Fill and Sign the For Internal Use Only This Sheet Will Not Become Part of the Form

FOR INTERNAL USE ONLY THIS SHEET WILL NOT BECOME PART OF THE PUBLIC RECORD, AND WILL BE USED FOR INTERNAL CASE TRACKING PURPOSES. DOMESTIC RELATIONS COVER SHEET IN THE DISTRICT COURT OF ___________________ COUNTY STATE OF OKLAHOMA PLAINTIFF _____________________________________ V . D EFENDANT ____________________________________ [ ] FD [ ] FR [ ] FP [ ] FI [ ] PA P ARTY INFORMATION THE INFORMATION BELOW IS REQUIRED OF EACH PARTY IN THE CASE. P ARTY TYPE : [ ] P LAINTIFF [ ] D EFENDANT [ ] OTHER _____________________ COMPANY OR LAST NAME FIRST NAME MIDDLE NAME PREFIX (MR., ETC .) SUFFIX (SR., ETC .) STREET ADDRESS ADDRESS TYPE [ ] H OME [ ] W ORK [ ] O THER _____________ DRIVERS LICENSE # (FEDERAL TAX ID FOR CORPORATE OR ENTITY PARTIES ) ______________________________________________________ ______________________________________________________ ______________________________________________________ C ITY STATE ZIP TELEPHONE DATE OF BIRTH DRIVERS LICENSE STATE ATTORNEY INFORMATION IF LICENSED IN OKLAHOMA , FILL IN ADDRESS INFO RMATIONONLY IF IT IS NE W SINCE THEY WERE REGISTERED WITH THE OKLAHOMA BAR ASSOCIATION . ATTACH ADDITIONAL COVER SHE ETS FOR ADDITIONAL ATTORNEYS. ALL ATTORNEYS SHOULD BE LISTED. NOTE: A DDRESS CHANGES ARE E FFECTIVE IN ALL OCIS COUNTIES . C OMPANY OR LAST NAME FIRST NAME MIDDLE NAME PREFIX (MR., ETC .) SUFFIX (SR., ETC .) STREET ADDRESS ADDRESS TYPE [ ] H OME [ ] W ORK [ ] O THER _____________ EMAIL ADDRESS ______________________________________________________ ______________________________________________________ ______________________________________________________ C ITY STATE ZIP TELEPHONE BAR NUMBER AND STATE SUMMONS INFORMATION NUMBER OF SUMMONS TO BE ISSUED __________ P ETITION TO BE SERVED BY : [ ] SHERIFF OF ________________C OUNTY [ ] PROCESS SERVER [ ] PUBLICATION [ ] BY HAND [ ] REGISTERED MAIL [ ] GIVEN TO THE ATTORNEY OF RECORD [ ] OTHER CLAIMS OF RELIEF REQUESTED (CIRCLE PRIMARY RELIEF , CHECK ALL OTHERS ) [ ] DIVORCE [ ] SEPARATE MAINTENANCE [ ] ANNULM ENT [ ] CIVIL PATERNITY [ ] APPEAL ON ADMINISTRATIVE ORDER [ ] RECIPROCAL OUTGOING [ ] CHILD CUSTODY [ ] HABEAS CORPUS [ ] PROTECTIVE ORDER [ ] TEMPORARY EMERGENCY PROTECTIVE ORDER [ ] REG OF FOREIGN JUDGEMENT [ ] VISITATION GRANDPARENT(S) [ ] DOMESTIC MISCELLANEOUS [ ] WAS THERE PREMARITAL COUNSELI NG? [ ] YES [ ] NO (check one) POST JUDGEMENT ACTION (check all that apply): [ ] MODIFICATION OF DECREE [ ] SET ASIDE DECREE/RESCIND FINAL ORDER [ ] APPLICATION FOR CONTEMPT (CHILD SUPPORT OR OTHER) [ ] ENFORCEMENT OF JUDGEMENT INCOME ASSIGNMENT ORIGINAL & P OST JUDGMENT ACTIONS RELIEF INVOLVES (check all that apply): [ ] MINOR CHILD(REN) OF THIS RELATIONSHIP [ ] YES [ ] NO (check one) IF YES, HOW MANY _________________ [ ] CUSTODY [ ] CHILD SUPPORT [ ] VISITATION [ ] VISITATION (other than parent) [ ] PROPERTY DIVISION [ ] DEBT DIVISION [ ] ALIMONY [ ] INDIAN CHILD WELFARE ACT [ ] RESTRAINING ORDER PROPERTY [ ] RESTRAINING ORDER PERSON [ ] RESTORATION OF FORMER NAME [ ] O THER ___________________________ [ ] OTHER ___________________________ [ ] OTHER ___________________________ THIS COVER SHEET IS REQUIRED TO BE SUBMITTED BY A LL PARTIES WITH THEIR INITIAL FILING. THIS DOCUMENT IS REQUIRED BY SUPREME COURT ADMINISTRATIVE DIRECTIVE SCAD-1999 -87. REVISION 5-16 -2000 Promulgated by the Oklahoma Administrative Office of the Courts CASE NO. ______________