New Hampshire Court Personal Data Sheet
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1Clear Form
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
Court Name:
Case Name:
Case Number:
(if known)
PERSONAL DATA SHEET
1. Name of person(s) completing this form
(Check if applicable) Because I believe that my safety, or the safety of my children is at risk, I request
that the information contained in this Personal Data Sheet not be disclosed to the other party. The
reasons are:
2. Type of case filed today:
Petition for Divorce
Petition for Legal Separation
Joint Petition for Legal Separation
Joint Petition for Divorce
Domestic Violence Petition
Petition for Civil Union Dissolution
Parenting Petition
Joint Petition for Civil Union Dissolution
Paternity/Legitimation
Petition to Change Court Order/Modification
Other:
3. Name of Petitioner
Date of Birth
State of Birth
Social Security Number
Residence Address
Mailing Address (if different)
Phone number (home)
(work)
E-mail Address
Employer’s Name and Address
4. Name of Respondent
Date of Birth
State of Birth
Social Security Number
Residence Address
Mailing Address (if different)
Phone number (home)
(work)
E-mail Address
Employer’s Name and Address
5. Child(ren)’s Full Name(s)
Date of Birth
Social Security #
State of Birth
Date
Signature
Date
Signature (if joint petition)
NHJB-2077-FS (12/27/2007)
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