APPENDIX A

YUMA COUNTY SUPERIOR COURT Attachment C DOMESTIC RELATIONS COVER SHEET AND POST ADJUDICATION PETITIONS' COVER ARE YOU THE PETITIONER? ​ ARE YOU THE RESPONDENT? ​ CASE NUMBER Name Name Mail Address Mail Address City/St/Zip City/St/Zip Telephone Telephone SS# DOB SS# DOB Employer Employer Address Address City/St/Zip City/St/Zip PETITIONER'S ATTORNEY RESPONDENT'S ATTORNEY/PRO PER Name Name Address Address City/St/Zip City/St/Zip Telephone Telephone State Bar # State Bar # MINOR CHILDREN (For additional children use reverse of this form) NAME DATE OF BIRTH GENDER SOCIAL SECURITY NUMBER THIS CASE DOES HAVE A RELATED IV-D CASE THIS CASE DOES NOT HAVE A RELATED IV-D CASE THERE IS CURRENTLY A WAGE ASSIGNMENT IN EFFECT THERE IS NOT CURRENTLY A WAGE ASSIGNMENT IN EFFECT DO--Domestic Relations D16--Foreign Judgment Other than Support D01--Dissolution with Children D17--URESA (from other jurisdiction) D02--Dissolution without Children D18--Out of County Judgment D11--Legal Separation D19--Establish Support D12--Paternity/Maternity D20--Habeas Corpus (custody) D13--Annulment D21--Visitation D14--Custody D30--Other Domestic Relations D15--Order of Protection D40--Emergency Order of Protection Is the Issue: Custody and/or Visitation? Have you ever had an Order of Protection Y/N When? Where?