Judgment Data Sheet
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Judgment Data Sheet Form. This is a Arizona form and can be use in Maricopa Local County.
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Tags: Judgment Data Sheet, 406, Arizona Local County, Maricopa
Case No.
ATLAS No.
JUDGMENT DATA SHEET (FOR INTERNAL USE ONLY*)
ATTENTION: COURT DIVISION AND STAFF. DO NOT FILE THIS DOCUMENT. DO
NOT DISTRIBUTE THE COMPLETED JUDGMENT DATA SHEET TO THE PARTIES.
THIS FORM IS FOR CLERK OF COURT INTERNAL USE ONLY.
PERSON TO RECEIVE PAYMENTS:
PERSON TO MAKE PAYMENTS:
Name:
Name:
Gender: Male Female Date of Birth:
Gender: Male Female Date of Birth:
SSN:
SSN:
Mailing Address:
Mailing Address:
Daytime Phone:
Daytime Phone:
Evening Phone:
Evening Phone:
Other (cell, pager):
Other (cell, pager):
Email Address:
Email Address:
EMPLOYER INFORMATION FOR PERSON MAKING PAYMENTS: Firm Name:
Payroll Mailing Address:
Phone:
Email Address:
CHILDREN:
Name
Gender (M/F)
Date of Birth
Social Security No. (if available)
Additional children listed on attached sheet.
FOR COURT USE ONLY
Order Date:
Current Child Support
Amount
Frequency
Due Date
Arrearages
Amount
Frequency
Total
Thru Date
Due Date
Current Spousal Maint.
Amount
Frequency
Total
Due Date
Type of Order:
Arrearages
Amount
Frequency
Total
Thru Date
Due Date
Miscellaneous
Med Ins
Frequency
Med Bills
Frequency
Due Date
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Form #406 LRD 01/31/2003 ALL RIGHTS RESERVED
© Clerk of Superior Court of Arizona in Maricopa County
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