SUPERIOR COURT OF COCONINO COUNTY, ARIZONA DOMESTIC RELATIONS COVER SHEET - CASE NUMBER DO Please print or type the following information TYPE OF ACTION: (Check One) [ ] Dissolution: [ ] With Children / [ ] Without Children [ ] Separation: [ ] With Children / [ ] Without Children [ ] Move a Case to This Court From Another State PETITIONER Name Mailing Address City, State, Zip Phone Number Email Gross Monthly Income: Date of Birth [ ] Male [ ] Female [ ] White [ ] Hispanic [ ] Black [ ] Native American [ ] Native Hawaiian/Pacific Islander [ ] Asian [ ] Other PETITIONER'S ATTORNEY Name Mailing Address City, State, Zip Phone Number MINOR CHILDREN Name Name Name Name DOB DOB DOB DOB [ ] Annulment [ ] Paternity/Maternity [ ] Custody (Unmarried Parents) [ ] Order of Protection RESPONDENT Name Mailing Address City, State, Zip Phone Number Email Gross Monthly Income: Date of Birth [ ] Male [ ] Female [ ] White [ ] Hispanic [ ] Black [ ] Native American [ ] Native Hawaiian/Pacific Islander [ ] Asian [ ] Other RESPONDENT'S ATTORNEY Name Mailing Address City, State, Zip Phone Number Names and DOB of any OTHER minor children of the petitioner and/or respondent, who are not involved in this case. Are any of the children named above parties in a [ ] Juvenile Delinquency, [ ] Dependency or [ ] Guardianship? Have there been any other cases (excluding minor traffic offenses) in any court involving members of this family? If so, provide the case number. Please ask the Clerk to look up the case number for you if you do not know it. Has anyone listed on this cover sheet been named in a Order of Protection or Injunction Against Harassment? If yes, please identify. What Court granted the Protection Order? Where did you get the forms you are filing today? [ ] Self -Help Center [ ] Online [ ] Attorney [ ] Bookstore [ ] Other: FLAP Attorney Initials Revised October 2012 Coconino County Clerk of Superior Court American LegalNet, Inc. www.FormsWorkFlow.com