The VS4 form is a vital document used in Virginia to report the details of a divorce or annulment. It must be completed by the petitioner or their attorney and filed with the clerk of court alongside the petition or decree. This form serves as a permanent record, ensuring that the state registrar receives the necessary information promptly after the final decree is granted.
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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
D
WIFE
(first, middle, last, suffix)
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.)
18. EDUCATION (specify only highest grade completed)
19. USUAL RESIDENCE
(city or town)
20. PLACE OF MARRIAGE
(county)
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
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)
30. ADDRESS OF
D ATTORNEYFOR PETITIONER
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)
The VS4 form is a report of divorce or annulment that must be filed with the clerk of court. In addition to the VS4 form, there are several other documents that are commonly used during divorce proceedings. Each of these documents serves a specific purpose in the legal process.
These documents are integral to the divorce process, ensuring that both parties' rights are protected and that the terms of the divorce are clearly established. Each document has its own requirements and implications, which can affect the overall outcome of the proceedings.