Family Court Party Information Sheet

IN THE 11TH JUDICIAL CIRCUIT COURT, STATE OF MISSOURI FAMILY COURT DIVISION (Please Print Neatly or Type) In Re the Matter of: Petitioner(s) Respondent(s) MANDATORY TWO-LETTER CASE TYPE CODE_____ (From back of this sheet) Case Number ___________________________ e-FILING/FAMILY COURT PARTY INFORMATION SHEET PETITIONER #1 Name (First, M.I., Last) Residential Address RESPONDENT #1 Mailing Address (leave blank if same as residential) Full Social Sec. No. Date of Birth Home Phone No. Counsel's Name and Bar ID List all minor children of Petitioner and Respondent: Name (First, Middle, Last) DOB Social Security No. Petitioner's Respondent's Children Children RELATED CASE(S) PENDING? Yes IS THIS CASE CONTESTED? Yes No No If yes, Case Number(s), if known: If yes, which issues appear to be contested? Child Custody Visitation Child Support Use and possession of family home and property Marital property issues involving: Valuation of business; Pensions, Bank accounts/IRA's; Real Property Paternity Other: I state that the parties to this action have been known by the following other names: CERTIFICATION: I hereby certify that the aforementioned information is true and correct to the best of my knowledge. Date:____________________ Filing Party: ________________________________________ 5093520 RSMo requires that a filing information sheet shall be completed and attached to all initial and responsive pleadings filed in the Family Court Division. LOCAL RULE 68.5 Filing Requirement ­ Family Court Proceedings (Attach additional pages for additional parties, if necessary) American LegalNet, Inc. www.FormsWorkFlow.com EMPLOYER INFORMATION Petitioner Employer Name: ________________________________________________________________________________ Employer Address: ______________________________________________________________________________________ City: ____________________________________________________ State: _____ Zip: _____________________________ Respondent Employer Name: ______________________________________________________________________________ Employer Address: ______________________________________________________________________________________ City: ____________________________________________________ State: _____ Zip: _____________________________ Submitted by: ____________________________________ Bar ID (required if attorney) ___________________________ Address: _______________________________________________________________________________________________ City: ____________________________________________________ State: _____ Zip: _____________________________ Phone: ____________________________________________________ Fax: _______________________________________ E-Mail: ________________________________________________________________________________________________ FAMILY COURT CODES QA QB QC QD QE QF QG QH QI QJ FAMILY COURT CODES CONTINUED Q1 IV-D Administrative Order with hearing Q2 IV-D Contempt Q3 IV-D Misc. Domestic Relations Q4 IV-D Motion to Modify Q5 IV-D Paternity Q6 IV-D UIFSA ­ Initiating Q7 IV-D UIFSA ­ Responding Q8 IV-D URESA ­ Initiating Q9 IV-D URESA ­ Responding Adult Abuse Not Stalking Adult Abuse Stalking Adult Abuse Extension/Modification Change of Name Child Protection Act Child Protection/Extension/Modification Contempt Dissolution of Marriage w/o Children Dissolution of Marriage with Children Habeas Corpus JUVENILE JA JB JC JD JE JF JG JH FC Status Offense FC FC FC FC Delinquency Abuse and Neglect Adoption ­ Regular Termination of Parental Rights QK QL QM QN QO QP QQ QR QS QT QU Legal Separation/Annulment/Separate Maintenance Modify Registration of Foreign Judgment Motion to Modify Paternity Registration of Foreign JudgmentCustody Registration of Foreign JudgmentDissolution Registration of Foreign Order of Protection Miscellaneous Domestic Relations Family Access Motion Set Aside Paternity Judgment Modification of Paternity FC Adoption Step-Child FC Adoption ­ Adult FC Permanency Planning Motion Updated February 2012 American LegalNet, Inc. www.FormsWorkFlow.com