CONFIDENTIAL FC-75 (revised April 2017) STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS FAMILY COURT COVER SHEET Pursuant to the Family Court222s Electronic Filing System Guidelines, a Cover Sheet shall be filed with any case initiating document. The information is being requested for the purpose of ensuring accurate internal record keeping. The filing party shall fill in the filing party222s information in the Plaintiff or the Defendant box as appropriate, the attorney information for the filing party, if applicable, and the party information for the opposing party in the Plaintiff or the Defendant box as appropriate, to the best of the filing party222s knowledge. PARTY INFORMATION FOR THE PLAINTIFF Party represented by an attorney Self-represented litigant NAME ADDRESS TELEPHONE DATE OF BIRTH EMAIL ADDRESS ATTORNEY INFORMATION FOR THE FILING PARTY NAME ADDRESS TELEPHONE BAR NUMBER EMAIL ADDRESS PARTY INFORMATION FOR THE DEFENDANT NAME ADDRESS TELEPHONE DATE OF BIRTH EMAIL ADDRESS This Cover Sheet contains information to the best of my knowledge. /s/ Attorney for the Plaintiff Defendant or the Plaintiff Defendant Date American LegalNet, Inc. www.FormsWorkFlow.com