Form A-13 Confidential Stalking and Harassment Protection Order Information (Adverse Party) 2512007 Nevada Supreme Court June 30, 2007 *CONFIDENTIAL* STALKING AND HARASSMENT PROTECTION ORDER INFORMATION (TO BE FILLED OUT BY ADVERSE PARTY) Instructions: Please provide all information and print legibly. The court requests this information in order to notify you about upcoming hearings or activity in your case. ADVERSE PARTY DATA Full Name: Other Name Used: (Last) (First) (Middle) (Last) (First) (Middle) Date of Birth: // and/or Social Security No.: (M) (D) (Y) Home Address: (Street Address) (Building/Apartment #) (City) (State) (Zip Code) Mailing Address: (If different from above) (Street Address) (Building/Apartment #) (City) (State) (Zip Code) Home Phone: Cell Phone: Occupation: Employer: Work Address: (Street Address) (City) (State) (Zip Code) Work Days: Work Hours: Work Phone: Additional Contact Person:Phone:Address: Does the Adverse Party speak English? If not, what language? (Yes or No) (Circle one) Are the Adverse Party and the Applicant living together now? Yes or No Are the Adverse Party and the Applicant employed by the same employer? Yes or No Do not write in this space. For court purposes only. Issuing Court ORI: NV Court Case Number: *CONFIDENTIAL* American LegalNet, Inc. www.FormsWorkFlow.com