Fill and Sign the Please Fill in a to K Pertaining to You the Applicantpetitioner Form

Form 240 Rev 6/17 1 of 2 The Family Court of the State of Delaware INFORMATION SHEET - PLEASE PRINT Date: File No.: Please fill in A to K pertaining to you the Applicant/Petitioner. (For additional petitioners use additional sheets) PLEASE PRINT CLEARLY A. Name: B. Address: City/State/Zip: C. Phone – Home: Work: Cell: D. Employer & Address: Hours/Shift E. Social Security No.: F. Date of Birth: G. Place of Birth (City & State): H. Sex: Race: Height: Weight:77 7Hair: Eyes: Marks/Scars/Tattoos: I. Type of motor vehicle operated by you: J. Driver’s License No.: State of Issue:77Expiration Date: K. Your relationship to the Defendant/Respondent: L. Attorney: I authorize Family Court to deliver court orders in my case(s) to my email address instead of to my mailingaddress. My email address is: .*Please note that if you provide an email address, all orders in your pending civil cases in Family Court will be sent in an encrypted email via Egress to the email address provided and will not be mailed to your physical address. For information on how to receive encrypted emails through Egress, please visit https://judicial.state.de.us/courtdox/Download.aspx?id=94888&court=readonly. Please fill out the information below in reference to the child(ren) who are involved. Children Name RelationshipSexRaceD.O.B.SSNBirthplaceCity & State OVER Form 240 Rev 6/17 2 of 2 Please fill in L to Y pertaining to the Defendant/Respondent. (For additional respondents use additional sheets)M. Defendant/Respondent is a: (Check One) ADULT JUVENILE N. Name: O. Address: City/State/Zip: P. Phone – Home: Work: Cell: Q. Employer & Address: Hours/Shift R. Social Security No.: S. Date of Birth: T. Place of Birth (City & State): U. Relationship to Child: Not Applicable Mother Father Relative Non-Relative Other (Please Describe) V. Sex: Race: Height:7777Weight:777Hair: Eyes: Marks/Scars/Tattoos: W. Driver’s License State & No.: X. Type of vehicle operated by Defendant/Respondent: Y. Parent’s Name (if a juvenile): Z. Time when Respondent is usually home: AA. Additional information about Respondent that may aid the process server in locating him/her to serve petition: _____________________________________________________________________________________________________ DIRECTIONS TO RESPONDENT’S RESIDENCE