ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number and address) FOR COURT USE ONLY TELEPHONE NUMBER: ATTORNEY FOR (Name): FAX NO: LASSEN SUPERIOR COURT 2610 RIVERSIDE DRIVE SUSANVILLE, CA 96130 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: CASE NUMBER: FAMILY SUPPORT INFORMATION FORM ATTENTION FAMILY SUPPORT INFORMATION MUST BE FILED IN ALL FAMILY LAW CASES. 1. 2. 3. NAME OF FILING PARTY:__________________________________________ NAME OF FILING PARTY'S ATTORNEY:_____________________________ IS THERE A SUPPORT REQUEST (child support or family support) IN YOUR CASE? YES _________ NO __________ LASSEN SUPERIOR COURT FAMILY SUPPORT INFORMATION FORM LSC Form 4A Mandatory Form, as amended 1/1/2013 American LegalNet, Inc. www.FormsWorkFlow.com