JDF 1000 R 2 1 9 District Court Denver Juvenile Court County Colorado Court Address In re t he Marriage of In re the Civil Union of In the Interest of in re ID: 853008
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1 JDF 1000 R 2 /1 9 CASE INFORMATIO
JDF 1000 R 2 /1 9 CASE INFORMATION SHEET District Court Denver Juvenile Court _________________________________ County, Colorado Court Address: In re t he Marriage of: In re the Civil Union of: In the Interest of: in re P arental Responsibilities concerning: ________________________________ ________________ Petitioner: and Co - Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom DOMESTIC CASE INFORMATION SHEET Full name of Petitioner : ______________________________________________________________________ Date of birth: ________________________ Social Security Number: _____________________ Residential address: __________________________________________________________ Apt. #__________ City: ______________________ State: ______________________ Zip Code: __________________ Mailing address (if different from res idential address): ___________________________________ Apt. # _______ City: ______________________ State: ______________________ Zip Code: __________________ Telephone Numbers: Home ___________________ Work ____________________ Cell _____________ __ ____ F ull name of Co - Petitioner/Respondent : ________________________________________________________ Date of birth: ________________________ Social Security Number: _______
2 ______________ Residential address: __
______________ Residential address: __________________________________________________ ________ Apt. #__________ City: ______________________ State: ______________________ Zip Code: __________________ Mailing address (if different from residential address): ___________________________________ Apt. # _______ City: ______________________ Sta te: ______________________ Zip Code: __________________ Telephone Numbers: Home ___________________ Work ____________________ Cell __________ ___ ______ The following child(ren) was/were born o r adopted of this marriage. (attach a second sheet, if necessa ry): Full Name of Child Present Address Sex Date of Birth Soc. Sec. No. The Petitioner is planning to be self - represented. JDF 1000 R 2 /1 9 CASE INFORMATION SHEET The Co - Petitioner/Respondent is planning to be self - represented. Both you and the other party have retained an attorney. By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. SIGNATURE __________________ _____ _____ ______ _____ _ ______________________________________ Printed name of Petitioner or Co - Petitioner/Respondent Signature of Petitioner or Co - Petitioner/Respondent ____________________________________________ Date 4 4 4 4 4 4 4 4 4 4 Print Clea