Arizona Superior Court, Pinal County
Severance Cover Sheet
Pursuant to Rule 4.1 Superior Court Local Rules - Pinal County, please provide the following information. (Type or print)
CASE NUMBER SV-___________________
ASSIGNED TO HON. _________________________
INITIATING AGENCY'S NAME and ADDRESS
Name: Address: City/State/Zip: City/State/Zip: Telephone: Social Security Number: DOB: Name: Address:
MINOR'S NAME
PETITIONER'S NAME and ADDRESS
Name:
PETITIONER'S ATTORNEY'S NAME and ADDRESS
Name:
State Bar #: Address: Address: City/State/Zip: City/State/Zip: Telephone: Telephone
NATURE OF ACTION
Place an "X" next to the one which describe the nature of the case.
SEVERANCE
__________ SV1
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NAMES OF ADDITIONAL MINORS
Soc. Sec. #
BIRTH DATES OF ADDITIONAL MINORS:
________________________________ ________________________________ ________________________________ ________________________________ ________________________________
_______________ _______________ _______________ _______________ _______________
_____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________
To the best of my knowledge, all information is true and correct
________________________________________________________ Attorney / ProPer Signature
NOTICE
Effective September 8, 1992 and pursuant to Pinal County Superior Court Administrative Order No. 92-15, the Superior Court requires that a "Cover Sheet", which categorizes the cause of action, accompany any new action filed with the Superior Court in Pinal County. For this purpose, this form has been developed. The cover sheet will result in increased accuracy of court records and statistics, and in reduced processing time for new case filings. Forms will be made available at the Clerk of the Superior Court's Filing Counter.
PLEASE DO NOT INCLUDE THIS FORM WITH CASES WHICH HAVE ALREADY BEEN FILED.
This form can only be processed at the time of filing New Complaints and Petitions.
Thank you for assisting us with our efforts to improve service. Rev 05-08-02
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