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Form Cv-502 - Confidential Address Information In Domestic Abuse, Child Abuse, Individual At Risk, And Harassment Temporary Restraining Order And Injunction Actions

STATE OF WISCONSIN, CIRCUIT COURT,

COUNTY

Amended

Petitioner/Child/

Confidential Address

Individual at Risk:

Information in

Name and Address of

Domestic Abuse,

person completing

Child Abuse,

Petition

(if different from

Individual at Risk, and

above):

Harassment

-vs-

Temporary Restraining

Respondent/Defendant:

Order and Injunction

Actions

Case No.

Petitioner/Child/

Individual at Risk’s

Address:

Phone Number(s):

Person Completing

Petition Phone

Number(s):

This address information is being provided as part of a

new case filing; OR

change of address on an existing temporary restraining order/injunction case.



Petitioner or person filing on behalf of petitioner

Name Printed or Typed

Date

The clerk shall maintain this address in a confidential manner. It will not be made available to any other

parties in this action, their attorney or representatives, or the public.

CONFIDENTIAL COURT RECORD

CV-502, 05/14 Confidential Address Information in Domestic Abuse, Child Abuse, Individual at Risk, and Harassment Temporary Restraining Order and Injunction Actions

§813.12(5m), 813.122(5g), 813.123(5g), 813.125(5m), Wisconsin Statutes

This form shall not be modified. It may be supplemented with additional material.