IRCP 3(a)(1) PAGE 1 OF 2 FAMILY LAW CASE INFORMATION SHEET CAO FL 1 - 1 2/2/2010 Family Law Case Information Sheet Case Number (Clerk fills in case #): Exempt from Public Disclosure Fill out this form to start a Family Law case. The information you give us is private . 1. Describe your case: Divorce Custody Paternity Guardianship Adoption Protective Order Other 2. Information about Petitioner N ame: First Middle Last Any other names used : Address: Street City State Zip Mailing Address: Phone numbers: Home Work Cell Social Security Number: Date of Birth: Sex: Male Female Is English your first language? Yes No If no, what language? Do you speak, read and write English? Yes No 3. Information about Respondent Name: First Middle Last Any other names used: Address: Street City State Zip Mailing Address: Phone numbers: Home Work Cell Social Security N umber: Date of Birth: Sex: Male Female Is English your first language? Yes No If no, what language? Do you speak, read and write English? Yes No American LegalNet, Inc. www.FormsWorkFlow.com IRCP 3(a)(1) PAGE 2 OF 2 FAMILY LAW CASE INFORMATION SHEET CAO FL 1 - 1 2/2/2010 4. Children under 18 in this case (List your children and the children of the person in .) Date of birth Social Security No. Whose child? 1. Mine Ours Other* 2. Mine Ours Other* 3. Mine Ours Other* 4. Mine Ours Other* * If Other, whose? (If there is more than one other parent, list name and specify relationship): Who do the children live with now? (name and relationship): 5. Other Cases Involving Children List any child support, custody, adoption, or guardianship order for any child listed on this form: Case Number Date of Order (or date requested) County / State For which children? Type of case 1. Support Custody Adoption Guardianship 2. Support Custody Adoption Guardianship 3. Support Custody Adoption Guardianship 4. Support Custody Adoption Guardianship 6. Other Cases Involving Violence or Abuse List any protective order, domestic violence or child abuse cases involving any adult or child listed on this form: Case Number Who was the Order against? Who did the Order protect? Date of Order (or date requested) County / State Type of case 1. Domestic Violence Child Abuse No Contact Order 2. Domestic Violence Child Abuse No Contact Order 3. Domestic Violence Child Abuse No Contact Order 4. Domestic Violence Child Abuse No Contact Order American LegalNet, Inc. www.FormsWorkFlow.com