Free Nebraska Hhs 73 Template in PDF Create Your Document Online

Free Nebraska Hhs 73 Template in PDF

The Nebraska HHS 73 form is a comprehensive document used by the Department of Health and Human Services Finance and Support in the state of Nebraska. It is designed to record the finalization of a dissolution of marriage or annulment, capturing detailed information including personal data of both parties, custody of children, settlements made, and court details. This form plays a crucial role in officially documenting the end of a marriage, ensuring that all legal and administrative aspects are properly addressed.

At the heart of family law proceedings in Nebraska is the Nebraska HHS 73 form, a comprehensive document designed to encapsulate the details pertaining to the dissolution of marriage or annulment within the state. Crafted by the Nebraska Department of Health and Human Services Finance and Support along with Vital Records, this form serves a pivotal role in ensuring that the state’s records accurately reflect such significant legal changes. Its sections meticulously gather information about the individuals involved, including names, residences, birthplaces, and the critical dates that chart the timeline of the marriage from its inception to its dissolution. Furthermore, it delves into matters concerning offsprings under 18, custody arrangements, and the involvement of legal representation, ensuring that all pertinent aspects are addressed. Beyond capturing data critical to the dissolution process itself, the form facilitates the reporting of settlements related to alimony, child support, property distribution, and medical reimbursements, offering a thorough overview of the financial adjustments following the legal separation. Additionally, it includes fields for the recording of social security numbers and racial backgrounds, illustrating the comprehensive nature of data collection aimed at serving administrative needs while ensuring the form's utility extends beyond the immediate legal requirements, establishing a foundation for both parties to move forward.

Nebraska Hhs 73 Example

1.฀฀County/Tribal฀Court฀฀฀฀฀฀฀฀State฀of฀Nebraska

Department฀of฀Health฀and฀Human฀Services฀Finance฀and฀Support

Vital฀Records

฀฀2.฀฀Court฀Record฀Number฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀cate฀of฀Dissolution฀of฀Marriage฀or฀Annulment

Certifi

WORKSHEET฀ONLY

฀฀3.฀฀Husband’s฀Name฀(First,฀Middle,฀Last,฀Suffi฀x)

฀฀4a.฀฀Current฀Residence฀-฀Country฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀ ฀ ฀ ฀ ฀

4b.฀฀State฀ ฀ ฀ ฀

4c.฀฀County

฀฀4d.฀City,฀Town฀or฀Location฀฀ ฀ ฀ ฀ ฀

4e.฀฀Residence฀-฀Street฀and฀Number฀ ฀ ฀ ฀

4f.฀฀Zip฀Code

฀฀5.฀฀Place฀of฀Birth฀(City฀and฀State฀or฀Foreign฀Country)฀฀ ฀ ฀ ฀ ฀ ฀

6.฀฀Date฀of฀Birth฀(Mo.,฀Day,฀Yr.)

฀฀7a.฀฀Wife’s฀Name฀(First,฀Middle,฀Last,฀Suffi฀x)฀฀ ฀

฀฀8a.฀฀Current฀Residence฀-฀Country฀฀

8b.฀฀State฀฀ ฀

8c.฀฀County

฀฀฀8d.฀City,฀Town฀or฀Location฀฀ ฀ ฀ ฀ ฀

฀8e.฀฀Residence฀-฀Street฀and฀Number฀ ฀ ฀ ฀

8f.฀฀Zip฀Code

฀฀9.฀฀Place฀of฀Birth฀(City฀and฀State฀or฀Foreign฀Country)฀฀ ฀ ฀ ฀ ฀ ฀

10.฀฀Date฀of฀Birth฀(Mo.,฀Day,฀Yr.)

 

฀11a.฀฀Place฀of฀Marriage฀-฀State฀

11b

.฀฀County฀฀฀

฀฀฀฀

 

฀฀฀฀฀฀฀฀฀฀฀฀

11c.฀฀City฀

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11d.฀฀Date฀of฀Marriage

฀(Mo.,฀Day,฀Yr.)

฀฀12a.฀฀Number฀of฀Children฀under฀18฀in฀this฀Household฀฀

฀฀12b.฀฀Number฀of฀Children฀Under฀18฀Whose฀Physical฀Custody฀was฀Awarded฀to:

 

 

 

 

 

 

฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀

 

Husband฀฀฀฀฀฀฀฀฀

Wife฀฀฀฀฀฀฀฀฀฀฀฀฀

Joint฀Husband/Wife฀

฀฀฀฀฀฀฀฀฀฀฀Number

 

 

 

 

 

 

฀฀

฀฀฀฀฀฀฀฀฀฀฀

 

Other

 

_______________฀฀฀฀฀฀

฀฀

฀฀

฀฀

฀฀

฀฀

฀฀

฀฀

฀฀

฀฀

 

฀No฀Children฀Awarded฀Custody฀

 

฀13.฀฀Plaintiff฀฀฀

฀฀14.฀฀List฀Former฀Name฀of฀Wife,฀if฀restored

 

 

฀฀Husband฀฀฀฀ ฀฀Wife฀

 

 

 

 

 

 

 

 

 

 

 

฀15a.฀฀Attorney฀for฀Plaintiff฀-฀Name฀

฀฀

15b.฀฀Address฀(Street,฀City฀or฀Town,฀State฀and฀Zip฀Code)

฀฀16a.฀฀I฀certify฀that฀the฀marriage฀of฀the฀above฀name฀persons฀was฀dissolved฀on฀฀ ฀

 

16b.฀฀Type฀of฀Decree

฀฀฀฀฀฀฀฀฀฀฀(Mo.,฀Day,฀Yr.)฀฀

 

฀฀฀฀฀฀฀฀฀฀______Dissolution฀฀฀฀฀฀______Annulment

 

฀17.฀฀Clerk฀of฀the฀District฀Court฀or฀Tribal฀Court฀Making฀Return฀to฀the฀Department฀of฀Health฀and฀Human฀Services฀Finance฀and฀Support

฀Information฀For฀Administrative฀Use฀Only.฀Information฀below฀will฀not฀appear฀on฀certifi฀ed฀copies฀of฀the฀record

18.฀฀Settlement(s)฀Made

฀฀฀฀฀฀฀฀฀฀Alimony ฀฀Yes฀ ฀฀No฀฀฀฀฀฀Child฀Support฀ ฀฀Yes ฀฀No฀฀฀฀฀฀฀Property฀Settlement฀ ฀฀Yes฀ ฀฀No฀฀฀฀฀฀฀Medical฀Reimbursement฀ ฀฀Yes฀ ฀฀No

19.฀฀Social฀Security฀Numbers

Husband: ฀฀Wife:

20a.

Is Husband of Hispanic or Latino Origin?

฀฀Yes฀฀ ฀฀No

20b. Is Wife of Hispanic or Latina Origin?

฀฀Yes฀฀ ฀฀No

 

21a. Husband

Race

 

21b. Wife

 

Check the race(s) each person considers him/herself to be

 

 

 

White/Caucasian

 

 

 

Black or African American

 

 

American Indian or Alaska Native

 

 

Asian

 

 

 

Native Hawaiian or Other Pacifi c Islander

 

HHS-73฀(55073)฀6/06

Document Properties

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Fact Detail
Form Number HHS-73
Issued by Department of Health and Human Services Finance and Support, State of Nebraska
Purpose For documenting the dissolution of marriage or annulment
Includes Information on Parties involved, residence, place and date of birth, marriage details, children, settlements, and attorney information
Governing Law(s)Nebraska Marriage and Divorce Laws
Accessibility Used in County/Tribal Courts within the State of Nebraska
Update Interval Last updated June 2006

Guide to Using Nebraska Hhs 73

Filling out the Nebraska HHS 73 form is an important step in documenting the dissolution of a marriage or annulment in the State of Nebraska. This form, submitted to the Department of Health and Human Services Finance and Support, ensures that the vital records are updated accordingly. To complete this form accurately, follow the instructions below. Remember to review the form thoroughly before submission to avoid any delays in processing.

  1. Enter the County/Tribal Court and State of Nebraska at the top of the form to identify the jurisdiction overseeing the dissolution or annulment.
  2. Provide the Court Record Number in the space allotted. This number is crucial for identifying your case within the court system.
  3. Fill in the husband's full name, including first, middle, last, and any suffix.
  4. Under the current residence section, specify the country in 4a, followed by the state, county, city, town or location, street and number, and zip code in fields 4b to 4f.
  5. In item 5, state the husband's place of birth, including city and state or foreign country.
  6. Enter the husband's date of birth in the format (Mo., Day, Yr.) in item 6.
  7. Repeat steps 3 through 6 for the wife, starting with her full name in item 7a and ending with her date of birth in item 10.
  8. For item 11, specify the place of marriage including the state, county, and city, as well as the date of marriage.
  9. List the number of children under 18 in the household in item 12a and specify the custody arrangements in item 12b.
  10. Indicate who the plaintiff was in the dissolution or annulment proceeding by checking the appropriate box in item 13.
  11. If applicable, list the former name of the wife if it was restored, in item 14.
  12. Provide the attorney's name and address for the plaintiff in items 15a and 15b.
  13. Certify the dissolution or annulment by entering the date it occurred in item 16a and specifying the type of decree in item 16b.
  14. The final section is for the clerk of the district or tribal court to complete, including information for administrative use only and details on settlements, social security numbers, and racial background.

After you've completed all the necessary fields on the Nebraska HHS 73 form, review the information to ensure accuracy. Submit the completed form to the Department of Health and Human Services Finance and Support or as directed by the court. This step is crucial for officially recording the change in marital status in the state's vital records.

More About Nebraska Hhs 73

What is the purpose of the Nebraska HHS 73 form?

The Nebraska HHS 73 form, also known as the form for the Certificate of Dissolution of Marriage or Annulment, serves a specific and essential purpose in documenting the dissolution or annulment of a marriage within the state of Nebraska. This official form, issued by the Department of Health and Human Services Finance and Support's Vital Records section, is critical for accurately recording the end of a marital relationship under the law. It includes detailed sections for both parties' personal information, the marriage, any children involved, and the final settlement decisions, such as alimony, child support, and property division. This information is vital for legal recognition of the marriage's dissolution and affects future legal documents, identity verification, and financial arrangements.

Who needs to fill out the HHS 73 form?

The Nebraska HHS 73 form must be completed by the clerk of the district or tribal court where the decree of dissolution or annulment was issued. It is part of the official proceedings in the legal process of finalizing a divorce or annulment. The detailed information required on the form, including personal details about the husband and wife, places of birth, custody arrangements for any children under 18, and the specifics of any settlements made, need to be accurately recorded to ensure the divorce or annulment is legally documented within the state's vital records. The individuals themselves, whose marriage is being dissolved, typically provide their information during the legal process, which the legal representatives or court personnel then transcribe onto the form.

What kind of information is required on the HHS 73 form?

The Nebraska HHS 73 form requires a comprehensive range of information, which can be broken down into several key categories:

  1. Personal details of both parties, including names, residences, places and dates of birth, and Social Security numbers.
  2. Details of the marriage, such as the place and date of marriage, and court records related to the dissolution or annulment, including the court record number and the issuance date of the dissolution or annulment decree.
  3. Information regarding any children under 18, including their custody arrangements and support details.
  4. Details of the legal proceedings, including settlements related to alimony, child support, property division, and medical reimbursement.
  5. Racial and ethnic backgrounds of both husband and wife, aimed at statistical purposes and ensuring comprehensive and inclusive record-keeping.
This information is essential for a multiplicity of legal purposes, including the official dissolution of marriage which affects taxation, property rights, and future marital status.

How does one acquire and submit the HHS 73 form in Nebraska?

Acquiring and submitting the HHS 73 form is typically part of the legal process handled by the court where the divorce or annulment is processed. Those going through a dissolution of marriage or an annulment in Nebraska will work through their attorney or directly with court officials to ensure that the form is correctly filled out and submitted. The original form should be obtained from the Department of Health and Human Services Finance and Support or through the legal system, such as the clerk's office at the district court handling the case. Once completed, the form is usually submitted back to the court for processing and will then be forwarded to the relevant state department for recording and issuing the official Certificate of Dissolution of Marriage or Annulment. For specific instructions and forms, individuals are encouraged to visit the official website of the Nebraska Department of Health and Human Services or consult their legal representative.

Common mistakes

Filling out official forms can often be a daunting task, especially when it comes to something as complex as the Nebraska Department of Health and Human Services Finance and Support Vital Records, commonly known as the HHS-73 form. Individuals frequently make mistakes that can delay processing times or cause other complications. Here are some common errors to avoid:

  1. Inaccurately reporting court information: The form requires specific details about the county or tribal court, including the court record number. A common error is inaccurately reporting these details or leaving them blank, assuming they're not important. Every piece of information requested on the form serves a purpose and helps in verifying the legal document's authenticity.

  2. Providing incomplete or incorrect residence details: Sections 4a through 4f ask for comprehensive information about the current residence, including country, state, county, city, town or location, street and number, and zip code. People often enter incorrect zip codes or city names, or they might leave some fields partially filled. It's crucial to double-check these details against a verified document to avoid any issues with your application.

  3. Forgetting to include information on children under 18: Question 12a asks for the number of children under 18 in the household, and 12b seeks details on custody arrangements. It's surprisingly common for individuals to overlook these sections or to not provide the full details requested. This omission can result in incomplete documentation and potentially delay legal proceedings or administrative actions related to children.

  4. Omitting former names if restored: After a dissolution of marriage or annulment, individuals may choose to revert to their former surname. Question 14 on the form specifically asks if the former name of the wife has been restored. Failing to indicate a name restoration can lead to discrepancies in legal and official documents, creating confusion and potentially legal challenges in the future.

To ensure your form is processed smoothly, always take the time to carefully review each section for accuracy and completeness. Remember, the information you provide is not only used for administrative purposes but also serves as a legal record. Double-check your entries against official documents, and don't hesitate to seek clarification if any section of the form is unclear.

Documents used along the form

When processing the Nebraska HHS 73 form, which is critical for recording the dissolution of marriage or annulment within the state, individuals are often required to gather additional documentation. These documents are essential for a thorough legal process and ensure that all aspects of the dissolution or annulment are accurately and comprehensively addressed.

  • Original Marriage Certificate: This certifies the legality of the marriage that is being dissolved or annulled, serving as proof that the union was officially recognized.
  • Financial Disclosure Forms: These are required to accurately assess and divide assets and liabilities between parties. They provide a detailed account of each party's financial situation.
  • Property Settlement Agreement: If the parties have reached an agreement regarding the division of property, this document outlines the terms of that division and is required for the court's approval.
  • Child Custody Agreement: For couples with children, this document outlines the agreements made regarding the custody and support of the children involved, including visitation schedules and financial support arrangements.
  • Child Support Documentation: This includes any forms or agreements that detail the financial responsibilities of each parent in supporting their children following the dissolution of marriage.
  • Spousal Support (Alimony) Agreement: If applicable, this document outlines the terms agreed upon for spousal support, including the amount and duration of payments.
  • Court Filing Receipts: Proof of filing the required documents with the court, including the payment of any filing fees associated with the dissolution or annulment process.
  • Final Decree of Dissolution of Marriage or Annulment: This is the court's final order officially ending the marriage. It confirms that all processes were appropriately followed and that the marriage is legally dissolved or annulled.

Ensuring that all relevant documents are accurately completed and filed in conjunction with the Nebraska HHS 73 form is vital. Together, these forms and documents allow for the legal dismantling of a marriage, addressing everything from the division of assets and debts to the custody and support of children. They serve as the legal foundation for both parties to move forward independently.

Similar forms

The Nebraska HHS-73 form, utilized for recording the dissolution of marriages or annulments, bears resemblance to various other documents within the legal and vital records frameworks, each serving a distinct purpose yet sharing foundational similarities in structure and function. Firstly, the form parallels the structure found in standard divorce decrees issued by courts. Similar to the HHS-73, divorce decrees outline the particulars of the marriage dissolution, including identification details of both parties involved, custody arrangements if there are children under 18, and details concerning settlements or alimony. Both documents serve as formal records of the termination of a marriage, yet the HHS-73 form specifically interacts with the Department of Health and Human Services for administrative purposes beyond the legal proceedings.

Another document that shares similarities with the Nebraska HHS-73 form is the Birth Certificate Application form used in many states. Although serving a fundamentally different purpose—registering a new life rather than the end of a marital union—both forms collect detailed personal information such as full names, places of birth, and residence details. They require precise data to accurately record significant life events into the public record and to ensure the individuals' identities are properly documented for government and administrative use. The critical similarity lies in their function as official requests for vital records, governed by state departments to maintain accurate and accessible records of life's key events.

Last, the HHS-73 form also aligns with the structure of Change of Name forms often filed through county or state courts. These forms document the legal process of changing one's name and, like the HHS-73, include sections for current legal names, residences, and personal identifiers. Both forms are pivotal in marking significant personal transitions, necessitating official recognition and recording by government bodies. While the context of the life changes they document differs—marriage dissolution versus personal identity change—the bureaucratic essence and informational requirements unite them in purpose and process.

Dos and Don'ts

Filling out the Nebraska Department of Health and Human Services (HHS-73) form for the dissolution of marriage or annulment can be a detailed process. Here are some guidelines to assist you in completing this form accurately and efficiently:

  • Do read all instructions provided on the form carefully before beginning to fill it out. This ensures you understand what information is required and how to provide it correctly.
  • Do use black ink when filling out the form, as this ensures the information is legible and can be scanned or photocopied without issues.
  • Do review the accuracy of all information, including dates, names, addresses, and Social Security numbers, before submitting the form to minimize the risk of errors or delays.
  • Do provide detailed information on settlements such as alimony, child support, property settlements, and medical reimbursement if applicable. This ensures a comprehensive record is maintained.
  • Do consult with a legal advisor if you have questions or concerns regarding any section of the form. Legal advisors can offer guidance and ensure that your rights and interests are adequately represented.
  • Don't leave any required fields blank. If a question does not apply to your situation, mark it as “N/A” (Not Applicable) instead of leaving it empty.
  • Don't guess on dates or factual information. If you are unsure, take the time to verify the correct information before entering it on the form.
  • Don't use correction fluid or tape. If you need to make corrections, it is advisable to start with a fresh form or clearly cross out the mistake and write the correct information nearby.
  • Don't include sensitive personal information that is not requested on the form, to protect your privacy and security.
  • Don't forget to sign and date the form in the designated area, as this verifies the authenticity and accuracy of the information provided.

By following these do's and don'ts, you will help ensure your Nebraska Department of Health and Human Services form is filled out correctly and processed without unnecessary delay, facilitating a smoother administrative process for your case.

Misconceptions

There are several misconceptions about the Nebraska HHS 73 form, commonly used for recording details of a dissolution of marriage or annulment. Here, we aim to clarify these misunderstandings:

  • It's only about financial settlements: While the form includes sections on settlements like alimony and child support, it also records a wide range of information, including personal details of the individuals involved, places of birth, and custody arrangements.
  • It serves as the official divorce decree: The HHS 73 form is a vital record used by the Department of Health and Human Services Finance and Support, and while it documents the dissolution of marriage or annulment, it is not the official divorce decree.
  • Submission by the individual is required: It is often misunderstood that individuals going through a divorce must file this form. Instead, it is typically submitted by the clerk of the district or tribal court managing the case.
  • It's publicly accessible: Information from the form is for administrative use and is not available publicly. Certified copies of the record do not include all the detailed information filled out on the form.
  • It covers custody details only: The form does document the number of children under 18 and custody arrangements, but it also covers a lot more, including marriage and dissolution details.
  • Social Security Numbers are made public: Although Social Security Numbers are collected, they are confidential and not included on certified copies of the record.
  • It's only for residents of Nebraska: The form is indeed specific to the State of Nebraska but can involve parties who live outside the state, as long as the legal action is taking place within Nebraska.
  • Race and ethnicity details are mandatory: While the form asks for the racial and ethnic backgrounds of the individuals, this section may not be compulsory, focusing instead on capturing demographic data for statistical purposes.
  • All sections must be filled out: Some sections of the form may not apply to all cases, such as settlement agreements or child custody, and thus, would not need to be completed by all.

Understanding the Nebraska HHS 73 form is crucial for those undergoing the process of dissolution of marriage or annulment. It is always recommended to seek clarification on any parts of the form or process that are not clear.

Key takeaways

When filling out the Nebraska HHS 73 form, which is used for recording the dissolution of marriage or annulment, applicants should pay attention to several crucial details to ensure the process proceeds smoothly. Understanding these key takeaways will facilitate a thorough and accurate submission of this legal document.

  • Always provide the Court Record Number accurately. This number links your form to the legal proceedings in the state of Nebraska, ensuring that your record of dissolution or annulment is correctly filed under the ongoing or completed case.
  • Include detailed residence information for both parties. The current residence sections (4a through 4f for the husband and 8a through 8f for the wife) are essential for maintaining accurate legal and governmental records.
  • Include the full names of both parties, utilizing the specified fields for the husband (section 3) and the wife (section 7a), and if applicable, list the former name of the wife if restored (section 14).
  • Provide accurate birth information for both the husband and wife, such as the place of birth (sections 5 and 9) and date of birth (sections 6 and 10), which are vital for verifying identities and processing the form.
  • The details of the marriage including the place (sections 11a through 11c) and date of marriage (section 11d) must be accurately recorded. This information is critical for the legal validation of the dissolution or annulment.
  • Specify the number of children under 18 in the household and custody arrangements (section 12), which are necessary for ensuring that proper legal and welfare considerations are made for minors.
  • Clearly indicate any settlements made such as alimony, child support, property settlement, and medical reimbursement (sections 18), as these details directly impact the legal responsibilities of each party following the dissolution or annulment.

Completing the Nebraska HHS 73 form with careful attention to detail and accuracy is crucial for the legal process of marriage dissolution or annulment. This documentation assists in the clear communication of vital information between all parties involved and the Nebraska Department of Health and Human Services. Accurate and thorough completion of this form is a critical step in ensuring that the dissolution or annulment is processed efficiently and effectively.

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