final hearing.

ALL PRO SE (parties who do not have attorneys) DISSOLUTIONS WILL BE SET FOR A A PRE-TRIAL/COMPLIANCE HEARING TO REVIEW THE PLEADINGS AND ENSURE THAT THE PARTIES HAVE ATTENDED THE MANDATORY PARENTING SEMINAR. IT IS STRONGLY SUGGESTED THAT AT LEAST ONE PARTY IN A PRO SE DISSOLUTION CONTACT AN ATTORNEY TO ASSIST IN THE PREPARATION OF THE REQUIRED DOCUMENTS.