Information Sheet for Domestic Abuse Registry and Service of Protective Orders Case Name ___________________________________________ VS ________________________________________________ Case Number ___________________________________________ County ___________________________________________ Name of Protected Party: _______________________________________________________Phone# _____________________ Mailing Address of Protected Party: ___________________________________________________________________________ Protected Party SS#:______________________ Date of Birth ________________ Race ________________ Gender__________ Name of Additional Protected Party: __________________________________________________Phone# __________________ Mailing Address of Protected Party: ___________________________________________________________________________ Protected Party SS#:______________________ Date of Birth ________________ Race ________________ Gender__________ ADDITIONAL PARTIES - INFORMATION MAY BE ATTACHED BY 2ND PAGE ___________________________________________________________________________________________________________ TO: SHERIFF OF _____________________________ COUNTY Please serve the attached documents(s) on: ___________________________________________________________________ (Provide full name ­ First, Middle and Last) Alias: ___________________________________________________________________ Phone #________________________ Home Address: __________________________________________________________________________________________ (Street address and city/town) Place of Employment: _____________________________________________________________________________________ Work Address: ___________________________________________________________________________________________ Times generally at home: ______________________________ Times generally at work: ________________________________ Other addresses at which Defendant may be found (include suggested times if possible): ___________________________________________________________________________________________________________ Information regarding Defendant to assist in service: Male Female Adult Juvenile Race ____________________________________ Date of Birth __________________________________ Height ___________________________________ Weight _______________________________________ Eye Color ________________________________ Hair Color _____________________________________ Glasses (yes or no) _________________________ Facial Hair ____________________________________ Skin Color ________________________________ Social Security Number __________________________ Physical Markings (including scars and tattoos): ____________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Drivers License Number: _________________________________ State: ____________________________ Vehicle Description ____________________________________ License Plate Number: ___________________ Special Concerns as to service (include possibility of weapons, mental problem, etc): ______________________________ __________________________________________________________________________________________________ Please file return of service promptly with clerk. Name of person completing form: _____________________________________________ Date: _________________________ American LegalNet, Inc. www.FormsWorkFlow.com