District Court Denver Juvenile Court _________________________________County, Colorado Court Address:
_____________________________________________

In re the Marriage of: In the Interest of: in re Parental Responsibilities concerning: ________________________________________________ Petitioner:__________________________________________ and Co-Petitioner/Respondent: ____________________________ Attorney or Party Without Attorney (Name and Address): ____________________________________________ ____________________________________________ Phone Number:___________________ E-mail:__________________ FAX Number:_____________________ Atty. Reg. #: _____________

COURT USE ONLY Case Number:__________________

Division_______ Courtroom _______

CASE INFORMATION SHEET
Full name of Petitioner: ______________________________________________________________________ Date of birth: ________________________ Social Security Number: _____________________

Residential address: __________________________________________________________ Apt. #__________ City: ______________________ State: ______________________ Zip Code: __________________ Mailing address (if different from residential address): ___________________________________ Apt. # _______ City: ______________________ State: ______________________ Zip Code: __________________ Telephone Numbers: Home ___________________ Work ____________________ Cell ___________________ Full name of Co-Petitioner/Respondent: ________________________________________________________ Date of birth: ________________________ Social Security Number: _____________________

Residential address: __________________________________________________________ Apt. #__________ City: ______________________ State: ______________________ Zip Code: __________________ Mailing address (if different from residential address): ___________________________________ Apt. # _______ City: ______________________ State: ______________________ Zip Code: __________________ Telephone Numbers: Home ___________________ Work ____________________ Cell ___________________ Names of children (attach a second sheet, if necessary): Full Name of Child Present Address Sex Date of Birth Soc. Sec. No.

The Petitioner is planning to be self-represented. The Co-Petitioner/Respondent is planning to be self-represented. Both you and the other party have retained an attorney. Date: _______________________ ______________________________________ Petitioner Co-Petitioner/Respondent

JDF 1000

R6/08 CASE INFORMATION SHEET