Fillable CONFIDENTIAL CASE FILING INFORMATION SHEET - DOMESTIC RELATIONS (16th Circuit Court of Jackson County, Missouri)

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CONFIDENTIAL CASE FILING INFORMATION SHEET - DOMESTIC RELATIONS (16th Circuit Court of Jackson County, Missouri)

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Case Number (For Court Use Only)
CONFIDENTIAL CASE FILING INFORMATION SHEET - DOMESTIC RELATIONS CASES
Required at Case Initiation and with Responsive Filings
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 Section 509.520 RSMo if the party is a
person.
√
√
Filing Date: County/City of St. Louis:
Style of Case:
(i.e. Petitioner v. Respondent)
Case Type Code:
Case Type Description:
Petitioner/Plaintiff Information:
Party Type Code: Party Type Description:
Name: (Last) (Middle)(First)
Address:
City: State: Zip: Contact Telephone Number:
DOB: Gender:
Male Female
SSN:
Attorney Name (if represented by counsel): Bar ID: Party Type Code:
Respondent/Defendent Information:
Party Type Description:Party Type Code:
Name: (Last) (First) (Middle)
Address:
Contact Telephone Number:Zip:State:City:
DOB: Gender:
Male Female
SSN:
Party Type Code:
Bar ID:Attorney Name (if represented by counsel):
Party Type Code: Party Type Description:
(Middle)(First)Name: (Last)
Address:
Contact Telephone Number:Zip:State:City:
DOB: Gender:
Male Female
SSN:
Party Type Code:
Bar ID:Attorney Name (if represented by counsel):
Party Type Code: Party Type Description:
(Middle)(First)Name: (Last)
Address:
Contact Telephone Number:Zip:State:City:
DOB: Gender:
Male Female
SSN:
Party Type Code:
Bar ID:Attorney Name (if represented by counsel):
OSCA (10-10) FI-10
Case Number (For Court Use Only)
Employer Information
Petitioner/Plaintiff Employer Name:
Employer Address:
City: State: Zip: Contact Telephone Number:
Respondent/Defendant Employer Name:
Employer Address:
Contact Telephone Number:Zip:State:City:
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: SSN: DOB:
Gender:
Male Female
Optional: MACSS Member Number (to be completed by the court):
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Name: SSN: DOB:
Optional: MACSS Member Number (to be completed by the court):
Female Male
Gender:
Check if more than ten children and attach additional sheet
Submitted by:
Bar ID (required if attorney):
Address (if not shown on previous
page):
City: State: Zip:
Phone: Email Address:
*IMPORTANT: It is the parties' responsibility to keep the court informed of any change of address or employment.*
Instructions to Clerk
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 (10-10) FI-10
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CONFIDENTIAL CASE FILING INFORMATION SHEET - DOMESTIC RELATIONS (16th Circuit Court of Jackson County, Missouri)

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Completed 11 June 2021

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