Case Data Information Sheet - Kentucky Court Of Justice
Download a blank fillable Case Data Information Sheet - Kentucky Court Of Justice in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Case Data Information Sheet - Kentucky Court Of Justice with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1AOC-FC-3
For Office Use Only
Rev. 11-11
Commonwealth of Kentucky
Court of Justice
Case #: ______________________
[ ] Minor Children Involved
[ ] C
[ ] D
irCuit
istriCt
[ ] Protective Order Issued For:
County: ______________________
[ ] F
C
amily
ourt
[ ] Petitioner
Division: _______
C
D
i
s
[ ] Respondent
ase
ata
nFormation
heet
PETITIONER:
RESPONDENT:
Name: _______________________________________
Name: _______________________________________
Address: _____________________________________
Address: _____________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Telephone: ( ______ ) ___________________________
Telephone: ( ______ ) ___________________________
DOB: ________________________________________
DOB: ________________________________________
SSN: ________________________________________
SSN: ________________________________________
Relationship to Respondent: ______________________
Relationship to Petitioner: ________________________
For ALL OTHER PARTIES to this case: please list below the name, current address, date of birth (DOB), social security
number (SSN), and relationship to the Petitioner, of any other parties to this action, or children of the Petitioner or Respon-
dent. If there is not enough room below, please attach a separate sheet with all the information requested.
OTHER PARTIES / CHILDREN:
Name: _______________________________________
Name: _______________________________________
Address: _____________________________________
Address: _____________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Telephone: ( ______ ) ___________________________
Telephone: ( ______ ) ___________________________
DOB: ________________________________________
DOB: ________________________________________
SSN: ________________________________________
SSN: ________________________________________
Relationship to Petitioner: ________________________
Relationship to Petitioner: ________________________
Name: _______________________________________
Name: _______________________________________
Address: _____________________________________
Address: _____________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Telephone: ( ______ ) ___________________________
Telephone: ( ______ ) ___________________________
DOB: ________________________________________
DOB: ________________________________________
SSN: ________________________________________
SSN: ________________________________________
Relationship to Petitioner: ________________________
Relationship to Petitioner: ________________________
Please list any / all cases, pending, or heard within the last five (5) years, that have involved the parties or children of the parties
in Family, District or Circuit Court. Please provide the case number, name of party and type of case: _________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_____________________________________________
NOTICE TO FILING PARTY: A REDACTED
Signature of Preparer / Relationship to Petitioner
COPY MUST BE FILED PURSUANT TO CR 7.03.
Print Name: ___________________________________
This form shall be completed in full, pursuant
Address: _____________________________________
to local rule and in compliance with federal law.
_____________________________________________
Phone: ( ______ ) ______________________________
DISTRIBUTION: Cabinet for Health and Family Services, placing a copy in the County Attorney's Wage Withholding
Order Box in Circuit Clerk's Office
Print
Reset Form
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal