IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS ____________________, Plaintiff vs. Case No. _______________ ____________________, Defendant PROTECTION FROM ABUSE CONFIDENTIAL ADDRESS FORM (K.S.A. 60-3104(e)) NOTE: IF THE COURT FINDS THAT THE PLAINTIFF’S ADDRESS AND TELEPHONE NUMBER NEED TO REMAIN CONFIDENTIAL FOR THE PROTECTION OF THE PLAINTIFF OR THE MINOR CHILD(REN), THIS FORM WILL BE SHOWN ONLY TO AUTHORIZED COURT OR LAW ENFORCEMENT PERSONNEL AND WILL NOT BE DISCLOSED TO THE PUBLIC OR TO THE DEFENDANT. IT IS THE PLAINTIFF’S RESPONSIBILITY TO NOTIFY THE COURT OF ANY CHANGE IN ADDRESS OR TELEPHONE NUMBER. Name of Plaintiff: Confidential Address: Street City ________________________ State Zip Code Phone Number ________________________________ 05/27/09 American LegalNet, Inc. www.FormsWorkFlow.com