Domestic Relations Case Filing Information Form
Superior Court County _____________________ Date Filed _____________
MM-DD-YYYY
Docket # ____________________
Plaintiff(s) Defendant(s)
__________________________________ __________________________________
Last First Middle I. Suffix Prefix Maiden Last First Middle I. Suffix Prefix Maiden
__________________________________ __________________________________
Last First Middle I. Suffix Prefix Maiden Last First Middle I. Suffix Prefix Maiden
Plaintiff/Petitioner's Attorney
Pro Se
__________________________________
Bar # _________________
Last First Middle I. Suffix
Check Case Type (one or more)
Divorce (includes annulment)
Contested? Yes No
Child Custody Issue? Yes No
Child Support Issue? Yes No
Separate Maintenance
Adoption
Paternity (includes legitimation)
Interstate Support Enforcement Action
Domestication of Foreign Custody Decree
Family Violence Act Petition
MODIFICATION
Modification - Custody, Visitation, or Parenting Time
Does the modification include a parent selection
by a child who is at least 14 years old? Yes No
Modification - Child Support and Alimony
Modification - Child Support
Modification - Alimony
CONTEMPT
Contempt - Custody, Visitation, or Parenting Time
Contempt - Child Support and Alimony
Contempt - Child Support
Contempt - Alimony
Other Domestic Contempt
Other Domestic Relations Specify_______________________
___________________________________________________
___________________________________________________
FAMILY VIOLENCE
Additional Information - Ex Parte Relief
Did the initial pleading include a request for relief?
1. From alleged family violence?
Yes No
2. Was ex parte relief requested? Yes No
3. Was ex parte relief granted? Yes No
OTHER
Have the parties agreed to binding arbitration? Yes No
Have the parties reached a custodial agreement? Yes No
If yes, check one:
Joint Custody
Joint Legal Custody
Joint Physical Custody
Sole Custody to: ______________________
Financial Affidavit submitted?
Yes No
Child Support Forms submitted? Yes No
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