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IN THE CIRCUIT COURT OF Saint Louis County , MI dk ED
(County where court is located. City of Saint Louis is considered. a county.)
JUL 03 2023
JOAN M, GILMER
In re the Marriage of: CIRCUIT CLERK, ST, LOUIS COUNTY
THONG TAN DANG Case
(First Name) (Middle Name) (Last Name) (Jr/Sr All) Number @35L~ ee e
Petitioner, (Enter your full legal name above) (Will be assigned when case is
-and-
HIEN THI PHAM Division
(First Name) (Middle Name) (Last Name) (Jr/Sr All) Number
Respondent. (Enter your spouse’s full legal name above) (Will be assign shen case is filed)
Petition for Dissolution of Marriag
Throughout this entire case, you, THONG TAN JANG
(First Name) (Middle Name, (Last Name) (Ir/SrMl)
will always be the Petitioner.
Your spouse, HIEN THI PHAM - will always be the
(First Name) (Middle Name) (Last Name) (Je/Sr Al)
Respondent.
Information about Petitioner THONG TAN DANG
(Enter your name on the lines) (First Name) +, (Middle Name) (Last Name) (Je./SrAll)
How many petitions have you filed case? (Check one of the three boxes)
M This is the first petition | have.filed in this case. (Original petition)
O This is the second petition-|-have filed in this case.
1 This is the third petition.1 have filed in this case.
What is your mailing réss?
This is the address the court will use to send information about your case to you. If you move during the time this case i
is pending, you must.send a letter to the ‘court notifying it-of your new address. This address is not necessarily the same t
as the address at which you live. Even if you do not wish to give the address at which you live, you must still give the
court a mailing ‘address. Because court actions are. a matter of. Public record, the address you list will be available; to the t
public.
6530, INONA AVE
(stra
‘SAINT LOUIS MO 63109
ity) (State) (Zip)
(314) 601-2997 THONGDANG99@YAHOO.COM
(Telephone Number with Area Code) (E-mail Address - Optional)
What are the last four numbers of your social security number?
| The last four digits of your ssocial security number are required by §452. 312, RSMo. _ doe
xxx.xx- 8049
Petition for Dissolution of Marriage Page 1 of 14
Form CAFCO01 01/01/2018 This form is available for free at www.selffepresent.mo.gov
Are you over the age of eighteen? (Check one of the two boxes)
M Yes
O No
| live in YZ] the United States [1] another country, which is
| live in ¥] Missouri [] another state, which isCae
/'Missouri law requires that one party to adissolution of marriage proceeding must have been a resident of ‘thes Stat
| issouri for at least 90 day the time i is less than four months, state the number of days you have livéd iri the
a at _—~ ee ee eres cere oe i veeeenee ——
28 7 0
Years Months Days
(Length of time you have lived in this state)
In whatacounty do you currently live and for what length ofSetime havenot.you lived t
==
} City ‘of Saint Louis is considered a county. if you live in th city of Saint Louis, you should er ai ouis in the
‘blank. fines aa ee co ree
fo
SAINT LOUIS 28 7 0
(County) Years Months Days
(Length of time you have lived in this ty)
What is your current employment status? (Check one of the-hreé boxes)
O Employed
O Unemployed
WI Self-employed
If you are employed
poe ye or self. nploye |, wher urrently work? =r
[ If you are self-émployed, enter a brief description of 38 “Landscaping” “or “l yy care” on'
pe of work you perform such as
“the-line for the name of your employer. If you are, sel mployed, you should also enter the address information fory‘your
(selff-employment. eee ae ae ae dA LL
SELF-EMPLOYMENT @ LUCKY NAILS
(Employer's name or type of ‘self-employment
871 FAIRFAX ST
(Street)
CARLYLE IL 62231
(City) (State) (Zip)
10 What is ; your titot / ‘monthly gross income from all sources?
i Gross i income isthe amount of money a person earns before anything such as taxes is ‘deducted. Fora ‘more detailed
lefiniton of
9 ross income” see Supreme Court Forrn No. 14.
Se aa = fe ne de ad
$1 500s
¢ Total ‘monthly gross income)
14 an you support yourself through the combined income from your employment anditincome from
Sy property that you will receive in the dissolution? (Check one of the two boxes) _
any tee
minor wt _
M Yes
O No
Petition for Dissolution of Marriage Page 2 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
Information about Respondent HIEN THI PHAM
(Enter your spouse's name on the lines) (First Name) (Middle Name) (Last Name) Gr/SrMl)
12, What i is your spouse’s mailing address? wee
This iis the address that the court will use to send information about jyour “case to |your spc
spouse. if you ‘do not know your i
Spouse's current address, you should enter, the last known address of your spouse. ee
1515 NUUANU AVE, APT 1557
(Street)
HONOLULU HI 96817
(City) (State) (Zip)
(314) 874-7799 MINHHIEN_PHAM2002@YAHOO.COM
(Telephone Number with Area Code) (E-mail Address - Optional)
13. What are the last four numbers of your spouse’s social security number?
The last four digits of your spouse’s social security number are required by §45: 12, RSMo: D jot leave this field
jot know your spouse’s security. number, enter “U! Ss fi -
XXX- 064 '
14. Is your spouse over the age of eighteen? (Check one of the two, boxes)
MW] Yes
O No
15. My spouse lives in [¥] the United States 1] another country, which is
16 My spouse lives i inOh Missouri a
VI al other stat hig HAWAII See oe ~
‘the time iis less ‘than four months, state ‘the number oft your spouse | has |lived ini the state,
a. -
8 0 0
Years Months Days
(Length of time they have lived in this state)
17. In what county does your spouse’ currently live and for how long hasye
your spouse lived there? _
1 Ifyou: do not know in which county your-spouse lives and cannot find out this information, then you should enter
: “Unknown.” "City of ‘Saint Louis iis considered a county,
we
‘HONOLULU 8 0 0
(County) Years Months Days
(Length of time they have lived in this county)
18 If your spouse durini Tarriag
as.a result of sexual intercourseor artificial insemination. LA (Number of Children)
31 How mene
many living
2 children did you and your spouse. adopt?~”
i Tt you have already accounted for this child in paragraph 30, do count them in this |
| paragraph. Include in this number all living children who we! (a) born to you or your 0
it spouse af
and later adopted byt the other ‘spouse; or (0) ado|
vee ees eee
by both parties.
nes ae —- (Number of Children)
32. How many living children do you and your spousee have together that were
born bef the dat f thi
— wn
lude imbe' ing chi to; ane spoust fore this rriag
: as a result of sexual intercourse or arti semination. You should attach a copy of 0|
,the birth certificate(s) for these id our Petit cae weed (Number of Children)
33. A How many living childre) were born to you (if you are female) with
someone other than,’ ‘our spouse during this marriage? (This number
includes children,bi after the parties separated.) ae ae 4 0
\dditional information may be required before the court proceeds with your case. (Number of Children)
'
How mi ing children were born to your spouse (if they are female)
with someone other than you during this marriage? (This number
incl children
born after the parties separated.) 0i
foe ee cr = ey
lonal information may bbe required before the court proceeds wil your casi (Number of Children)
oe ne! =
i
0:
inter the total number of children from lines 30, 31, 32 and 33 A and B
(Total Number of Children)
Petition for Dissolution of Marriage Page 5 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
!
If line 34 is zero, then go directly to Question 47. If line 34 is one or more, you must answer the
following questions.
Information about Children
ee — - o~ — ae - — ~
‘Question 35 (a-j) represents the information for the first child, Question 36 @ ) represents the information for the second
child, and so on. See the chart below for more information.
'
: You must list the children regardless of age even if they are in someone else’s custody. You must answer
a evel
«part of
¢ the ‘question. —
—- _ a a
Number of children you wrote on line 34 Questions you should answer
1 35 (a-j) and 39-47
2 35 (a-j), 36 (a-j) and 39-47
3 35 (a-j), 36 (a-j), 37 (a-j) and 39-47¢,-
4 35 (a-j), 36 (a-j), 37 (a-j), 38 (a }-47
More than 4 35 (a-j), 36 (a-j), 37 (a-j), 38,( ittach additional
pages answering all the éstions asked in 38 (a-j) for
each additional child and 47
Bf
Petition for Dissolution of Marriage Page 6 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
35. Child One
'"To beee
aanswered if the answer ‘to ) question 234i is one ormore _
35a. What is the full name of this child?
(First Name) (Middle Name) (Last Name) (r/Sr.Mil)
35b. What are the last four numbers of this child’s Social Security Number? XXX-Xx-
35c. What is the current address of this child?
(Street)
(City) (State) (Zip)
35d. What is this child’s age?
35e. Check all of the following boxes that apply:
O1 This child is married
O This child is on active duty in the military.
O This child is self-supporting.
O This child is attending high school
O This child is attending college or vocational scho
35f. With whom has this child primarily lived during the:previous 60 days?
(First Name) (Middle Name) “(Last Name) (Jr/SrMl)
35g. Who should have legal custody of this chi “(Check one of the four boxes) Legal custody refers to
who will make the decisions conceming health, cation and welfare for this child. §452.375.1(2), RSMo
O Me (Petitioner)
0 My Spouse (Respondent)
O Both Spouses Jointly
0 Other Person (State narné)_
(First Name) (Middle Name) (Last Name) (ir/Srll)
35h. Who should have physi¢al custody of this child? (Check one of the four boxes) Physical custody
refers to where this iid will reside and what time this child spends with each parent. §452.375.1(3), RSMo
O Me (Petitione’
O My Spouse (Respondent)
0 Both Spotises Jointly
Cl Other Person (State name)
(First Name) (Middle Name) (Last Name) (Jr/Sr All)
35i are6 the parents of this child? (Check all that apply) if you or your spouse are not a parent of this
by sexual intercourse, adoption or artificial insemination, please name the other parent.
Me (Petitioner)
OO My Spouse (Respondent).
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (Je/Sr Ml)
35] Who are listed as parents on this child’s birth certificate? (Check all that apply)
O Me (Petitioner)
1 My Spouse (Respondent)
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (Jr/Sr)
Petition for Dissolution of Marriage Page 7 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
36. Child Two ~ oe.
To be answered if the answer to question 34 is two or more a a ee
36a. What is the full name of this child?
(First Name) (Middle Name) (Last Name) Gr /SrMl)
36b. What are the last four numbers of this child’s Social Security Number? XXX-XX-
36c. What is the current address of this child?
(Street)
(City) (State) (Zip)
36d, What is this child’s age?
36e. Check all of the following boxes that apply:
D This child is married
O This child is on active duty in the military.
O This child is self-supporting.
O This child is attending high school
O This child is attending college or vocational scho
36f. With whom has this child primarily lived during the‘previous 60 days?
”
(First Name) (Middle Name) (Last Name) (Je./SrAll)
36g. Who should have legal custody of this c! ‘Check one of the four boxes) Legal custody refers to
who will make the decisions conceming health, cation and welfare for this child. §452.375.1(2), RSMo
0 Me (Petitioner)
O My Spouse (Respondent)
O Both Spouses Jointly
O Other Person (State n
. (First Name) (Middle Name) (Last Name) (I-/Sr-All)
36h, Who should have physical custody of this child? (Check one of the four boxes) Physical custody
refers to where this child lI reside and what time this child spends with each parent. §452.375.1(3), RSMo
O Me (Petitioner!
0 My Spouse-(Respondent)
O Both Spouses Jointly
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (SrA)
36i. are6 the parents of this child? (Check all that apply) If you or your spouse are not a parent of this
jld by sexual intercourse, adoption or artificial insemination, please name the other parent.
Me (Petitioner)
Oi My Spouse (Respondent)
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (Ir/Sr/)
36) Who are listed as parents on this child’s birth certificate? (Check all that apply)
O Me (Petitioner)
Oi My Spouse (Respondent)
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (Jr/Sr All)
Petition for Dissolution of Marriage Page 8 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov-
37. Child Three
answer to q ion 34 is r more een ae
37a. What is the full name of this child?
(First Name) (Middle Name) (Last Name) (r/Sr.Mlll)
37b. What are the last four numbers of this child's Social Security Number? XXX-XX-
37c. What is the current address of this child?
(Street)
(City) (State) (Zip)
37d. What is this child’s age?
37e. Check all of the following boxes that apply.
O This child is married
O This child is on active duty in the military.
O This child is self-supporting
O This child is attending high school.
O This child is attending college or vocational scho
37F. With whom has this child primarily lived during the previous 60 days?
(First Name) (Middle Name) (Last Name) (r/Sr.Mll)
37g. Who should have legal custody of this cl (Check one of the four boxes) Legal custody refers to
who will make the decisions conceming health, tion and welfare for this child. §452.375.1(2), RSMo
O Me (Petitioner)
DI My Spouse (Respondent)
O Both Spouses Jointly
O Other Person (State namé)
(First Name) (Middle Name) (Last Name) (Se/Sr All)
37h. Who should have physi sal custody of this child? (Check one of the four boxes) Physical custody
refers to where this child will reside and what time this child spends with each parent. §452.375.1(3), RSMo
O Me (Petitioner);
O My Spou: espondent)
O Both Spor s Jointly
O Other: Person (State name)
(First Name) (Middle Name) (Last Name) (dr/Sr All)
371. 10-aree the parents of this child? (Check all that apply) If you or your spouse are not a parent of this
lid by sexual intercourse, adoption or artificial insemination, please name the other parent.
| Me (Petitioner)
O My Spouse (Respondent)
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (Jr/Sr All)
37) Who are listed as parents on this child’s birth certificate? (Check all that apply)
O Me (Petitioner)
O My Spouse (Respondent)
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (I-/Sr.Mll)
Petition for Dissolution of Marriage Page 9 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
38. Child Four aoe ao
To be'answered if thé answer to question 34 is four or more wee
38a. What is the full name of this child?
(First Name) (Middle Name) (Last Name) (Je /SrMl)
38b. What are the last four numbers of this child’s Social Security Number? XXX-XX-
38c. What is the current address of this child?
(Street)
(City) (State) (Zip)
38d. What is this child’s age?
38e. Check all of the following boxes that apply.
O This child is married
O This child is on active duty in the military.
O This child is self-supporting
C1 This child is attending high school.
O This child is attending college or vocational school.
38f. With whom has this child primarily lived curing the:
t e prévious 60 days?
(First Name) (Middle Name) 4 ast Name) (Ir /8rMl)
38g. Who should have legal custody of this ch ’(Check one of the four boxes) Legal custody refers to
who will make the decisions conceming health, ot ion and welfare for this child. §452.375.1(2), RSMo
O Me (Petitioner) ‘
0 My Spouse (Respondent) .
O Both Spouses Jointly ‘
O Other Person (State ni
(First Name) (Middle Name) (Last Name) i (Arf)
38h. Who should have phys al custody of this child? (Check one of the four boxes) Physical custody
refers to where this child will reside and what time this child spends with each parent. §452.375.1(3), RSMo
O Me (Petitioner
CO My Spouse (Respondent)
O Both Spouses Jointly
O Othe erson (State name)
(First Name) (Middle Name) (Last Name) (JSr/SrMl)
38i. 10.are the parents of this child? (Check all that apply) if you or your spouse are not a parent of this
by sexual intercourse, adoption or artificial insemination, please name the other parent.
°LD Me (Petitioner)
C1 My Spouse (Respondent)
O Other Person (State name)
(First Name) (Middle Name) (Last Name) (Jr /SrMll)
38) Who are listed as parents on this child’s birth certificate? (Check all that apply)
O Me (Petitioner)
O My Spouse (Respondent)
C1 Other Person (State name)
(First Name) (Middle Name) (Last Name) (Jr/Sr Ml)
Petition for Dissolution of Marriage Page 10 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
If you have more than four children, attach additional pages answering all the questions asked in
38 (a-j) for each additional child.
Additional Information about Children
39. List all addresses at which the children have lived during the past five years and the name of the
parent or guardian with whom said children lived
(First Name) (Middle Name) (Last Name) (Gr /Sr/il)
(Street)
(City) (State) (Zip)
(First Name) (Middle Name) (Last Name) (de/Sr Ml)
(Street)
(City) (State) (Zip)
(First Name) (Middle Name) (Last Name, (Je /SrAll)
(Street)
(City) (State) (Zip)
40. Do you know of anyone other than you" your spouse who has physical custody of any of the
children or claims to have custody or. Visitation rights with respect to any of the children? (Check one
of the two boxes)
O Yes
O No
41 Do you have informati. bout any other custody proceeding concerning any of the children pending
in a court of this o1 ‘other state? (Check one of the two boxes)
O Yes
O No
42 Have yo, ipated in other litigation concerning the custody of any of the children in this or any
other state? (Check one of the two boxes)
oO Nes!
-No
43 Have any of the children been a victim of abuse or neglect? (Check one of the two boxes)
O Yes
O No
If you answered “Yes” to questions 40, 41, 42 or 43, please explain
Petition for Dissolution of Marriage Page 11 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
45. Have any orders pertaining to any of the children been entered by the Family Support Division?
(Check one of the two boxes)
0 Yes, | have attached a copy of the order to this Petition for Dissolution of Marriage
Ol No
46. Are you or your spouse currently receiving Temporary Assistance to Needy Families (TANF)
benefits? (Check one of the two boxes)
OO Yes
O No
Other Allegations
#
‘
47. Are there any other allegations? ae +
there are statem: ish to include in yor jon, you _-
Request for Relief
| want the court to do the following: (Check all that apply)
Grant a dissolution of my marriage
Grant custody of the child(ren) of the marriage. a: d herein (if applicable)
Enter appropriate orders with respect to the Support of the child(ren) (if applicable)
Divide the marital property and debts
Award maintenance to me
Award maintenance to my spouse
Change my name to my former name of
(First Name) (Middle Name) (Last Name) (Jr/SrMl)
Other (Please state thi her request(s))
Petition for Dissolution of Marriage Page 12 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov_
Directions for Service on Respondent Spouse
Before your case can proceed, your spouse must be given notice that you have filed this case.
This notice must be given in one of the methods described in this section
If you do not know the location of your spouse and you have no way of contacting them, you must
attempt to serve your spouse at their last known address or place of employment. Once you make an
honest and reasonable effort to personally serve your spouse and are still unable to get service, then you
mayfile a Request for Service by Publication asking the court to publish notice of your Petition in the. sachs
local newspaper. The Request for Service by Publication is available on the Representing Yourseli ‘ene
website at selfrepresent.mo.gov. If you have service by publication, you are not entitled to tain
any kind of money judgment against your spouse for such things as child support. Thi: tion
should only be used as a last resort.
¥] Respondent Spouse has signed a verified Respondent’s Answer to Petition for D. ution of Marriage,
which is beingfiled with the Petition ae
for Dissolution of Marriage. Therefore, do not ue a summons.
mf you check this box, you ‘must file the Respondent's ‘Answer to Petition for Dissolution of ‘Mai same time.
. you file this petition. The Respondent's Answer to Petition for Dissolution of Marriage must’ igned by your, spouse
:. front of a notary pul -— sec aa ~
Respondent Spouse ee
should be served
Ee withee a summonssat
| ‘their | hom
" Your spouse must be served within 30 days of the issuance ‘of the summons. going toh have you Spouse ~
| Served, you! must fille éanotherir COPY of
| all your documents in this case tobe rved ee
on your spouse. |
ee ee ee eed
(Street)
(City) (State) (Zip)
Respondent
SE Spouse should
Rn be served
ee with a ions at their place of employme:
,, Your spouse must be served within 30 days of the issuance of the summons. If you.are going to have your ‘bpousé
| | Served, , YOu must fil le another r COpy of allyour do ments in this case to be served on your spouse. i
ee ee
(Employer's Name) (Hours of Employment)
.
(Street)
(City) (State) (Zip)
Respondent Spouse not be served in Missouri. Therefore, service by registered mail is!
requested. A cop he Affidavit for Service by Mail is attached to this form. See Missouri Supreme
Court Rule 54. (
If you listed children in this Petition and either you or your spouse receive Temporary Assistance
for Needy ainilies (TANF) benefits, you must serve the Family Support Division with a copy of
your Pe: ni and Parenting Plan.
oO Me my spouse currently receive TANF benefits through the Family Support Division. The Family
pport Division shall be served at the following address:
irector, Family Support Division
615 Howerton Court
Jefferson City, Missouri 65102
If you request a summons to be served outside of the county where you filed this Petition, the
court will mail the summons to you. You must then deliver the summons to the sheriff of the
county where the summons will be served. You must also pay the appropriate service fee to that
sheriff.
Petition for Dissolution of Marriage Page 13 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
Sign Below in the Presence of a Notary Public
be verifi the press fa notary pi by §
—— -—
Petitioner, of lawful age, being duly sworn on his or her oath, states that he or she is the Petitioner
named above and that the facts stated in the Petition for Dissolution of Marriage are true according
to his or her best knowledge, information and belief.
(Sign above in the presence(ofa Notary Public)
THONG
(Print your name above)
TAN DAWG
The following information must be completed by a notary public.
STATE OF M\Syouc: )
COUNTY
OF Sk, Lows)
On this 3 day of Tune 2023 , before me personally appeared
ony Ton Cuind to me known to be the person described in and who
executed'the foregoing ingtrument and acknowledged that he/she executed the same as his/her tea act
and deed.
IN WITNESS WHEREOF, | have hereunto set my hand and affixed my official seal in the County and
State aforesaid, the day and year first above written.
KENNETH AUSTIN. KRUEGER
Notary Public, Notary Seal
State of Missouri
St. Louis County
Commission # 22997:
DA tA |Y
My Commission Expires 11-14-2026
mack whin \CrueyerNotary Public
SF Loniy County, State of Missouri
My commission expires JI-IU- 2026
Attorney Information
"This information | may be ‘completed | by your attorney. Do not enter any information here if you ‘are filing this case without the
‘ assistance of an attorney.
a — a -- ae ee a |
oO | have assisted Petitioner iin the preparation of these pleadings, but lam not entering rmy appearance
on behalf of Petitioner.
i
(Attorney - Sign above) (Missouri Bar Number)
(Attorney - Print your name above)
(Street)
(City) (State) (Zip)
(Telephone Number with Area Code) (Fax Number with Area Code) (E-mail Address - Optional)
Petition for Dissolution of Marriage Page 14 of 14
Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov
Preview
IN THE CIRCUIT COURT OF Saint Louis County , MI dk ED (County where court is located. City of Saint Louis is considered. a county.) JUL 03 2023 JOAN M, GILMER In re the Marriage of: CIRCUIT CLERK, ST, LOUIS COUNTY THONG TAN DANG Case (First Name) (Middle Name) (Last Name) (Jr/Sr All) Number @35L~ ee e Petitioner, (Enter your full legal name above) (Will be assigned when case is -and- HIEN THI PHAM Division (First Name) (Middle Name) (Last Name) (Jr/Sr All) Number Respondent. (Enter your spouse’s full legal name above) (Will be assign shen case is filed) Petition for Dissolution of Marriag Throughout this entire case, you, THONG TAN JANG (First Name) (Middle Name, (Last Name) (Ir/SrMl) will always be the Petitioner. Your spouse, HIEN THI PHAM - will always be the (First Name) (Middle Name) (Last Name) (Je/Sr Al) Respondent. Information about Petitioner THONG TAN DANG (Enter your name on the lines) (First Name) +, (Middle Name) (Last Name) (Je./SrAll) How many petitions have you filed case? (Check one of the three boxes) M This is the first petition | have.filed in this case. (Original petition) O This is the second petition-|-have filed in this case. 1 This is the third petition.1 have filed in this case. What is your mailing réss? This is the address the court will use to send information about your case to you. If you move during the time this case i is pending, you must.send a letter to the ‘court notifying it-of your new address. This address is not necessarily the same t as the address at which you live. Even if you do not wish to give the address at which you live, you must still give the court a mailing ‘address. Because court actions are. a matter of. Public record, the address you list will be available; to the t public. 6530, INONA AVE (stra ‘SAINT LOUIS MO 63109 ity) (State) (Zip) (314) 601-2997 THONGDANG99@YAHOO.COM (Telephone Number with Area Code) (E-mail Address - Optional) What are the last four numbers of your social security number? | The last four digits of your ssocial security number are required by §452. 312, RSMo. _ doe xxx.xx- 8049 Petition for Dissolution of Marriage Page 1 of 14 Form CAFCO01 01/01/2018 This form is available for free at www.selffepresent.mo.gov Are you over the age of eighteen? (Check one of the two boxes) M Yes O No | live in YZ] the United States [1] another country, which is | live in ¥] Missouri [] another state, which isCae /'Missouri law requires that one party to adissolution of marriage proceeding must have been a resident of ‘thes Stat | issouri for at least 90 day the time i is less than four months, state the number of days you have livéd iri the a at _—~ ee ee eres cere oe i veeeenee —— 28 7 0 Years Months Days (Length of time you have lived in this state) In whatacounty do you currently live and for what length ofSetime havenot.you lived t == } City ‘of Saint Louis is considered a county. if you live in th city of Saint Louis, you should er ai ouis in the ‘blank. fines aa ee co ree fo SAINT LOUIS 28 7 0 (County) Years Months Days (Length of time you have lived in this ty) What is your current employment status? (Check one of the-hreé boxes) O Employed O Unemployed WI Self-employed If you are employed poe ye or self. nploye |, wher urrently work? =r [ If you are self-émployed, enter a brief description of 38 “Landscaping” “or “l yy care” on' pe of work you perform such as “the-line for the name of your employer. If you are, sel mployed, you should also enter the address information fory‘your (selff-employment. eee ae ae ae dA LL SELF-EMPLOYMENT @ LUCKY NAILS (Employer's name or type of ‘self-employment 871 FAIRFAX ST (Street) CARLYLE IL 62231 (City) (State) (Zip) 10 What is ; your titot / ‘monthly gross income from all sources? i Gross i income isthe amount of money a person earns before anything such as taxes is ‘deducted. Fora ‘more detailed lefiniton of 9 ross income” see Supreme Court Forrn No. 14. Se aa = fe ne de ad $1 500s ¢ Total ‘monthly gross income) 14 an you support yourself through the combined income from your employment anditincome from Sy property that you will receive in the dissolution? (Check one of the two boxes) _ any tee minor wt _ M Yes O No Petition for Dissolution of Marriage Page 2 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov Information about Respondent HIEN THI PHAM (Enter your spouse's name on the lines) (First Name) (Middle Name) (Last Name) Gr/SrMl) 12, What i is your spouse’s mailing address? wee This iis the address that the court will use to send information about jyour “case to |your spc spouse. if you ‘do not know your i Spouse's current address, you should enter, the last known address of your spouse. ee 1515 NUUANU AVE, APT 1557 (Street) HONOLULU HI 96817 (City) (State) (Zip) (314) 874-7799 MINHHIEN_PHAM2002@YAHOO.COM (Telephone Number with Area Code) (E-mail Address - Optional) 13. What are the last four numbers of your spouse’s social security number? The last four digits of your spouse’s social security number are required by §45: 12, RSMo: D jot leave this field jot know your spouse’s security. number, enter “U! Ss fi - XXX- 064 ' 14. Is your spouse over the age of eighteen? (Check one of the two, boxes) MW] Yes O No 15. My spouse lives in [¥] the United States 1] another country, which is 16 My spouse lives i inOh Missouri a VI al other stat hig HAWAII See oe ~ ‘the time iis less ‘than four months, state ‘the number oft your spouse | has |lived ini the state, a. - 8 0 0 Years Months Days (Length of time they have lived in this state) 17. In what county does your spouse’ currently live and for how long hasye your spouse lived there? _ 1 Ifyou: do not know in which county your-spouse lives and cannot find out this information, then you should enter : “Unknown.” "City of ‘Saint Louis iis considered a county, we ‘HONOLULU 8 0 0 (County) Years Months Days (Length of time they have lived in this county) 18 If your spouse durini Tarriag as.a result of sexual intercourseor artificial insemination. LA (Number of Children) 31 How mene many living 2 children did you and your spouse. adopt?~” i Tt you have already accounted for this child in paragraph 30, do count them in this | | paragraph. Include in this number all living children who we! (a) born to you or your 0 it spouse af and later adopted byt the other ‘spouse; or (0) ado| vee ees eee by both parties. nes ae —- (Number of Children) 32. How many living children do you and your spousee have together that were born bef the dat f thi — wn lude imbe' ing chi to; ane spoust fore this rriag : as a result of sexual intercourse or arti semination. You should attach a copy of 0| ,the birth certificate(s) for these id our Petit cae weed (Number of Children) 33. A How many living childre) were born to you (if you are female) with someone other than,’ ‘our spouse during this marriage? (This number includes children,bi after the parties separated.) ae ae 4 0 \dditional information may be required before the court proceeds with your case. (Number of Children) ' How mi ing children were born to your spouse (if they are female) with someone other than you during this marriage? (This number incl children born after the parties separated.) 0i foe ee cr = ey lonal information may bbe required before the court proceeds wil your casi (Number of Children) oe ne! = i 0: inter the total number of children from lines 30, 31, 32 and 33 A and B (Total Number of Children) Petition for Dissolution of Marriage Page 5 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov ! If line 34 is zero, then go directly to Question 47. If line 34 is one or more, you must answer the following questions. Information about Children ee — - o~ — ae - — ~ ‘Question 35 (a-j) represents the information for the first child, Question 36 @ ) represents the information for the second child, and so on. See the chart below for more information. ' : You must list the children regardless of age even if they are in someone else’s custody. You must answer a evel «part of ¢ the ‘question. — —- _ a a Number of children you wrote on line 34 Questions you should answer 1 35 (a-j) and 39-47 2 35 (a-j), 36 (a-j) and 39-47 3 35 (a-j), 36 (a-j), 37 (a-j) and 39-47¢,- 4 35 (a-j), 36 (a-j), 37 (a-j), 38 (a }-47 More than 4 35 (a-j), 36 (a-j), 37 (a-j), 38,( ittach additional pages answering all the éstions asked in 38 (a-j) for each additional child and 47 Bf Petition for Dissolution of Marriage Page 6 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov 35. Child One '"To beee aanswered if the answer ‘to ) question 234i is one ormore _ 35a. What is the full name of this child? (First Name) (Middle Name) (Last Name) (r/Sr.Mil) 35b. What are the last four numbers of this child’s Social Security Number? XXX-Xx- 35c. What is the current address of this child? (Street) (City) (State) (Zip) 35d. What is this child’s age? 35e. Check all of the following boxes that apply: O1 This child is married O This child is on active duty in the military. O This child is self-supporting. O This child is attending high school O This child is attending college or vocational scho 35f. With whom has this child primarily lived during the:previous 60 days? (First Name) (Middle Name) “(Last Name) (Jr/SrMl) 35g. Who should have legal custody of this chi “(Check one of the four boxes) Legal custody refers to who will make the decisions conceming health, cation and welfare for this child. §452.375.1(2), RSMo O Me (Petitioner) 0 My Spouse (Respondent) O Both Spouses Jointly 0 Other Person (State narné)_ (First Name) (Middle Name) (Last Name) (ir/Srll) 35h. Who should have physi¢al custody of this child? (Check one of the four boxes) Physical custody refers to where this iid will reside and what time this child spends with each parent. §452.375.1(3), RSMo O Me (Petitione’ O My Spouse (Respondent) 0 Both Spotises Jointly Cl Other Person (State name) (First Name) (Middle Name) (Last Name) (Jr/Sr All) 35i are6 the parents of this child? (Check all that apply) if you or your spouse are not a parent of this by sexual intercourse, adoption or artificial insemination, please name the other parent. Me (Petitioner) OO My Spouse (Respondent). O Other Person (State name) (First Name) (Middle Name) (Last Name) (Je/Sr Ml) 35] Who are listed as parents on this child’s birth certificate? (Check all that apply) O Me (Petitioner) 1 My Spouse (Respondent) O Other Person (State name) (First Name) (Middle Name) (Last Name) (Jr/Sr) Petition for Dissolution of Marriage Page 7 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov 36. Child Two ~ oe. To be answered if the answer to question 34 is two or more a a ee 36a. What is the full name of this child? (First Name) (Middle Name) (Last Name) Gr /SrMl) 36b. What are the last four numbers of this child’s Social Security Number? XXX-XX- 36c. What is the current address of this child? (Street) (City) (State) (Zip) 36d, What is this child’s age? 36e. Check all of the following boxes that apply: D This child is married O This child is on active duty in the military. O This child is self-supporting. O This child is attending high school O This child is attending college or vocational scho 36f. With whom has this child primarily lived during the‘previous 60 days? ” (First Name) (Middle Name) (Last Name) (Je./SrAll) 36g. Who should have legal custody of this c! ‘Check one of the four boxes) Legal custody refers to who will make the decisions conceming health, cation and welfare for this child. §452.375.1(2), RSMo 0 Me (Petitioner) O My Spouse (Respondent) O Both Spouses Jointly O Other Person (State n . (First Name) (Middle Name) (Last Name) (I-/Sr-All) 36h, Who should have physical custody of this child? (Check one of the four boxes) Physical custody refers to where this child lI reside and what time this child spends with each parent. §452.375.1(3), RSMo O Me (Petitioner! 0 My Spouse-(Respondent) O Both Spouses Jointly O Other Person (State name) (First Name) (Middle Name) (Last Name) (SrA) 36i. are6 the parents of this child? (Check all that apply) If you or your spouse are not a parent of this jld by sexual intercourse, adoption or artificial insemination, please name the other parent. Me (Petitioner) Oi My Spouse (Respondent) O Other Person (State name) (First Name) (Middle Name) (Last Name) (Ir/Sr/) 36) Who are listed as parents on this child’s birth certificate? (Check all that apply) O Me (Petitioner) Oi My Spouse (Respondent) O Other Person (State name) (First Name) (Middle Name) (Last Name) (Jr/Sr All) Petition for Dissolution of Marriage Page 8 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov- 37. Child Three answer to q ion 34 is r more een ae 37a. What is the full name of this child? (First Name) (Middle Name) (Last Name) (r/Sr.Mlll) 37b. What are the last four numbers of this child's Social Security Number? XXX-XX- 37c. What is the current address of this child? (Street) (City) (State) (Zip) 37d. What is this child’s age? 37e. Check all of the following boxes that apply. O This child is married O This child is on active duty in the military. O This child is self-supporting O This child is attending high school. O This child is attending college or vocational scho 37F. With whom has this child primarily lived during the previous 60 days? (First Name) (Middle Name) (Last Name) (r/Sr.Mll) 37g. Who should have legal custody of this cl (Check one of the four boxes) Legal custody refers to who will make the decisions conceming health, tion and welfare for this child. §452.375.1(2), RSMo O Me (Petitioner) DI My Spouse (Respondent) O Both Spouses Jointly O Other Person (State namé) (First Name) (Middle Name) (Last Name) (Se/Sr All) 37h. Who should have physi sal custody of this child? (Check one of the four boxes) Physical custody refers to where this child will reside and what time this child spends with each parent. §452.375.1(3), RSMo O Me (Petitioner); O My Spou: espondent) O Both Spor s Jointly O Other: Person (State name) (First Name) (Middle Name) (Last Name) (dr/Sr All) 371. 10-aree the parents of this child? (Check all that apply) If you or your spouse are not a parent of this lid by sexual intercourse, adoption or artificial insemination, please name the other parent. | Me (Petitioner) O My Spouse (Respondent) O Other Person (State name) (First Name) (Middle Name) (Last Name) (Jr/Sr All) 37) Who are listed as parents on this child’s birth certificate? (Check all that apply) O Me (Petitioner) O My Spouse (Respondent) O Other Person (State name) (First Name) (Middle Name) (Last Name) (I-/Sr.Mll) Petition for Dissolution of Marriage Page 9 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov 38. Child Four aoe ao To be'answered if thé answer to question 34 is four or more wee 38a. What is the full name of this child? (First Name) (Middle Name) (Last Name) (Je /SrMl) 38b. What are the last four numbers of this child’s Social Security Number? XXX-XX- 38c. What is the current address of this child? (Street) (City) (State) (Zip) 38d. What is this child’s age? 38e. Check all of the following boxes that apply. O This child is married O This child is on active duty in the military. O This child is self-supporting C1 This child is attending high school. O This child is attending college or vocational school. 38f. With whom has this child primarily lived curing the: t e prévious 60 days? (First Name) (Middle Name) 4 ast Name) (Ir /8rMl) 38g. Who should have legal custody of this ch ’(Check one of the four boxes) Legal custody refers to who will make the decisions conceming health, ot ion and welfare for this child. §452.375.1(2), RSMo O Me (Petitioner) ‘ 0 My Spouse (Respondent) . O Both Spouses Jointly ‘ O Other Person (State ni (First Name) (Middle Name) (Last Name) i (Arf) 38h. Who should have phys al custody of this child? (Check one of the four boxes) Physical custody refers to where this child will reside and what time this child spends with each parent. §452.375.1(3), RSMo O Me (Petitioner CO My Spouse (Respondent) O Both Spouses Jointly O Othe erson (State name) (First Name) (Middle Name) (Last Name) (JSr/SrMl) 38i. 10.are the parents of this child? (Check all that apply) if you or your spouse are not a parent of this by sexual intercourse, adoption or artificial insemination, please name the other parent. °LD Me (Petitioner) C1 My Spouse (Respondent) O Other Person (State name) (First Name) (Middle Name) (Last Name) (Jr /SrMll) 38) Who are listed as parents on this child’s birth certificate? (Check all that apply) O Me (Petitioner) O My Spouse (Respondent) C1 Other Person (State name) (First Name) (Middle Name) (Last Name) (Jr/Sr Ml) Petition for Dissolution of Marriage Page 10 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov If you have more than four children, attach additional pages answering all the questions asked in 38 (a-j) for each additional child. Additional Information about Children 39. List all addresses at which the children have lived during the past five years and the name of the parent or guardian with whom said children lived (First Name) (Middle Name) (Last Name) (Gr /Sr/il) (Street) (City) (State) (Zip) (First Name) (Middle Name) (Last Name) (de/Sr Ml) (Street) (City) (State) (Zip) (First Name) (Middle Name) (Last Name, (Je /SrAll) (Street) (City) (State) (Zip) 40. Do you know of anyone other than you" your spouse who has physical custody of any of the children or claims to have custody or. Visitation rights with respect to any of the children? (Check one of the two boxes) O Yes O No 41 Do you have informati. bout any other custody proceeding concerning any of the children pending in a court of this o1 ‘other state? (Check one of the two boxes) O Yes O No 42 Have yo, ipated in other litigation concerning the custody of any of the children in this or any other state? (Check one of the two boxes) oO Nes! -No 43 Have any of the children been a victim of abuse or neglect? (Check one of the two boxes) O Yes O No If you answered “Yes” to questions 40, 41, 42 or 43, please explain Petition for Dissolution of Marriage Page 11 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov 45. Have any orders pertaining to any of the children been entered by the Family Support Division? (Check one of the two boxes) 0 Yes, | have attached a copy of the order to this Petition for Dissolution of Marriage Ol No 46. Are you or your spouse currently receiving Temporary Assistance to Needy Families (TANF) benefits? (Check one of the two boxes) OO Yes O No Other Allegations # ‘ 47. Are there any other allegations? ae + there are statem: ish to include in yor jon, you _- Request for Relief | want the court to do the following: (Check all that apply) Grant a dissolution of my marriage Grant custody of the child(ren) of the marriage. a: d herein (if applicable) Enter appropriate orders with respect to the Support of the child(ren) (if applicable) Divide the marital property and debts Award maintenance to me Award maintenance to my spouse Change my name to my former name of (First Name) (Middle Name) (Last Name) (Jr/SrMl) Other (Please state thi her request(s)) Petition for Dissolution of Marriage Page 12 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov_ Directions for Service on Respondent Spouse Before your case can proceed, your spouse must be given notice that you have filed this case. This notice must be given in one of the methods described in this section If you do not know the location of your spouse and you have no way of contacting them, you must attempt to serve your spouse at their last known address or place of employment. Once you make an honest and reasonable effort to personally serve your spouse and are still unable to get service, then you mayfile a Request for Service by Publication asking the court to publish notice of your Petition in the. sachs local newspaper. The Request for Service by Publication is available on the Representing Yourseli ‘ene website at selfrepresent.mo.gov. If you have service by publication, you are not entitled to tain any kind of money judgment against your spouse for such things as child support. Thi: tion should only be used as a last resort. ¥] Respondent Spouse has signed a verified Respondent’s Answer to Petition for D. ution of Marriage, which is beingfiled with the Petition ae for Dissolution of Marriage. Therefore, do not ue a summons. mf you check this box, you ‘must file the Respondent's ‘Answer to Petition for Dissolution of ‘Mai same time. . you file this petition. The Respondent's Answer to Petition for Dissolution of Marriage must’ igned by your, spouse :. front of a notary pul -— sec aa ~ Respondent Spouse ee should be served Ee withee a summonssat | ‘their | hom " Your spouse must be served within 30 days of the issuance ‘of the summons. going toh have you Spouse ~ | Served, you! must fille éanotherir COPY of | all your documents in this case tobe rved ee on your spouse. | ee ee ee eed (Street) (City) (State) (Zip) Respondent SE Spouse should Rn be served ee with a ions at their place of employme: ,, Your spouse must be served within 30 days of the issuance of the summons. If you.are going to have your ‘bpousé | | Served, , YOu must fil le another r COpy of allyour do ments in this case to be served on your spouse. i ee ee (Employer's Name) (Hours of Employment) . (Street) (City) (State) (Zip) Respondent Spouse not be served in Missouri. Therefore, service by registered mail is! requested. A cop he Affidavit for Service by Mail is attached to this form. See Missouri Supreme Court Rule 54. ( If you listed children in this Petition and either you or your spouse receive Temporary Assistance for Needy ainilies (TANF) benefits, you must serve the Family Support Division with a copy of your Pe: ni and Parenting Plan. oO Me my spouse currently receive TANF benefits through the Family Support Division. The Family pport Division shall be served at the following address: irector, Family Support Division 615 Howerton Court Jefferson City, Missouri 65102 If you request a summons to be served outside of the county where you filed this Petition, the court will mail the summons to you. You must then deliver the summons to the sheriff of the county where the summons will be served. You must also pay the appropriate service fee to that sheriff. Petition for Dissolution of Marriage Page 13 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov Sign Below in the Presence of a Notary Public be verifi the press fa notary pi by § —— -— Petitioner, of lawful age, being duly sworn on his or her oath, states that he or she is the Petitioner named above and that the facts stated in the Petition for Dissolution of Marriage are true according to his or her best knowledge, information and belief. (Sign above in the presence(ofa Notary Public) THONG (Print your name above) TAN DAWG The following information must be completed by a notary public. STATE OF M\Syouc: ) COUNTY OF Sk, Lows) On this 3 day of Tune 2023 , before me personally appeared ony Ton Cuind to me known to be the person described in and who executed'the foregoing ingtrument and acknowledged that he/she executed the same as his/her tea act and deed. IN WITNESS WHEREOF, | have hereunto set my hand and affixed my official seal in the County and State aforesaid, the day and year first above written. KENNETH AUSTIN. KRUEGER Notary Public, Notary Seal State of Missouri St. Louis County Commission # 22997: DA tA |Y My Commission Expires 11-14-2026 mack whin \CrueyerNotary Public SF Loniy County, State of Missouri My commission expires JI-IU- 2026 Attorney Information "This information | may be ‘completed | by your attorney. Do not enter any information here if you ‘are filing this case without the ‘ assistance of an attorney. a — a -- ae ee a | oO | have assisted Petitioner iin the preparation of these pleadings, but lam not entering rmy appearance on behalf of Petitioner. i (Attorney - Sign above) (Missouri Bar Number) (Attorney - Print your name above) (Street) (City) (State) (Zip) (Telephone Number with Area Code) (Fax Number with Area Code) (E-mail Address - Optional) Petition for Dissolution of Marriage Page 14 of 14 Form CAFC001 01/01/2018 This form is available for free at www.selfrepresent.mo.gov