Instructions for Completing the Fields
- Field 1: Fill in the county in which the action is brought. Be consistent with other forms.
- Field 2: Print the Plaintiff's name.
- Field 3: Write in the index number assigned to this matter.
- Field 4: Print the Defendant's name.
- Field 5: Write the name of Plaintiff's attorney in the blank space or, if Plaintiff is representing himself or herself, strike the word "by" and leave the space blank.
- Field 6: This section informs the court of whether it has the jurisdiction (authority) to hear the case. Check the appropriate box or boxes.
- Field 7: Insert the date that the spouses were married as listed on the marriage license, and the city, town or village, and the state or country of the marriage.
- Field 8: Check the appropriate box. If there was a religious ceremony, strike the word "not" in the first line and check one of the three options below regarding removal of barriers to remarriage. If there was a civil ceremony, leave the word "not" in place and do not check any of the three options below. A Sworn Statement of Barriers to Remarriage and Affirmation of Service of the Sworn Statement (Forms UD-4 and UD-4a) must be filed with proof of service unless the Defendant waives the filing. Despite passage of Chapter 559, Laws of 2023, which amends CPLR 2106 to permit civil litigants to file affirmations instead of affidavits, this form should still be signed before a notary public to comply with DRL 253, which requires a sworn statement and remains in effect.
- Field 9: Check the appropriate box. List the number of children of the marriage (see the definition on page 7). List the names, dates of birth and addresses for each child.
- Field 10: List the Plaintiff's and Defendant's addresses.
- Field 11: Fill in the required information about Plaintiff's and Defendant's insurance coverage, including the type of coverage. Examples include, but are not limited to, medical, dental and optical coverage. If either party has more than one insurance plan, list the additional coverage. Strike this section if child support is not an issue.
- Field 12: State and describe the grounds for divorce. In addition to selecting the section (be as specific as possible) of the Domestic Relations Law that applies, fill in the date where appropriate and give a brief description of how New York State's grounds requirements are met. Refer to "Grounds for Divorce" on pages 2 through 5 of the instructions.
- Field 13: No response is required in this section. If a judgment of divorce has already been entered in this state or another state between the spouses and/or there is another action for divorce pending between the spouses, this action may not be permitted to be maintained. Legal assistance should be sought as noted in the Foreword. Page 17 of 44 Rev 12/24.
Field 14: “Ancillary” or Other Relief. If other relief is requested in addition to the request for a divorce, this other relief must be listed in this section as “ancillary relief.” Examples include, but are not limited to, custody, visitation, child support, equitable distribution of specific property from the marriage, maintenance, counsel and/or experts’ fees, orders of protection, pension benefits, use of a former last name, exclusive occupancy of the marital residence, and a request for transfer of title to the marital residence (whether a house, cooperative apartment or condominium apartment). If there are unemancipated children of the marriage (see the definition on page 7), child support must be listed in this section.
Also list any presently existing court orders (including the docket, case or index number) that should be continued. When minor children of the marriage reside in New York State, custody must be determined. List any stipulations or agreements made in writing with the Defendant that should become part of the judgment.
If distribution of marital property is being waived, or if marital property is being distributed pursuant to an agreement or stipulation, check the appropriate box. If maintenance is not being sought as described in the Notice of Guideline Maintenance other than what was already agreed to in a written agreement or stipulation, or if maintenance is sought as described in the Notice of Guideline Maintenance, check the appropriate box. If the requesting party would be the party with greater income, both boxes should be left blank.
Do not check these boxes if the action was commenced before January 25, 2016, because the Maintenance Guidelines Law will not apply. If the action was commenced before that date and maintenance is sought, include the request on the lines for “Ancillary” or Other Relief at Field 14 together with the reasons. The court will decide the request in its discretion after considering certain factors. If “Ancillary” or Other Relief is not being requested, check the appropriate box.
Important Note: If a type of “Ancillary” or Other Relief is not requested in this section, rights to relief that might otherwise be available may be lost.
- Field 15: Insert the date that the document was prepared.
- Field 16: Check the appropriate box. The attorney for the Plaintiff must sign this line and print the attorney’s name, address and telephone number. If the Plaintiff does not have an attorney, the Plaintiff must sign on that line and provide an address and telephone number.
- Field 17: The Plaintiff must fill in the name and the date and sign the affirmation when the document is completed. This form no longer needs to be notarized because of a change in law.