Date Occupational/Professional License If yes, type: Yes No 35. Member of the Armed Forces If yes, Branch Yes No Active Retired From To Veterans Benefits Yes No 36. Please provide the information below and any other information you believe may help find the mother. Include all addresses where relatives might live and the type of income and assets the mother may have. Include any additional information on separate pages and attached. Please include a picture of the mother if available. Distinguishing Marks (tattoos/scars/birth marks): SECTION 3 (continued) - Information about the children’s MOTHER Height Weight Race Hair Eye Color Has the mother ever been arrested or convicted? Date of Arrest or Conviction Yes No Do Not Know Name of Parole/Probation Officer City and State of or Conviction Name of the Mother’s Mother (last, first, middle, maiden) Name of the Mother’s Father (last, first, middle) SECTION 4 Information about the Children (These children must have the same father and mother the parents – – listed on this form in Sections 2 and 3.) If there are more than three (3) children, please provide the information about the children on pages 8. 37. Name of Child (last, first, middle, suffix, e.g., Jr.) Social Security Number/ITIN Male Race (optional) Date of Birth Female Is the Father’s name on the Birth Certificate? City of Yes No Do Not Know State of Country of Birth Does the child receive Social Security Benefits? If yes, Monthly Amount: Yes No $ If this child is now in high school, expected date of graduation: Month Year Name of School Address City State/Zip Code Does this child live with you? Do you have legal custody of this child? Yes No Yes No 38. Name of Second Child (last, first, middle, suffix, e.g., Jr.) Social Security Number/ITIN Male Race (optional) Date of Birth Female
Date Occupational/Professional License Yes No If yes, type: 35. Member of the Armed Forces Yes No If yes, Active Retired Branch From To Veterans Benefits Yes No 36. Please provide the information below and any other information you believe may help find the mother. Include all addresses where relatives might live and the type of income and assets the mother may have. Include any additional information on separate pages and attached. Please include a picture of the mother if available. Distinguishing Marks (tattoos/scars/birth marks): SECTION 3 (continued) - Information about the children’s MOTHER Height Weight Race Hair Eye Color Has the mother ever been arrested or convicted? Yes No Do Not Know Date of Arrest or Conviction City and State of or Conviction Name of Parole/Probation Officer Name of the Mother’s Mother (last, first, middle, maiden) Name of the Mother’s Father (last, first, middle) SECTION 4 – Information about the Children (These children must have the same father and mother – the parents listed on this form in Sections 2 and 3.) If there are more than three (3) children, please provide the information about the children on pages 8. 37. Name of Child (last, first, middle, suffix, e.g., Jr.) Social Security Number/ITIN Male Female Race (optional) Date of Birth Is the Father’s name on the Birth Certificate? Yes No Do Not Know City of State of Country of Birth Does the child receive Social Security Benefits? Yes No If yes, Monthly Amount: $ If this child is now in high school, expected date of graduation: Month Year Name of School Address City State/Zip Code Does this child live with you? Yes No Do you have legal custody of this child? Yes No 38. Name of Second Child (last, first, middle, suffix, e.g., Jr.) Social Security Number/ITIN Male Female Race (optional) Date of Birth
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