Fill and Sign the Mailing Address If Different from Residential Address Apt Form

JDF 1000 R2/19 CASE INFORMATION SHEETDistrict Court Denver Juvenile Court_________________________________County, ColoradoCourt Address:In re the Marriage of:In re the Civil Union of:In the Interest of:in re Parental Responsibilities concerning:________________________________________________Petitioner:andCo-Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg. #:Case Number:Division Courtroom DOMESTIC CASE INFORMATION SHEET Full name of Petitioner : ______________________________________________________________________Date of birth: ________________________ Social Security Number: _____________________Residential address: __________________________________________________________ Apt. #__________ City: ______________________ State: ______________________ Zip Code: __________________Mailing address (if different from residential address): ___________________________________ Apt. # _______City: ______________________ State: ______________________ Zip Code: __________________Telephone Numbers: Home ___________________ Work ____________________ Cell ___________________ Full name of Co-Petitioner/Respondent : ________________________________________________________Date of birth: ________________________ Social Security Number: _____________________Residential address: __________________________________________________________ Apt. #__________ City: ______________________ State: ______________________ Zip Code: __________________Mailing address (if different from residential address): ___________________________________ Apt. # _______City: ______________________ State: ______________________ Zip Code: __________________Telephone Numbers: Home ___________________ Work ____________________ Cell ___________________ The following child(ren) was/were born or adopted of this marriage. (attach a second sheet, if necessary):Full Name of ChildPresent AddressSexDate of BirthSoc. Sec. No.The Petitioner is planning to be self-represented. JDF 1000 R2/19 CASE INFORMATION SHEETThe Co-Petitioner/Respondent is planning to be self-represented.Both you and the other party have retained an attorney. By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. SIGNATURE ________________________________________ ______________________________________Printed name of Petitioner or Co-Petitioner/Respondent Signature of Petitioner or Co-Petitioner/Respondent____________________________________________Date