Confidential Information Sheet (Page 2 of 3) in pdf

Confidential Information Sheet Page 2

Number of this marriage: for you:

for opposing party:

Are you and opposing party living together now? □ Yes □ No Date of separation:

If you have been married before, list the names of prior spouse(s), how the prior marriage(s)

ended, the date it ended, and if there are other children not of this marriage:

If the opposing party has been married before, list the names of prior spouse(s), how the prior

marriage(s) ended, the date it ended, and if there are other children not of this marriage:

Information about your children

Name

Date of Birth

Living With

Social Security

Number

List each address where your children have resided over the previous 5 years:

Do any of your children have exceptional health of dental needs? □ Yes □ No

If so, please explain:

Do any of your children have exceptional or special education needs? □ Yes □ No

If so, please explain:

Have you or your spouse participated in any capacity in any litigation concerning any of your

children? □ Yes □ No If so, please explain:

Information about your employment

Are you employed? □ Yes □ No

Name of Employer:

Job Title:

Address of Employer:

Salary or Hourly rate:

Employed since:

If unemployed, last job:

Gross annual wages (as reported on your most recent tax return):

Please check the highest level of education/training for you:

□ Grade school

□ High School

□ GED

□ Vocational

□ College

□ Post Graduate

Confidential Information Sheet Page 2