Civil Information Sheet - Kansas Page 2
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1
2ADDITIONAL CIVIL PARTY INFORMATION
PLTF/SUB/DEF/OTHER PTY INFORMATION
PLTF/SUB/DEF/OTHER PTY INFORMATION
(CIRCLE ONE)
(CIRCLE ONE)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
PHONE:
SEX:
PHONE:
SEX:
SSN:
DOB:
SSN:
DOB:
DL OR STATE ID NO:__________________________
DL OR STATE ID NO:_ _________________________
State and Number
State and Number
ALIAS NAMES USED:__________________________
ALIAS NAMES USED:
__________________________________________
ATTORNEYS
ATTORNEYS
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
____________________________________________
PLTF/SUB/DEF/OTHER PTY INFORMATION
PLTF/SUB/DEF/OTHER PTY INFORMATION
(CIRCLE ONE)
(CIRCLE ONE)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
PHONE:
SEX:
PHONE:
SEX:
SSN:
DOB:
SSN:
DOB:
DL OR STATE ID NO:__________________________
DL OR STATE ID NO:_ _________________________
State and Number
State and Number
ALIAS NAMES USED:__________________________
ALIAS NAMES USED:
__________________________________________
ATTORNEYS
ATTORNEYS
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
____________________________________________
PLTF/SUB/DEF/OTHER PTY INFORMATION
PLTF/SUB/DEF/OTHER PTY INFORMATION
(CIRCLE ONE)
(CIRCLE ONE)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
PHONE:
SEX:
PHONE:
SEX:
SSN:
DOB:
SSN:
DOB:
DL OR STATE ID NO:__________________________
DL OR STATE ID NO:_ _________________________
State and Number
State and Number
ALIAS NAMES USED:__________________________
ALIAS NAMES USED:
__________________________________________
ATTORNEYS
ATTORNEYS
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
____________________________________________
FOR DOMESTIC CASES - NAME, DATE OF BIRTH AND SOCIAL SECURITY NUMBER OF EACH DEPENDENT CHILD:
(Name)
(Date of Birth)
(Social Security Number)
The requirement that Social Security numbers be included on domestic cases is mandatory, and authorized by the Supreme Court
and federal law. On non-domestic cases, the Social Security number is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
07-01-12
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