In The Court of Common Pleas Tuscarawas County, Ohio General Trial Division Domestic Relations Case Designation Form __________________________________________ Address: ___________________________________ __________________________________________ Plaintiff/Petitioner vs. __________________________________________ Address: ___________________________________ __________________________________________ Defendant(s)/Petitioner/Respondent : : : : : : : : : : : : Case Number: _________________________ Judge: ________________________________ Has this case been previously filed and dismissed? Check one: Yes No If yes, list case number and judge: ______________________________________________ List all open or closed case(s), involving your children, including case number and judge: (for example, a Juvenile Court case regarding custody and/or support) _________________________________________ ____________________________________________________________________________________ Please indicate which category: A. B. C. D. E. F. Termination of Marriage w/children (Divorce) Termination of Marriage w/o children (Divorce) Dissolution of Marriage w/children Dissolution of Marriage w/o children Change of Custody Visitation/Parenting Time Enforcement or Modification Check one: Attorney: ________________________________________ Attorney of Record G. H. I. J. Support Enforcement/ Modification Domestic Violence U.I.F.S.A. Parentage K. Other (i.e., Post Decree Property/ QDRO Issues) Yes No Mediation: Is this case appropriate for mediation? Non-attorney/pro se litigant: ____________________________________ Party Name (if not represented by an attorney) ____________________________________ Signature ________________________________________ Signature ____________________________________ Address ________________________________________ Attorney Registration Number ____________________________________ Address (continued) ________________________________________ Firm Name ________________________________________ ____________________________________ Home Telephone Firm Address ____________________________________ Cell Phone ________________________________________ ________________________________________ Firm Phone Number ____________________________________ Email Address ________________________________________ Attorney Email Address American LegalNet, Inc. www.FormsWorkFlow.com Rev. 3/22/2016 for web Exhibit C