Fill and Sign the Non Custodial Parent Form

(e.g., John Smith v. All American Insurance Co; In re Mary Ann Jones; In the Matter of the Estate of George Jackson) A civil case information sheet must be completed and submi tted when an original petition or application is filed to initiate a new civil, family law, probate, or mental health case or when a post-judgment petition for modifi cation or motion for enforcement is filed in a family law case. The information should be the best available a t the time of filing. 1. Contact information for person completing case information sheet: Names of parties in case: Person or entity completing sheet is: Name: _____________________________ Address: _____________________________ City/State/Zip: _____________________________ Signature: _____________________________ Email: ____________________________ Telephone: ____________________________ Fax: ____________________________ State Bar No: ____________________________ Plaintiff(s)/Petitioner(s): _________________________________ _________________________________ Defendant(s)/Respondent(s): _________________________________ _________________________________ _________________________________ [Attach additional page as necessary to list all parties ] Attorney for Plaintiff/Petitioner Pro Se Plaintiff/Petitioner Title IV-D Agency Other: _________________________ Additional Parties in Child Support Case: Custodial Parent: _________________________________ N on -Custodial Parent: _________________________________ Presumed Father: _________________________________ 2. Indicate case type, or identify the most important issue in the case (select only 1): Civil Family Law Contract Injury or Damage Real Property Marriage Relationship Post-judgment Actions (non-Title IV-D) Debt/Contract Consumer/DTPA Debt/Contract Fraud/Misrepresentation Other Debt/Contract: ____________________ Foreclosure Home Equity —Expedited Other Foreclosure Franchise Insurance Landlord/Tenant Non-Competition Partnership Other Contract: ______________________ Assault/Battery Construction Defamation Malpractice Accounting Legal Medical Other Professional Liability: _______________ Motor Vehicle Accident Premises Product Liability Asbestos/Silica Other Product Liability List Product: _________________ Other Injury or Damage: _________________ Eminent Domain/ Condemnation Partition Quiet Title Trespass to Try Title Other Property: ____________________ Annulment Declare Marriage Void Divorce With Children No Children Enforcement Modification —Custody Modification —Other Title IV-D Enforcement/Modification Paternity Reciprocals (UIFSA) Support Order Related to Criminal Matters Other Family Law  Parent-Child Relationship Expunction Judgment Nisi Non-Disclosure Seizure/Forfeiture Writ of Habeas Corpus P re-indictment Other: _______________ Enforce Foreign Judgment Habeas Corpus Name Change Protective Order Removal of Disabilities of Minority Other:  Adoption/Adoption with Termination Child Protection Child Support Custody or Visitation Gestational Parenting Grandparent Access Parentage/Paternity Termination of Parental Rights Other Parent-Child: _____________________ Employment Other Civil Discrimination Retaliation Termination Workers’ Compensation Other Employment: ______________________ Administrative Appeal Antitrust/Unfair Competition Code Violations Foreign Judgment Intellectual Property Lawyer Discipline Perpetuate Testimony Securities/StockTortious Interference Other: _______________ Tax Probate & Mental Health Tax Appraisal Tax Delinquency Other Tax Probate/Wills/Intestate Administration Dependent Administration Independent Administration Other Estate Proceedings Guardianship—Adult Guardianship —Minor Mental Health Other: ____________________ 3. Indicate procedure or remedy, if applicable (may select more than 1): Appeal from Municipal or Justice Court Arbitration-related Attachment Bill of Review Certiorari Class Action Declaratory Judgment Garnishment Interpleader License Mandamus Post-judgment Prejudgment Remedy Protective Order Receiver Sequestration Temporary Restraining Order/Injunction Turnover 4. Indicate damages sought ( do not select if it is a family law case ): Less than $100,000, including damages of any kind, penalti es, costs, expenses, pre-judgment interest, and attorney fees Less than $100,000 and non-monetary relief Over $100, 000 but not more than $200,000 Over $200,000 but not more than $1,000,000 Over $1,000,000 CIVIL CASE INFORMATION SHEET C AUSE NUMBER (FOR CLERK USE ONLY ): ___ ____________________________ C OURT (FOR CLERK USE ONLY ): ______________________ S TYLED ___________________________________________________ ________________________________________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ — __________________