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Domestic Relations Case Filing Information Form
Superior Court Plaintiff(s)
Last First
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County _____________________
Date Filed _____________
MM-DD-YYYY
Reset
Docket # ____________________ Defendant(s)
Middle I. Suffix Prefix Maiden Last First
__________________________________
__________________________________
Middle I. Suffix Prefix
Maiden
__________________________________
Last First Middle I. Suffix Prefix
Maiden
__________________________________
Last First Middle I. Suffix Prefix
Maiden
Plaintiff/Petitioner's Attorney
Last First Middle I.
Pro Se
Suffix
__________________________________
Bar # _________________
Check Case Type (one or more)
Divorce (includes annulment)
FAMILY VIOLENCE
Additional Information - Ex Parte Relief
Did the initial pleading include a request for relief? 1. From alleged family violence? 2. Was ex parte relief requested? 3. Was ex parte relief granted?
Contested? Child Custody Issue? Child Support Issue?
Separate Maintenance Adoption
Yes Yes Yes
No No No
Yes Yes Yes
No No No
Paternity (includes legitimation) Interstate Support Enforcement Action Domestication of Foreign Custody Decree Family Violence Act Petition
OTHER
Have the parties agreed to binding arbitration? Yes No Have the parties reached a custodial agreement? Yes No If yes, check one:
MODIFICATION
Modification - Custody, Visitation, or Parenting Time
Does the modification include a parent selection by a child who is at least 14 years old? Yes
Modification - Child Support and Alimony Modification - Child Support Modification - Alimony
No
Joint Custody Joint Legal Custody Joint Physical Custody Sole Custody to: ______________________
Financial Affidavit submitted? Child Support Forms submitted?
CONTEMPT
Contempt - Custody, Visitation, or Parenting Time Contempt - Child Support and Alimony Contempt - Child Support Contempt - Alimony Other Domestic Contempt Other Domestic Relations Specify_______________________ ___________________________________________________ ___________________________________________________
Yes No Yes No