Confidential Case Filing Information Sheet Adult Abuse Stalking {FI-15}

Case Number (For Court Use Only) ___________________________ CONFIDENTIAL CASE FILING INFORMATION SHEET DOMESTIC RELATIONS CASES ­ ADULT ABUSE/STALKING Required at Case Initiation NOTICE TO LAW ENFORCEMENT: This is a confidential form and shall be used only to validate the electronic transfer of the case into the Missouri Uniform Law Enforcement System (MULES). DO NOT SERVE THIS FORM TO THE RESPONDENT. INSTRUCTIONS: Complete this form for all parties known at the time of filing. Provide the most appropriate Case Type and Party Type codes and descriptions. (Found on the Case Types List and Party Types List at www.courts.mo.gov on the Court Forms/Filing Information page.) If additional space is needed, complete additional Confidential Case Filing Information Sheets. NOTE: The full Social Security Number (SSN) is required pursuant to Court Operating Rule 4.07 if the party is a person and is reasonably available. This is a confidential document. This information is needed to open a case in the court's case management system. While cases deemed public under Missouri statutes can be accessed through Case.net, the day and month of birth, SSN, and confidential addresses are NOT provided to the public through Case.net. County/City of St. Louis: (i.e. Petitioner v. Respondent) Filing Date: Style of Case: Case Type Code: Case Type Description: Petitioner/Protected Person Information: Party Type Code: Name: (Last) Address: City: DOB: Height: Weight: State: Age: Hair Color: Zip: Gender: Male Race: Bar ID: Contact Telephone Number: Female SSN: Eye Color: Party Type Code: Party Type Description: (First) (Middle) Attorney Name (if represented by counsel): Respondent Information: Party Type Code: Name: (Last) Address: City: DOB: Height: Weight: State: Age: Hair Color: Zip: Gender: Male Race: Bar ID: Contact Telephone Number: Female SSN: Eye Color: Party Type Code: Party Type Description: (First) (Middle) Attorney Name (if represented by counsel): Employer Information Petitioner/Protected Person Employer Name: Employer Address: City: Respondent Employer Name: Employer Address: City: OSCA (05-13) FI-15 State: Zip: Contact Telephone Number: State: Zip: Contact Telephone Number: www.FormsWorkFlow.com Case Number (For Court Use Only) ___________________________ The following information regarding children is required. Complete this section for any child subject to the action of this case. *MACSS ­ Missouri Automated Child Support System Children: Name: Gender: Male Female SSN: SSN: Male Female DOB: DOB: DOB: DOB: DOB: Optional: MACSS Member Number (to be completed by the court): Name: Gender: Optional: MACSS Member Number (to be completed by the court): Name: Gender: Male Female SSN: SSN: Male Female Optional: MACSS Member Number (to be completed by the court): Name: Gender: Optional: MACSS Member Number (to be completed by the court): Name: Gender: Male Female SSN: Optional: MACSS Member Number (to be completed by the court): Check if more than five children and attach additional sheet Submitted by: Address (if not shown on previous page): City: Phone: Bar ID (required if attorney): State: Email Address: Zip: *IMPORTANT: It is the parties' responsibility to keep the court informed of any change of address or employment.* Instructions to Clerk This copy of this form shall be sent to law enforcement to validate the electronic transfer of the case into MULES. Maintain the closed portion(s) of the record in a sealed manila envelope within the file. The file can be maintained with other open records. If a request is made to review the open portion of the file, the envelope can be removed from the file. Access to the record must be restricted to avoid access to the closed portion of the record. OSCA (05-13) FI-15 www.FormsWorkflow.com