400 - 00 854 Confidential Notificat ion for AbuseNeglectExploitation ( 0 9 /201 7 ) Page 1 of 1 STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION Unit Docket No. Plaintiff DOB Defendant DOB V. C ONFIDENTIAL NOTIFICATION FOR ABUSE/NEGLECT/EXPLOITATION Address for Notification I am the Plaintiff Interested Person Vermont Family Court Rules say that parties filing documents in Relief f rom Abuse /Neglect/Exploitation cases must give the C ourt an address and telephone number. The address and telephone number you give are for the C ourt to contact you about your case. Pl ease complete the information below: For the C ourt to contact me about my case, I can be reached at: Name: Address: City/State/Zip: Phone Number(s) : The address & phone number(s) y ou have given in this case cannot be given to any p erson without your permission. Do you consent to the release of this information? Yes No Important I nformation The R ule that requires the C ourt to keep your address and phone number (s) confi dential applies ONLY to Relief f rom Abuse /Neglect/Exploitation cases. If you have other cases in C ourt, and you want the C ou rt to keep your address and phone number (s) confidential in those cases, you must file a separate written request in each. Your request will be given to the judge. It is up to the judge to decide. Dated Signature American LegalNet, Inc. www.FormsWorkFlow.com