Fill and Sign the Social Security Gender and Birth Datesnebraska Judicial Form

IN THE DISTRICT COURT OF ___________________ COUNTY, NEBRASKA (county where original action was filed) THIS DOCUMENT IS CONFIDENTIAL AND SHALL NOT BE MADE PART OF THE CASE FILE OR PROVIDED TO THE PUBLIC Case No. CI ____________ (case number assigned by Clerk of Court) SOCIAL S ECURITY NUM BERS, GENDER, AND BIRTH DATE(S) vs. _________ _______________________________, (name of person listed as defendant/respondent in original action) Defendant/Respondent. Names Social Security Number Gender Date of Birth Plaintiff /Petitioner : __________________ ____________________ _______ _____________ Defendant/ Respondent : ____________________ _______ _____________ ___________________ Additional Petitioner(s)/Minor Children: ___________________ ____________________ _______ _____________ ___________________ ____________________ _______ _____________ ___________________ ____________________ _______ _____________ ___________________ ____________________ _______ _____________ ___________________ ____________________ _______ _____________ N ebraska State Court Form DC 6:5(12) Rev. 02/18 Neb. Ct. R. § 6-1521 S OCIAL SECURITY NUMBERS, GENDER, AND BIRTH DATE(S) (For o ther information, add pages as required.) Page 1 of 1 S ocial S ecurity, Gender, Birth Date DC 6:5(12) Rev. 02/18 PSC Nebraska o/b/o OR Additional Petitioner/Minor Child(ren) , Additional Petitioner/Minor C hild(ren), _______________________________________ _, (name of person listed as plaintiff/petitioner in original action) Plaintiff/Petitioner , If you are filing for a protection order , fill in the next two lines the same way that they are listed on the petition