Family Law Case Demographics Information Sheet for Child …
Family Law Case Demographics Information Sheet for Child Custody/Visitation
FL/E-ME-811
Court Case Number: ____________________
Family Court Services Number: _____________________
Petitioner's Information
_________________________________________________
First Name
Middle Initial
Last Name
_________________________________________________ Mailing Address (Include Apt. or Suite #)
_________________________________________________
City
State Zip Code
Date of Birth: ________________________________ Month Day Year
Home Phone: ( )
Work Phone: ( )
Relationship to Child/ren: ___________________________
Petitioner's Attorney Information
_________________________________________________
First Name
Middle Initial
Last Name
_________________________________________________ Mailing Address (Include Suite #)
_________________________________________________
City
State Zip Code
Work Phone: ( )
Respondent's Information
_________________________________________________
First Name
Middle Initial
Last Name
_________________________________________________ Mailing Address (Include Apt. or Suite #)
_________________________________________________
City
State Zip Code
Date of Birth: ________________________________ Month Day Year
Home Phone: ( )
Work Phone: ( )
Relationship to Child/ren: ___________________________
Respondent's Attorney Information
_________________________________________________
First Name
Middle Initial
Last Name
_________________________________________________ Mailing Address (Include Suite #)
_________________________________________________
City
State Zip Code
Work Phone: ( )
FL/E-ME-811 (Revised 11/08/19) Mandatory
Family Law Case Demographics Information Sheet
Page 1 of 2 saccourt.
Court Case Number: ____________________
FL/E-ME-811 Family Court Services Number: _____________________
Claimant's (3rd Party's) Information
_________________________________________________
First Name
Middle Initial
Last Name
_________________________________________________ Mailing Address (Include Apt. or Suite #)
_________________________________________________
City
State Zip Code
Date of Birth: ________________________________ Month Day Year
Home Phone: ( )
Work Phone: ( )
Relationship to Child/ren: ___________________________
Claimant's Attorney Information
_________________________________________________
First Name
Middle Initial
Last Name
_________________________________________________ Mailing Address (Include Suite #)
_________________________________________________
City
State Zip Code
Work Phone: ( )
List all of the children you had or adopted with the other party in this case:
Full Name
Date of Birth Age
School
Resides with
Does any party need an interpreter? _____ Yes If Yes, for which party? _____ Petitioner
_____ No _____ Respondent
_____ Claimant / 3rd Party
If Yes, please indicate for what language? _____________________________________
I declare under penalty of perjury that the foregoing information is true and correct.
____/___/_______ DATE
FL/E-ME-811 (Revised 11/08/19) Mandatory
SIGNATURE OF DECLARANT
______________________________________________________ TYPE OR PRINT NAME
Family Law Case Demographics Information Sheet
Page 2 of 2 saccourt.
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