STATE OF NEBRASKA FORM NO. DC 6:5(9) NEW 1/08 Neb. Rev. Stat. 43-2925(3)
ATTORNEY CERTIFICATE OF PROVIDING PARENTING ACT INFORMATION
CASE NUMBER:
IN THE DISTRICT COURT OF ________________ COUNTY, NEBRASKA , Plaintiff, vs. , Defendant. ) ) ) ) ) ) )
ATTORNEY CERTIFICATE OF PROVIDING PARENTING ACT INFORMATION
The undersigned attorney for the _________________________________
(plaintiff or defendant)
hereby certifies to the court that required Parenting Act information pursuant to Neb. Rev. Stat. Section 43-2925 has been provided to the undersigned's client in this action. Dated: Signed: Attorney Name (Bar Number) Firm Street Address/P. O. Box City/State/Zip Area Code/Phone Number