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CONFIDENTIAL FINANCIAL DOCUMENTS INFORMATION FORM (Required by SDCL 15-15A-9) Plaintiff/Petitioner Defendant/Respondent Case No.

This form and the attached documents are protected and will be filed in a non-public part of the record. Document Income Tax Returns Financial Account Statements Wage Stubs Credit Card Account Statements W2's and Schedules Check Registers Other (list below) Period Covered

Information supplied by: Signed: Firm: Address: Date:

Documents to be recorded in the Register of Actions by caption as confidential.

Rev. July 1, 2006