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Information for any of your children who were not born to a relationship listed on page 9:

CHILD’S NAME

BIRTHDATE

VISITATION/ CUSTODY ARRANGEMENT

___________________________________________________________________________________________________________

Please provide the name, address and telephone number of the other parent for any child listed

immediately above.

NAME

ADDRESS

TELEPHONE NUMBER

___________________________________________________________________________________________________________

If you are in a current relationship, please provide that person’s name, telephone number and address.

__________________________________________________________________________________________

INFORMATION ABOUT ALL CHILDREN IN YOUR HOUSEHOLD

(whether living primarily with you or visiting you, including step-children or unrelated children)

NAME

NAME AND ADDRESS AND PHONE NUMBER OF SCHOOL

GRADE

1. __________________________________________________________________________________________________________

2. __________________________________________________________________________________________________________

3. __________________________________________________________________________________________________________

4. __________________________________________________________________________________________________________

CHILD CARE

List name, address and phone number of all people or agencies providing childcare over the last 5 years

(including relatives), beginning with the present childcare provider.

1. NAME_____________________________________________START DATE: _________________________________________

ADDRESS AND PHONE NUMBER_____________________________________________________________________________

2. NAME_____________________________________________START DATE: ____________ END DATE: ________________

ADDRESS AND PHONE NUMBER____________________________________________________________________________

3. NAME_____________________________________________START DATE: ____________ END DATE: ________________

ADDRESS AND PHONE NUMBER ____________________________________________________________________________

4. NAME_____________________________________________START DATE: ____________ END DATE: ________________

ADDRESS AND PHONE NUMBER

____________________________________________________________________________

Personal Data Form And Social Study Information Sheet - Tarrant County Family Court Services Page 11