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NOTE:

ITEMS 1-30 ON THIS FORM TO BE COMPLETED BY PETITIONER OR ATTORNEY AND FILED WITH CLERK OF COURT WITH PETITION OR DECREE

PLEASE PREPARE BY TYPEWRITER OR PRINT IN BLACK UNFADING INK. THIS IS A PERMANENT RECORD

CLERK OF COURT WILL CERTIFY AND FORWARD TO STATE REGISTRAR BY 10TH DAY OF MONTH FOLLOWING DATE FINAL DECREE IS GRANTED

Section 32.1-268

CODE OF VIRGINIA

VS4 7/15

 

 

COMMONWEALTH OF VIRGINIA- REPORT OF DIVORCE OR ANNULMENT

 

 

 

 

Department of Health- Division of Vital Records- Richmond

 

1. CIRCUIT COURT FOR CITYOR COUNTYOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I STATE FILE NUMBER

 

2. FULL NAME

 

 

PARTYA

(check one)

 

0 HUSBAND

 

 

 

 

0 WIFE

D SPOUSE

 

 

(first. middle, last, suffix)

 

 

I 5. DATE OF BIRTH

 

 

 

 

 

 

 

 

 

(maiden name, if any)

 

I

 

3. SOCIAL SECURITYNUMBER

4. PLACE OF BIRTH

(state or foreign country)

 

 

 

 

 

 

 

16. RACE

 

 

 

 

 

17. SEX

 

8. NUMBER OF THIS MARRIAGE (first, second, etc.)

 

 

 

 

I 9. EDUCATION (specify only highest grade

completed)

 

10. USUAL RESIDENCE

 

 

 

 

 

 

 

 

 

 

 

 

Elementary or Secondary (0-12)

 

College (1-4 or 5+)

 

(street number or rural route number)

 

 

 

(city or

town)

 

 

 

(county if not independent city)

(state)

11. FULL NAME

 

 

PARTYB

(check one)

 

0 HUSBAND

 

 

 

 

D

WIFE

D SPOUSE

 

 

(first, middle, last, suffix)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(maiden name, if any)

 

112. SOCIAL SECURITYNUMBER

13. PLACE OF BIRTH (state or foreign country)

 

114. DATE OF BIRTH

 

 

 

 

 

 

1

15. RACE

 

 

116. SEX

 

17. NUMBER OF THIS MARRIAGE (first, second, etc.)

 

 

 

 

1

18. EDUCATION (specify only highest grade completed)

 

19. USUAL RESIDENCE

 

 

 

 

 

 

 

 

 

 

Elementary or Secondary (0-12)

 

 

College (1-4 or 5+)

 

(street number or rural route number)

 

 

 

(city or town)

 

 

 

(county if not independent city)

(state)

20. PLACE OF MARRIAGE

(city or town)

 

 

(county)

 

 

(state or foreign country)

121. DATE OF MARRIAGE

 

122. DATE OF SEPARATION

23. NUMBER OF CHILDREN UNDER 18

24. NUMBER OF CHILDREN UNDER 18 IN THIS FAMILYWHOSE PHYSICAL CUSTODY\/VAS

AWARDED TO:

 

IN THIS FAMILY

 

 

 

Party A

Party B

 

Joint (Party A/Party B)

 

 

 

Other

 

 

 

DNo Children

 

25. PLAINTIFF

OPARTYB

OBOTH

26. DIVORCE GRANTED TO

0BOTH

 

I

 

27. LEGAL GROUND OR

CAUSE OF DIVORCE (if annulment- so state)

 

OPARTYA

 

DPARTYA

D PARTYB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28. INFORMANT'S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D PETITIONER

 

 

 

SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29. NAME OF INFORMANT (Type or Print)

 

 

 

I

30. ADDRESS OF

 

 

 

 

 

 

 

 

D ATTORNEYFOR PETITIONER

 

 

 

 

 

(street number or rural route number)

 

(city or town)

(state)

I CERTIFYTHAT A FINAL DECREE OF

 

 

 

 

INFORMANT

 

 

 

 

 

 

 

 

 

 

 

 

CONCERNING THE ABOVE

 

 

 

WAS ENTERED

 

 

 

 

 

 

 

 

 

 

 

(divorce or annulment)

 

 

 

 

(date of divorce or annulment)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MARRIAGE ANO WAS NUMBERED

 

(court file number)

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF CLERK OF COURT OR DEPUTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF CLERK OR DEPUTY

(Type or Print)

 

Document Information

Fact Name Description
Governing Law This form is governed by Section 32.1-268 of the Code of Virginia, which outlines the requirements for reporting divorces and annulments.
Purpose The VS4 form is used to officially report a divorce or annulment to the state registrar, ensuring that vital records are updated accurately.
Filing Requirements Petitioners or their attorneys must complete items 1-30 on the form and file it with the clerk of court alongside the petition or decree.
Deadline for Submission The clerk of court must certify and forward the completed form to the state registrar by the 10th day of the month following the final decree.
Information Required The form requires detailed information about both parties, including names, birthdates, social security numbers, and details about the marriage and children.

Vs 4 - Usage Guidelines

Filling out the Vs 4 form is an essential step in the process of reporting a divorce or annulment. It requires careful attention to detail to ensure that all necessary information is provided accurately. Once completed, the form must be filed with the Clerk of Court alongside the petition or decree, and it will be certified and forwarded to the State Registrar.

  1. Obtain the Vs 4 form. Ensure you have the most recent version of the form, which can typically be found online or at your local courthouse.
  2. Complete the first section. Fill in the name of the Circuit Court, the state file number, and the full name of Party A, checking the appropriate box for husband, wife, or spouse.
  3. Provide personal details for Party A. Enter the social security number, place of birth, date of birth, race, sex, number of this marriage, and education level.
  4. Fill in the usual residence of Party A. Include the street number, city or town, county, and state.
  5. Complete the section for Party B. Repeat the process for Party B, providing their full name, social security number, place of birth, date of birth, race, sex, number of this marriage, and education level.
  6. Provide the usual residence for Party B. Include the necessary address details as you did for Party A.
  7. Indicate the place and date of marriage. Fill in the city or town, county, and state or foreign country where the marriage took place, along with the date of marriage.
  8. Enter the date of separation. Clearly state the date when the parties separated.
  9. Report the number of children. Specify the number of children under 18 and indicate who has physical custody.
  10. Identify the plaintiff. Mark whether it is Party A, Party B, or both.
  11. State the divorce grant details. Indicate who the divorce was granted to and provide the legal ground or cause for the divorce.
  12. Fill in the informant's details. Sign the form as the informant and print your name and address.
  13. Certification by Clerk of Court. Leave space for the Clerk of Court to certify the document and provide their signature and printed name.

Once you have completed all sections of the Vs 4 form, review it carefully for any errors or omissions. After ensuring accuracy, submit the form to the Clerk of Court along with your petition or decree. This step is crucial for the proper processing of your divorce or annulment.

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Dos and Don'ts

When filling out the VS 4 form, it is crucial to follow specific guidelines to ensure accuracy and compliance. Here’s a list of things you should and shouldn’t do:

  • Do: Complete the form using a typewriter or print in black, unfading ink.
  • Do: Ensure all required fields are filled out completely and accurately.
  • Do: Double-check the spelling of names and places to avoid errors.
  • Do: Use the full legal names of all parties involved.
  • Do: Submit the form to the Clerk of Court along with the petition or decree.
  • Do: Keep a copy of the completed form for your records.
  • Do: File the form within the specified timeframe after the final decree.
  • Don't: Leave any mandatory fields blank; this can delay processing.
  • Don't: Use pencil or any ink color other than black.
  • Don't: Provide incorrect or outdated information.
  • Don't: Forget to sign and date the form where required.
  • Don't: Submit the form without verifying all details are correct.
  • Don't: Delay in filing; adhere to the deadline for submission.
  • Don't: Assume the Clerk will correct any mistakes for you.

Common mistakes

When filling out the VS 4 form, individuals often encounter challenges that can lead to mistakes. Here are four common errors to avoid:

  1. Incomplete Information: Many people fail to provide all the required details. For example, missing sections such as social security numbers or dates of birth can delay processing. Ensure that every field is filled out accurately.

  2. Illegible Handwriting: If the form is not typed or written in clear, black ink, it may be difficult for the clerk to read. This can result in further complications. Always use a typewriter or print neatly to maintain clarity.

  3. Incorrect Checkboxes: Selecting the wrong checkbox for party designation (Husband, Wife, or Spouse) can lead to confusion. Double-check your selections to ensure they reflect the correct parties involved.

  4. Omitting the Signature: Forgetting to sign the form is a frequent oversight. Without a signature, the form cannot be processed. Always review the document to confirm that it is signed before submission.

By being aware of these common mistakes, individuals can improve the accuracy of their submissions and facilitate a smoother process in filing for divorce or annulment.

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