Domestic Case Designation Form

DENISE M. KAMINSKI Geauga County Clerk of Courts Legal Office 100 Short Court Ste. 300 Chardon, Ohio 44024 Title Office 470 Center St. Bldg. 8 Chardon, Ohio 44024 COMMON PLEAS COURT DOMESTIC CASE DESIGNATION FORM TO BE USED BY COUNSEL TO INDICATE THE CATEGORY OF THE CAUSE NO.___________________________ -VSJUDGE: ____________________________ Has this case been previously filed and dismissed? Check One: Yes ( ) If yes, list case number, Judge and/or Magistrate. ______________________________________________________________________________________ Pending or Closed Related Case(s) list case number and judge. ( ) DIVORCE WITH CHILDREN ( ) DIVORCE WITHOUT CHILDREN ( ) DISSOLUTION WITH CHILDREN ( ) DISSOLUTION WITHOUT CHILDREN ( ) LEGAL SEPARATION ** Please note all domestic cases require: name, address, date of birth, and number of marriages.** **Please note all domestic cases with children require a child custody affidavit.** **Please note all domestic cases require a Family Law Sensitive Information Sheet.** I certify that to the best of my knowledge the within case is not related to any now pending or previously filed, except as noted above. _________________________________________ Firm Name ____________________________________ Attorney of Record (Print or Type) _________________________________________ Address ____________________________________ Signature (440) 285-2222 834-1856 564-7131 Legal Office Ext. 2380 Fax: (440) 286-2127 Title Office Ext. 6417 Fax: (440) 286-1429 Email: dkaminski@co.geauga.oh.us American LegalNet, Inc. www.FormsWorkFlow.com