CASE FILING STATEMENT - Informational Only; Not Retained in Case Records Provide the Case File No. for the record you are filing into or the Case Type if initiating a new action: *Available Case Type options can be on the UJS internet website at . Social Security Numbers (not Driver’s License Numbers) must be provided for divorce, support, & paternity cases, 42 All filers are to provide the SSN DL# for each of participants regardless of the case type. USC 666(a)(13)(B). required or their Business entities must provide the EIN number in lieu of SSN or DL#. INFORMATION FOR PLAINTIFF/PETITIONER/APPLICANT: INFORMATION FOR DEFENDANT/RESPONDENT: Last/Business Name First Name Middle Suffix Physical Address City State Zip Check if Same as Physical Mailing Address City State Zip Date of mo/day/ yr Home: - Work: Social Security No. Driver’s License No. State Employer ID (if def is a Cell: business) Attorney: Last Name First Phone No. . State Bar ID # Mailing Address City State Zip
CASE FILING STATEMENT - Informational Only; Not Retained in Case Records Provide the Case File No. for the record you are filing into or the Case Type if initiating a new action: *Available Case Type options can be on the UJS internet website at . Social Security Numbers (not Driver’s License Numbers) must be provided for divorce, support, & paternity cases, 42 USC 666(a)(13)(B). All filers are required to provide the SSN or DL# for each of their participants regardless of the case type. Business entities must provide the EIN number in lieu of SSN or DL#. INFORMATION FOR PLAINTIFF/PETITIONER/APPLICANT: INFORMATION FOR DEFENDANT/RESPONDENT: Last/Business Name First Name Middle Suffix Physical Address City State Zip Check if Same as Physical Mailing Address City State Zip Date of mo/day/ yr Home: Work: Cell: - Social Security No. Driver’s License No. State Employer ID (if def is a business) Attorney: Last Name First Phone No. . State Bar ID # Mailing Address City State Zip
CASE%20FILING%20STATEMENT%20Fillable.docx