Fill and Sign the Cv 001 Summary Sheet Rev 0614 Mainegov Form

FM-002, Rev. 06/16 Page 1 of 2 FAMILY MATTER SUMMARY SHEET : M.R. Civ. P. 5(h ) This form is used for entering basic information abo ut the case and the parties into court records. You must complete and file this form with the Clerk when you file your Complaint or M otion. You are not required to give a copy of this form to the other party. COURT LOCATION (where you are filing this action): TYPE OF ACTION: (Check one box) Divorce - Real Estate involved Divorce - No Real Estate Parental Rights & Responsibilities (Unmarried parent s of child) Parentage (Determine parents of the child(ren)) Judicial Separation Probate Matter Foreign Judgment Other Family Matter TYPE OF FILING: (Check one box) Original Proceeding Probate Matter, Original Docket # is: Post -Judgment Motion: to Modify to Enforce for Contempt Original Docket # is: Plaintiff Information: (Person starting the action or if post -judgment, name of person who was the plaintiff in the origin al case.) Name: First Middle Last Maiden Mailing Address: City State Zip Physical Address: City State Zip Gender: Date of Birth: SS Number Disclosure Required on separate form Home Telephone: Work Telephone: Attorney’s Name: Bar ID#: Defendant Information : (Person being served or if post -judgment, name of person who was the defendant in the or iginal case.) Name: First Middle Last Maiden Mailing Address: City State Zip Physical Address: City State Zip Gender: Date of Birth: SS Number Disclosure Required on separate form Home Telephone: Work Telephone: Attorney’s Name: Bar ID#: Minor Children (of above parties) full name: Date of Bi rth: Gender: SS Number Disclosure Required SS Number Disclosure Required SS Number Disclosure Required SS Number Disclosure Required SS Number Disclosure Required FM-002, Rev. 06/16 Page 2 of 2 Parentage Issues (if any): The child(ren) do not have any other acknowledged, adjudicated, intended, de facto, or presumed parents. OR The child(ren) have an acknowledged, adjudicated, intended, de facto, or presumed parent. (You must complete a separate summary sheet for every additional parent that your child has, and all parents must be served with a copy of the Complaint and made a party to your action.) Date: Signature of Party or Party’s Attorney