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Rule 17.300--Form 303: Confidential Information Form This form is to be used by paper filers only. Each party must complete one of these forms if filing in paper. Iowa Code section 602.6111 requires the parties to a case to provide the clerk of court with certain personal identification information. Each party's completed form will be kept confidential by the clerk of court. If you do not understand how to use this form, or if you should use this form, talk to an attorney. In the Iowa District Court for County where Application is filed County Upon the Petition of Petitioner Full name of Petitioner as it is in the Application Equity case no. Confidential Information Form and concerning Respondent Full name of Respondent as it is in the Application 1. Applicant's Information / Full name: First, Middle, Last Birth date / - - Social Security number 2. Other Party's Information / Full name: First, Middle, Last Birth date / - - Social Security number 3. Children's Information A. Child 1: / Full name: First, Middle, Last Birth date / - - Social Security number B. Child 2: / Full name: First, Middle, Last Birth date / - - Social Security number C. Child 3: / Full name: First, Middle, Last Birth date / - - Social Security number D. Child 4: / Full name: First, Middle, Last Birth date / - - Social Security number Continued on next page February 2014 Rule 17.300--Form 303 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 303 Confidential Information Form, continued E. Child 5: / Full name: First, Middle, Last Birth date / - - Social Security number Check this box if you have attached a separate sheet listing additional children. 4. Signature of Provider of Information The party or parties submit this information in compliance with the court's Order and with the knowledge the information will be used to enforce any support order under the Code of Iowa, chapters 234, 252A, 252C, 252F, 252H, 252K, or 600B, as provided for in section 598. If a party's address or employment changes, the party must promptly file an update of this information with the clerk of court or the Child Support Recovery Unit. Information provided by: Print your full name: first, middle, last , 20 Your signature Month Day Year Important Notice Do not give copies of this form to anyone except the clerk of court. February 2014 Rule 17.300--Form 303 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com