Fillable SUPPLEMENTAL INFORMATION SHEET RE: COMPLAINT TO ESTABLISH PARENTAGE (Vermont Judiciary)

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SUPPLEMENTAL INFORMATION SHEET RE: COMPLAINT TO ESTABLISH PARENTAGE (Vermont Judiciary)

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400-00817A – Supp. Info re: Complaint & Summons – Parentage (11/2018) Page 1 of 1
STATE OF VERMONT
SUPERIOR COURT
FAMILY DIVISION
Unit
Docket No.
Plaintiff Name
Defendant Name
v.
SUPPLEMENTAL INFORMATION SHEET
RE: COMPLAINT TO ESTABLISH PARENTAGE
Other possible parent, if any (notice will be sent):
Name: ________________________________________________ Date of Birth: ____________________________
Street Address: _________________________________________ City/State/Zip: ___________________________
Mailing
Address (if different from Street Address): _______________________________________________________________
City/State/Zip: __________________________________________ Email Address: __________________________
Daytime Phone: _________________________________________ Evening Phone: _________________________
Attorney Name: ________________________________________ Attorney Phone: _________________________
The nature of the relationship between ________________________ and ________________________ is
(Name of Other Possible Parent) (Name of Child(ren)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Other possible parent, if any (notice will be sent):
Name: ________________________________________________ Date of Birth: ____________________________
Street Address: _________________________________________ City/State/Zip: ___________________________
Mailing
Address (if different from Street Address): _______________________________________________________________
City/State/Zip: __________________________________________ Email Address: __________________________
Daytime Phone: _________________________________________ Evening Phone: _________________________
Attorney Name: ________________________________________ Attorney Phone: _________________________
The nature of the relationship between ________________________ and ________________________ is
(Name of Other Possible Parent) (Name of Child(ren)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
☐ This Supplemental Information Sheet (form 400-00817A) is associated with the Complaint and Summons –
Parentage ( form 400-00817) filed for the above-named Plaintiff and Defendant.
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SUPPLEMENTAL INFORMATION SHEET RE: COMPLAINT TO ESTABLISH PARENTAGE (Vermont Judiciary)

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Completed 30 July 2020

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