Mandatory Case Disclosure

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NO. (A) ____________________
__________________ CIRCUIT COURT
FAMILY DIVISION _________
(B) __________________________
PETITIONER
SELF-HELP FORM #2B
v.
MANDATORY CASE DISCLOSURE
(With Children Under 18 and/or in High School)
(C) __________________________
RESPONDENT
* * * * * * * * *
1)
(D) INFORMATION ON PETITIONER:
Name:
Address:
Telephone Number:
Age:
Date of Birth:
Date and Place of Marriage to Respondent:
Check One:
" EMPLOYED " UNEMPLOYED " DISABLED " RETIRED
(E) If Petitioner is Employed:
Employer’s Name:
Employer’s Address:
Employer’s Telephone Number:
Petitioner started working for this employer on
(date)
Check One:
" Petitioner is paid by the hour. Petitioner earns $_________ per hour and works
________ hours per week.
Revised 7/18/2007

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