Form Sc-1 - Domestic Relations Case Filing Information Form Page 2

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Domestic Relations Case Filing Information Form
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Superior Court
County _____________________
Date Filed _____________
MM-DD-YYYY
Docket # ____________________
Plaintiff(s)
Defendant(s)
__________________________________
__________________________________
Last
First
Middle I. Suffix Prefix
Maiden
Last
First
Middle I. Suffix Prefix
Maiden
__________________________________
__________________________________
Last
First
Middle I. Suffix Prefix
Maiden
Last
First
Middle I. Suffix Prefix
Maiden
Plaintiff/Petitioner's Attorney
Pro Se
__________________________________
Bar # _________________
Last
First
Middle I.
Suffix
Check Case Type (one or more)
FAMILY VIOLENCE
 Divorce (includes annulment)
Additional Information - Ex Parte Relief
Contested?
 Yes  No
Child Custody Issue?
 Yes  No
Did the initial pleading include a request for relief?
Child Support Issue?
 Yes  No
1. From alleged family violence?
 Yes  No
 Separate Maintenance
2. Was ex parte relief requested?
 Yes  No
 Adoption
 Yes  No
3. Was ex parte relief granted?
 Paternity (includes legitimation)
 Interstate Support Enforcement Action
 Domestication of Foreign Custody Decree
OTHER
 Family Violence Act Petition
Have the parties agreed to binding arbitration?  Yes  No
MODIFICATION
Have the parties reached a custodial agreement?  Yes  No
 Modification - Custody, Visitation, or Parenting Time
If yes, check one:
Does the modification include a parent selection
 Joint Custody
by a child who is at least 14 years old?  Yes  No
 Joint Legal Custody
 Modification - Child Support and Alimony
 Joint Physical Custody
 Modification - Child Support
 Sole Custody to: ______________________
 Modification - Alimony
 Yes  No
Financial Affidavit submitted?
CONTEMPT
 Yes  No
Child Support Forms submitted?
 Contempt - Custody, Visitation, or Parenting Time
 Contempt - Child Support and Alimony
 Contempt - Child Support
 Contempt - Alimony
 Other Domestic Contempt
 Other Domestic Relations Specify_______________________
___________________________________________________
___________________________________________________

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