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Confidential Information Form. This is a Arkansas form and can be use in Domestic Relations Statewide.
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Tags: Confidential Information, AOC 35, Arkansas Statewide, Domestic Relations
CONFIDENTIAL INFORMATION
FOR USE ONLY BY THOSE AUTHORIZED BY
Arkansas Code Annotated 9-14-205
Custodial Parent/Custodian: _________________________________________
(Street)
(City)
(St)
(Zip)
Mailing Addr:______________________________________________________
(Street or PO Box)
(City)
(St)
(Zip)
Phone Numbers: (Home) _______________(Cell)_________________________
Social Security Number: __________________DOB:______________________
Employer’s Name or Business: ________________________________________
Address: ________________________________City:______________________
State: ______________________ Zip Code:_______________________________
Residential Addr:___________________________________________________
(Street)
(City)
(St)
(Zip)
Mailing Addr:______________________________________________________
(Street or PO Box)
(City)
(St)
(Zip)
Phone Numbers: (Home) ________________ (Cell)________________________
Social Security Number: ___________________DOB:______________________
Driver’s License Number: (State)____________ (Number)__________________
Employer’s Name or Business: _________________________________________
Address: _______________________________City:________________________
State:_______________________ Zip Code:_______________________________
Children’s Names and Birth Dates:
Name:__________________________DOB:______________SSN:______________
Name:__________________________DOB:______________SSN:______________
Name:__________________________DOB:______________SSN:______________
Name:__________________________DOB:______________SSN:______________
Print or Type preparer’s name:_____________________________________________
Style of Case _____________________________________
Non-Custodial Parent: ______________________________________________
OCSE Case Number__________________
Driver’s License Number: (State)___________(Number)___________________
Docket Number___________________
Residential Addr:___________________________________________________
AOC Form 35
6/2005
This is confidential information and shall not be released to any person or entity except as authorized by law. The information is required to be submitted by the parties or their attorneys pursuant to ACA 9-14-205
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