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The Michigan DCH 0838 form serves as an essential document for recording the details of a divorce or annulment in the state. This form collects vital information about both parties involved in the legal proceedings, including their names, birthdates, and residences. It also requires details about the marriage, such as the date and place of the ceremony, as well as the number of minor children in the household at the time of separation. Understanding the significance of this form is crucial for ensuring that all necessary information is accurately submitted to the Michigan Department of Health and Human Services. The DCH 0838 not only facilitates the legal process but also helps maintain accurate public records. Additionally, it includes sections for attorney information and custody arrangements, reflecting the complexities often involved in divorce cases. Failing to provide the required information on this form can lead to serious consequences, underscoring the importance of careful completion. By addressing these key aspects, individuals can navigate the divorce process with greater confidence and clarity.

Form Example

__________________________________

State File Number

RECORD OF

DIVORCE OR ANNULMENT

MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES

By authority of MCL 333.2813.

_________________________________

Court Case Number

_________________________________

County

1. Plaintiff’s Full Name _______________________________________________________ 2.

Plaintiff’s Birthdate ______________

Male

Female

(First, Middle, Last)

(Month, Day, Year)

 

 

3.Last Name Before First Married (if different) _____________________________________________________________________

4.Plaintiff’s Residence _______________________________________________________________________________________

(City, Village, or Township)(County)(State)

5.

Plaintiff’s Birthplace ______________________________________________________ 6. Number of this Marriage __________

 

 

 

 

 

(State or Foreign Country)

(First, Second, etc. - Specify)

7.

Defendant’s Full Name ____________________________________________________ 8. Defendant’s Birthdate ____________

 

Male

Female

(First, Middle, Last)

(Month, Day, Year)

9.Last Name Before First Married (if different) _____________________________________________________________________

10.Defendant’s Residence _____________________________________________________________________________________

(City, Village, or Township)(County)(State)

11. Defendant’s Birthplace ___________________________________________________ 12. Number of this Marriage __________

 

 

(State or Foreign Country)

 

(First, Second, etc. - Specify)

13.

Place of this Marriage ______________________________________________________________________________________

 

(City, Village, or Township)

(County)

(State or Foreign Country)

 

 

 

 

 

14.

Date of this Marriage _____________________

15. Date Couple Last Resided

Check if Not

 

 

Separated

______________

in Same Household

 

(Month, Day, Year)

(Month, Day, Year)

 

 

 

 

 

 

 

 

Check If

 

 

16.

Number of Minor Children in Household at Separation Date (Filing Date if Not Separated)

None

______________

 

 

 

 

(Number)

 

17.

Plaintiff’s Attorney _________________________________________________________________________________________

 

 

(Name - Type or Print)

(Bar Number)

 

18.

Attorney’s Address _________________________________________________________________________________________

 

(Number and Street)

(City)

(State)

(Zip Code)

 

 

20. Number of Minor Children Whose

 

 

 

19.

Judgment of ____________________ Physical Custody was Awarded to: Plaintiff____ Defendant____ Joint____ Other____

 

(Divorce/Annulment - Specify)

(Number)

(Number)

(Number)

(Number)

 

 

No Children

Unknown

 

 

21.

Judgment Recorded on _______________________ 22. I certify that this Divorce was granted on ________________________

 

(Month, Day, Year)

 

(Month, Day, Year)

 

23.

Certifying Oficial _________________________________________________________________________________________

 

(Signature)

(Title)

(Date Signed)

 

Failure to provide the required information is a misdemeanor punishable by imprisonment

of not more than 1 year or a ine of not more than $1,000.00 or both.

DCH-0838 (Rev. 08/2015)

Document Specs

Fact Name Description
Form Purpose The Michigan DCH 0838 form is used to record the details of a divorce or annulment in the state of Michigan.
Governing Law This form is authorized under the Michigan Compiled Laws (MCL) 333.2813, which outlines the requirements for vital records.
Information Required Key details needed on the form include the names, birthdates, and residences of both the plaintiff and defendant, as well as marriage specifics.
Minor Children The form requires information about any minor children involved, including custody arrangements and the number of children at the time of separation.
Certification A certifying official must sign the form, confirming that the divorce was granted on the specified date.
Penalties for Inaccuracy Failure to provide accurate information can lead to misdemeanor charges, which may include imprisonment or fines.
Form Revision The current version of the DCH 0838 form was revised in August 2015, ensuring that it complies with updated legal standards.
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