SUMMIT COUNTY COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION Case No.:__________________________ Sets No.:__________________________ NEW CASE DESIGNATION FORM INSTRUCTIONS: Pursuant to the Summit County Court of Common Pleas-Domestic Relations Division order filed on March 1 , 2007, this form must be completed and submitted with any new cause of action filed with the Summit County Clerk of Courts. You must include an e-mail address for any court correspondence. Case Type: ___________________________________________________________________________________________________________________ (e.g., dissolution, dissolution with children, divorce, divorce with children, parentage, visitation rights, answer, or counterclaim) Plaintiff Information: First Middle Name:________________________________________________ Initial: _________ Last Name: ______________________________________________ Defendant Information: First Middle Name:________________________________________________ Initial: _________ Last Name: ______________________________________________ st Suffix__________ Suffix__________ Address: _____________________________________________________________ _____________________________________________________________ City :________________________ State_________ Zip ______________________ SSN: ________________________________ DOB: __________________________ E-Mail (REQUIRED)_____________________________________________________ Telephone:____________________________________________(if unrepresented) Address: _____________________________________________________________ _____________________________________________________________ City :________________________ State_________ Zip ______________________ SSN: ________________________________ DOB: __________________________ E-Mail (REQUIRED)_____________________________________________________ Telephone:____________________________________________(if unrepresented) Plaintiff Attorney Information: PRO SE Attorney Name: ______________________________________________________ Attorney E-Mail (REQUIRED) ___________________________________________ Ohio Sup Ct #: ________________________ Telephone: _____________________ Firm Name: __________________________________________________________ Address: ____________________________________________________________ ____________________________________________________________ City :________________________ State_________ Zip ______________________ Defendant Attorney Information (if known) Attorney Name: ______________________________________________________ Attorney E-Mail (REQUIRED) ___________________________________________ Ohio Sup Ct #: ________________________ Telephone: _____________________ Firm Name: __________________________________________________________ Address: ____________________________________________________________ ____________________________________________________________ City :________________________ State_________ Zip ______________________ Child Information: 1st Child Name: ___________________________________________________________ DOB: ________________________________________________________________ Address _________________________________________________________________ City _________________________ State _________ Zip ______________________ 2Nd Child Name: ___________________________________________________________ DOB: ________________________________________________________________ Address _________________________________________________________________ City _________________________ State _________ Zip ______________________ 3rd Child Name: ___________________________________________________________ DOB: ________________________________________________________________ Address _________________________________________________________________ City _________________________ State _________ Zip ______________________ Attorney for Plaintiff (or pro se litigant) American LegalNet, Inc. www.FormsWorkFlow.com