CLARK COUNTY, NEVADA FAMILY COURT COVER SHEET
Case Number: _________________________ (to be assigned by the Clerk's Office)
CLARK COUNTY, NEVADA FAMILY COURT COVER SHEET
PARTIES:
Last Name: First Name: Mailing Address: City, State, Zip: Phone #: Email Address:
Name: Address: City, State, Zip: Phone #:
Plaintiff/Petitioner
Defendant/Respondent/Co-Petitioner/Protected Person
Last Name:
Middle Name:
First Name:
Middle Name:
Mailing Address:
City, State, Zip:
Date of Birth:
Phone #:
Date of Birth:
Email Address:
Attorney Information
not applicable
Attorney Information
not applicable
Bar No.
Name:
Bar No:
Address: City, State, Zip:
Phone #:
CASE TYPE: (Check only one box only for the primary type of case you are filing)
DISSOLUTION
Annulment Divorce ?No minor child(ren) Divorce ?With minor child(ren) Foreign Decree Joint Petition ?No minor child(ren) Joint Petition ? With minor child(ren) Separate Maintenance
MISC. DOMESTIC RELATIONS PETITIONS
Adoption ?Minor Adoption ?Adult Child Custody (non-divorce) Child Support (private party) Mental Health Name Change Paternity Permission to Marry Temporary Protective Order (TPO) Termination of Parental Rights (private party) Termination of Parental Rights (State initiated) Visitation (non-divorce) Other (identify) __________________
GUARDIANSHIP
Guardianship of an Adult Person Estate Person and Estate
Guardianship of a Minor Person Estate Person and Estate
Guardianship Trust
OTHER
DA Child Support DA ? UIFSA DA ? Child Support In State
DA Child Dependency DA ? Abuse/Neglect DA ? No Fault DA ? Other (identify) __________________
Juvenile Emancipation
CHILDREN INVOLVED IN THIS CASE (if applicable)
Last Name
First Name
1.
2.
3.
4.
5.
6.
7.
8.
Middle Name
Date of Birth
Relationship
Does this family have any other current or past case(s) in the Clark County Family Court or Juvenile Court?
YES
NO
_________________________________ Your Printed Name
Nevada AOC ? Research & Statistics Unit Pursuant to NRS 3.275
__________________________________ Your Signature
________________ Date
Revised 03/2019
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