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This form is used to declare a request for divorce due to infidelity.
The form requires personal details such as names and CPR numbers of both spouses.
The declaring spouse must confirm having had a sexual relationship with someone other than their spouse within the last two years.
The spouse must acknowledge being aware of the infidelity within the last six months and that they have not accepted it.
Providing false information on this form can lead to fines or imprisonment under Section 163 of the Penal Code.
Both spouses must sign and date the form to validate the declaration.