Disclosure Statement For Changing Court Orders About Children

When you file this with this court, do not file any of the enclosures or attachments. Those just go to the other party. Person Filing: Mailing Address: City, State, Zip: Phone Number: Representing Self COCONINO COUNTY SUPERIOR COURT Petitioner's Name on the Petition for divorce, legal separation, or parenting time: Case Number: DO DISCLOSURE STATEMENT Respondent's Name: For Changing Court Orders About Children WITNESSES: If a witness isn't listed here, they won't be allowed at the court date. I plan to bring these witnesses to the court date: I reserve my right to call myself and witnesses from the other party's witness list as witnesses. Phone Number: Witness Name: Address: This witness's testimony will be [ ] only in a deposition or [ ] in person in court. Detailed summary of what they'll say in court: Page 1 of 4 Revised September 2016 © 2016 Coconino County Law Library American LegalNet, Inc. www.FormsWorkFlow.com Phone Number: Witness Name: Address: This witness's testimony will be [ ] only in a deposition or [ ] in person in court. Detailed summary of what they'll say in court: Phone Number: Expert Witness Name: Address: What makes them an expert: This witness's testimony will be [ ] only in a deposition or [ ] in person in court. Detailed summary of what they'll say in court: Have they prepared a report about what they'll say? [ ] Yes [ ] No Name of person who has the report: Address of person who has the report: Phone Number: Expert Witness Name: Address: What makes them an expert: This witness's testimony will be [ ] only in a deposition or [ ] in person in court. Detailed summary of what they'll say in court: Have they prepared a report about what they'll say? [ ] Yes [ ] No Name of person who has the report: Address of person who has the report: Page 2 of 4 Revised September 2016 © 2016 Coconino County Law Library American LegalNet, Inc. www.FormsWorkFlow.com EXHIBITS: I plan to bring these exhibits to the court date: My most current Affidavit of Financial Information and Parent's Worksheet for Child Support Amount. Description of each additional exhibit: Page 3 of 4 Revised September 2016 © 2016 Coconino County Law Library American LegalNet, Inc. www.FormsWorkFlow.com Sending To the Other Party: I'm sending the other party a copy of each exhibit listed above along with this Disclosure Statement. I'm also sending the other party all of the items listed in the box below for my case type. For Changing Legal-Decision Making, Parenting Time, and/or the Children's Residence For Changing Child Support Only A copy of any past or current protective order, and the petition that asked for it, involving me or the other party or one of our household members. For any treatment I or the other party received for psychiatric or psychological issues, anger management, substance abuse, or domestic violence in the five years before the Petition was filed: the name and address of each treatment provider and the time period of the treatment. The date, description, location, and documentation of any criminal charge against or conviction of me, the other party, or one of our household members in the ten years before the Petition was filed. The date, description, location, and documentation of any Child Protective Services investigation or proceeding involving me or the other party or one of our household members in the ten years before the Petition was filed. A copy of my most recently filed federal and state income tax returns, with all schedules. A copy of my four most recent consecutive wage statements from all employment. A copy of my most recent federal tax W-2, 1099, and K-1 forms. A statement from my employer of the cost of medical and dental insurance coverage for our children. A copy of my most recently filed federal and state income tax returns, with all schedules. A copy of my four most recent consecutive wage statements from all employment. A copy of my most recent federal tax W-2, 1099, and K-1 forms. A statement from my employer of the cost of medical and dental insurance coverage for our children. My Signature: Page 4 of 4 Revised September 2016 © 2016 Coconino County Law Library American LegalNet, Inc. www.FormsWorkFlow.com