Fill and Sign the 7 New 0710 Form

Names Social Security No. Gender Birth Date Plaintiff: Defendant: Minor Child: Minor Child: Minor Child: FINANCIAL INFORMATION ACCOUNT NUMBER 1._______________________________________ ____________________________________ 2.________________________________________________________________ ___________ 3._____________________________________________________________________ ______ 4._____________________________________________________________ ______________ (For other information, add pages as required.) Instructions: When parties are required to report personal and financial information to the court, the complete information shall be provided on Appendix 7. On pleadings or documents to be filed with the court, financial account numbers, dates of birth, and Social Security numbers, where required, should reference Appendix 7 : (i.e. , “See Appendix 7 ”). Financial account numbers should be listed by the last four digits of the financial account when the account is reported on a pleading or document filed with the Court . This form is neither approved nor disapproved by any court or judicial tribunal. Use of this form provides no immunity from er ror. Appendix 7 (Neb. Ct. R. – Chapter 6, Article 14) Appendix 3 adopted July 13, 2010 STATE OF NEBRASKA REQUIRED PERSONAL AND FINANCIAL INFORMATION OF PARTIES (General Civil Cases) CASE NUMBER IN THE COUNTY COURT OF _________________ COUNTY, NEBRASKA THIS DOCUMENT IS CONFIDENTIAL AND SHALL NOT BE MADE PART OF THE COURT FILE OR PROVIDED TO THE PUBLIC PURSUANT TO NEB CT.R. § 6-1464. Plaintiff vs. PERSONAL AND FINANCIAL INFORMATION OF PARTIES (General Civil Cases) Defendant Ch. 6, Art. 14, App. 7 New 07/ 10 Page 1 of 1 Personal and Financial Information of Parties Ch6Art14App7 New 07/2010 CC 16:13 NAME OF ACCOUNT Neb . Ct. R. § 6-1464(B)