FAMILY MATTER SUMMARY SHEET: M.R. Civ. P. 5(h) This form is used for entering basic information about the case and the parties into court records. You must complete and file this form with the Clerk when you file your Complaint or Motion. You are not required to give a copy of this form to the other party. COURT LOCATION (where you are filing this action): TYPE OF ACTION: (Check one box) Divorce - Real Estate involved Parental Rights & Responsibilities (Unmarried parents of child) Judicial Separation Probate Matter Divorce - No Real Estate Parentage (Determine parents of the child(ren)) Other Family Matter Foreign Judgment TYPE OF FILING: (Check one box) Original Proceeding Probate Matter, Original Docket # is: Post-Judgment Motion: to Modify to Enforce for Contempt Original Docket # is: Plaintiff Information: (Person starting the action or if post-judgment, name of person who was the plaintiff in the original case.) Name: First Middle Last Maiden Mailing Address: City State Zip Physical Address: City State Zip Gender: Home Telephone: Attorney's Name: Date of Birth: SS Number Disclosure Required on separate form Work Telephone: Bar ID#: Defendant Information: (Person being served or if post-judgment, name of person who was the defendant in the original case.) Name: First Middle Last Maiden Mailing Address: City State Zip Physical Address: City State Zip Gender: Home Telephone: Attorney's Name: Date of Birth: SS Number Disclosure Required on separate form Work Telephone: Bar ID#: Date of Birth: Gender: SS Number Disclosure Required SS Number Disclosure Required SS Number Disclosure Required SS Number Disclosure Required SS Number Disclosure Required Minor Children (of above parties) full name: FM-002, Rev. 06/16 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Parentage Issues (if any): The child(ren) do not have any other acknowledged, adjudicated, intended, de facto, or presumed parents. OR The child(ren) have an acknowledged, adjudicated, intended, de facto, or presumed parent. (You must complete a separate summary sheet for every additional parent that your child has, and all parents must be served with a copy of the Complaint and made a party to your action.) Date: Signature of Party or Party's Attorney FM-002, Rev. 06/16 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com