Domestic Relations Cover Sheet Page 2
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NOTE TO COURT CLERK: DO NOT FILE THE INFORMATION SHEET.
DOMESTIC RELATIONS INFORMATION SHEET
Case number: __________ Assigned judge: ____________
The following information is required by New Mexico law and federal law for child support
enforcement. The information also is needed to identify and monitor the case.
1.
Information regarding petitioner and respondent. (Do not use an attorney’s mailing
address. Use a separate sheet if necessary.)
Petitioner
Respondent
Name: ____________________________
Name: ________________________________
(Last name, first, middle)
(Last name, first, middle)
Other names (e.g. maiden name):
Other names (e.g. maiden name):
___________________________________ ______________________________________
Address: __________________________
Address: _____________________________
City: _____________________________
City: ________________________________
State: ____________________________
State: _______________________________
Zip code: _________________________
Zip code: ____________________________
Date of birth: _____________________
Date of birth: _______________________
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Social Security number
: _____________
Social Security number
: ______________
2.
Parties’ minor children. (Provide the date of birth and social security number for each
minor child, if any. Use a separate sheet if necessary.)
Name: ____________________________
Name: ________________________________
(Last name, first, middle)
(Last name, first, middle)
Date of birth: _____________________
Date of birth: __________________________
Social Security number: ____________
Social Security number: _________________
Name: ____________________________
Name: ________________________________
(Last name, first, middle)
(Last name, first, middle)
Date of birth: _____________________
Date of birth: _______________________
Social Security number: ____________
Social Security number: ______________
Has any court made an order for child support? ___Yes ___No
Has any court changed the amount of child support you requested? ___Yes ___No
If you answered “Yes” to either question, what state and what court issued the order?
________________ State ________________ Court.
3.
Request to limit access to information.
(Optional - complete only if applicable)
[ ]
The [petitioner] [respondent] has reason to fear domestic violence or child abuse. For
this reason, please limit access to information about the [petitioner] [respondent] in
the Child Support & Paternity Case Registry to the extent possible. The [petitioner]
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