Fill and Sign the Confidential Notification for Abuseneglectexploitation Form

STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION Unit Plaintiff Docket No. DOB Defendant DOB V. CONFIDENTIAL NOTIFICATION FOR ABUSE/NEGLECT/EXPLOITATION Address for Notification I am the ☐ Plaintiff ☐ Interested Person Vermont Family Court Rules say that parties filing documents in Relief from Abuse/Neglect/Exploitation cases must give the Court an address and telephone number. The address and telephone number you give are for the Court to contact you about your case. Please complete the information below: For the Court to contact me about my case, I can be reached at: Name: ______________________________________________________________________________________ Address: ____________________________________________________________________________________ City/State/Zip: _______________________________________________________________________________ Phone Number(s): _________________________________________________ The address & phone number(s) you have given in this case cannot be given to any person without your permission. Do you consent to the release of this information? ☐ Yes ☐ No Important Information The Rule that requires the Court to keep your address and phone number(s) confidential applies ONLY to Relief from Abuse/Neglect/Exploitation cases. If you have other cases in Court, and you want the Court to keep your address and phone number(s) confidential in those cases, you must file a separate written request in each. Your request will be given to the judge. It is up to the judge to decide. Dated _____________________________ ___________________________________ Signature 400-00854 – Confidential Notification for Abuse_Neglect_Exploitation (09/2017) Page 1 of 1