Local Rules of Court, Sandusky County Common Pleas Court Form F CSEA INFORMATION SHEET Case No. ___ DR ______ Sandusky County Common Pleas Court Plaintiff/petitioner Name Address City, State & ZIP Social Security No. Date of birth _______________________ _______________________ _______________________ ____-___ - ____ ___/___/___ Employment Name Address City, State & ZIP Pay Period _______________________ _______________________ _______________________ Monthly Semi-monthly Bi-weekly Weekly _______________________ _______________________ _______________________ Monthly Semi-monthly Bi-weekly Weekly Dated: ____________ Defendant/petitioner _______________________ _______________________ _______________________ ____-___- ____ ___/___/___ ================================================ Minor Children Name Present address City, State & ZIP Social Security No. Date of birth Name Present address City, State & ZIP Social Security No. Date of birth Name Present address City, State & ZIP Social Security No. Date of birth (1)_ ___________________ _______________________ _______________________ ____-___ - ____ ___/___/___ (2)_____________________ _______________________ _______________________ ____-___ - ____ ___/___/___ (3)_____________________ _______________________ _______________________ ____-___ - ____ ___/___/___ (4) ____________________ _______________________ _______________________ ____-___- ____ ___/___/___ (5) ____________________ _______________________ _______________________ ____-___- ____ ___/___/___ (6) ____________________ _______________________ _______________________ ____-___- ____ ___/___/___ Note: Complete this form and deliver it to Clerk of Courts when the first Support Order is filed. The Clerk will forward the form to the CSEA with the Support Order; it is not a public record, and will not be filed in the case. The parties must promptly inform the CSEA of any changes in the information contained in this form. Page 34 of 34 pages American LegalNet, Inc. www.USCourtForms.com