Fill and Sign the Note to Clerk Do Not File the Information Sheet

4A-101. Domestic relations information sheet.DOMESTIC RELATIONS INFORMATION SHEET1NOTE TO CLERK: DO NOT FILE THE INFORMATION SHEETType or print responses. Required in all domestic relations cases.2 (Do not use in domestic violence cases.)A.Petitioner’s attorney information. (Complete only if Petitioner has an attorney.)Petitioner’s name: ____________________________________________Attorney’s name: ____________________________________________Attorney’s address: ___________________________________________City: ______________________________________________________State: ______________________________________________________Zip code: ___________________________________________________Telephone: _________________________________________________B.Information regarding petitioner and respondent. (Do not use an attorney’s mailingaddress. Use a separate sheet if necessary.)PetitionerRespondentName: ___________________________Name: ___________________________(Last name, first, middle)(Last name, first, middle)Other names (e.g. maiden name):Other names (e.g. maiden name):__________________________________________________________________Address: _________________________Address: _________________________City: ____________________________City: ____________________________State: ___________________________State: ___________________________Zip code: ________________________Zip code: ________________________Date of birth: _____________________Date of birth: _____________________Social Security number3 : ____________Social Security number3 : ____________C.Parties’ minor children. (Provide the date of birth and social security number for eachminor child, if any. Use a separate sheet if necessary.)Name: ____________________________Name: _______________________________(Last name, first, middle)(Last name, first, middle)Date of birth: ______________________Date of birth: _________________________Social Security number: ______________Social Security number: _________________Name: ____________________________Name: _______________________________(Last name, first, middle)(Last name, first, middle)Date of birth: ______________________Date of birth: _________________________Social Security number: ______________Social Security number: ________________ D.Request to limit access to information.(Optional - complete only if applicable) [ ]The [petitioner] [respondent] has reason to fear domestic violence or child abuse.For this reason, please limit access to information about the [petitioner][respondent] in the Child Support & Paternity Case Registry to the extentpossible.4 The [petitioner] [respondent] realizes that this request may make itmore difficult to assist in collecting child support. The [petitioner] [respondent]understands that the other party and the public might still view information aboutthis case under some circumstances.I affirm that this request is legitimately made and not designed to harass or intimidate theother party or mislead the court._____________________________________Signature of PetitionerEND OF INFORMATION SHEETUSE NOTE1.The Domestic Relations Information Sheet is not required in domestic violence,commitment, guardianship, probate, or adoption actions; or if you are filing a pleading that doesnot change or add to the first pleading.In uncontested domestic relations matters, the parties may submit one Information Sheetwith the initial pleading, and the documents need not be served.In all other contested domestic relations cases each attorney representing a petitioner, orthe petitioner proceeding pro se, in a contested case must submit the Information Sheet and servea blank copy of the Information Sheet on the respondent. Respondents must submit thecompleted Information Sheet with their first responsive pleading.The information submitted on these forms does not replace or supplement the filing andservice of pleadings or other papers required by law. These forms, approved by the SupremeCourt of New Mexico, are required to initiate domestic relations cases and are used by the courtsfor case management.Forms are available from the court clerks and the NMRA. Electronic copies may beobtained from the Supreme Court's internet site (www.supremecourt.nm.org) and New MexicoLaw on Disc. If re-keying the form it must appear substantially in the same format as theSupreme Court approved form. Type or print only. If using a word processing system, pleaseprint your answers in bold.2.Unless there are more than four children, the Information Sheet is to be submittedon a single page. The clerk will key-enter the information on the Information Sheet. TheInformation Sheet will not be filed in the court file.3.If the party has more than one social security number, please include it. Pursuantto Sections 27-1-10 and 27-1-11 NMSA 1978 and federal law, each party must submit the socialsecurity number of each party as well as the name, date of birth and social security number for each minor child. This information will be provided to the State Case Registry and, uponrequest, to child support enforcement agencies. The parties’ addresses and social securitynumbers are also used to accurately identify and track court users, obtain feedback from courtusers on a periodic basis and to issue process in contempt proceedings. Addresses provided onthis page will not be made a part of the public record unless that party is or becomes selfrepresented.4.The Child Support & Paternity Case Registry is a required, nationwide database ofchild support and paternity orders. Access to registry information is strictly limited to court andchild support administrative personnel. Requesting that your registry information be“nondisclosed” does not prevent authorized parties from reviewing the information. Rather, italerts courts and child support administrative personnel to act with caution when viewing yourinformation. However, be aware that requesting “nondisclosure” of registry information doesnot limit access to your official district court case file which is a public record. If you areconcerned about such access, ask your lawyer, or the court clerk if you do not have a lawyer,about ways in which the court may restrict access to your court file.[Provisionally approved as 4-211 NMRA, effective November 1, 1999 until November 1, 2000;approved, as amended, effective November 1, 2000; as amended by Supreme Court Order No.13-8300-010, effective for all pleadings and papers filed on or after May 31, 2013, in all casespending or filed on or after May 31, 2013; as amended by Supreme Court Order No. 14-8300-011, effective for all cases filed on or after December 31, 2014.]