Confidential Information Form (Info)
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1
2Confidential Information Form (INFO)
County:
Cause Number:
Do not file in a
Court Clerk: This is a Restricted Access Document
public access file.
Divorce/Separation/Invalidity/Nonparental Custody/Paternity/Modifications
Sexual Assault
Other
Domestic Violence
Antiharassment
Information Change (Check if you are updating information)
A restraining order or protection order is in effect protecting
the petitioner
the respondent
the children.
The health, safety, or liberty of a party or child would be jeopardized by disclosure of address
information because:
The following information about the parties is required in all cases:
( Use the
Addendum To Confidential Information Form to list additional parties or children
)
Petitioner Information
Type or Print Only
Respondent Information
Name (Last, First, Middle)
Name (Last, First, Middle)
Race
Sex
Birthdate
Race
Sex
Birthdate
Driver’s Lic. or Identicard (# and State)
Driver’s Lic. or Identicard (# and State), (or, if
unavailable, residential address)
Mailing Address (P.O. Box/Street, City, State, Zip)
Mailing Address (P.O. Box/Street, City, State, Zip)
Relationship to Child(ren)
Relationship to Child(ren)
The following information is required if there are children involved in the proceeding.
(Soc. Sec.
No. is not required for petitions in protection order cases (Domestic Violence/Antiharassment/Sexual Assault).)
1) Child's Name (Last, First, Middle)
Child's Race/Sex/Birthdate
Child's Soc. Sec. No. (If required)
Child's Present Address or Whereabouts
WPF DRPSCU 09.0200 Confidential Information Form (INFO) (07/2011) RCW 26.23.050- Page 1 of 2
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