Fill and Sign the Relief from Abusevermont Judiciary Form

SUPERIOR COURT Unit STATE OF VERMONT FAMILY DIVISION Docket No. CONFIDENTIAL Litigant's Address for Notification Name: _________________________________________________________________________________ Vermont Family Court Rules say that parties filing documents in Relief From Abuse cases must give the Court an address and telephone number. The address and telephone number you give are for the Court to contact you about your case. Please complete the information below: For the Court to contact me about my case, I can be reached at: Mailing Address: __________________________________________________________________ City, State Zip: __________________________________________________________________ Home/Cell Phone: _________________________ Work Phone: _________________________ The address & telephone number(s) you have given in this case cannot be given to any person without your permission. Do you consent to the release of this information? ☐ Yes ☐ No _______________________________________ Date ____________________________________ Signature Important information: The rule that requires the Court to keep your address and telephone number confidential applies ONLY to Relief From Abuse cases. If you have other cases in Court, and you want the Court to keep your address and telephone number(s) confidential in those cases, you must file a written request in each. Your request will be given to the Judge. It is up to the Judge to decide. 400-00156 – Confidential Notification for Relief from Abuse (09/2017) Page 1 of 1