Free 2F-P-345KidsFirstInfo - Hawaii

STATE OF HAWAI`I
FAMILY COURT SECOND CIRCUIT

KIDS FIRST INFORMATION SHEET

CASE NUMBER

FC-D:

PLAINTIFF
NAMES: _____________________________________ ____________________________________________
MOTHER/FATHER

DEFENDANT
NAMES: _________________________________ ________________________________________
MOTHER/FATHER

ADDRESS: ___________________________________ ____________________________________________ TELEPHONE: _________________________________

ADDRESS: _______________________________ ________________________________________ TELEPHONE: _____________________________

DATE OF PROGRAM: C-H-I-L-D-R-E-N
NAME 1. ______________________________ 2. ______________________________ 3. ______________________________ 4 ______________________________ 5. ______________________________ SEX ____ ____ ____ ____ ____ AGE/DATE OF BIRTH ________________ ________________ ________________ ________________ ________________ LIVING W/WHOM? _________________ _________________ _________________ _________________ _________________

DO NOT WRITE BELOW THIS LINE · FOR STAFF USE ONLY ATTENDED NOTES (Y/N) FATHER ___ _____________________________________________ MOTHER ___ CHILD 1 CHILD 2 CHILD 3 CHILD 4 CHILD 5 ___ ___ ___ ___ ___ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ VERIFICATION (INL) (DATE) _________________ _________________ _________________ _________________ _________________ _________________ _________________

COMMENTS: ____________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ IF EITHER PARENT LIVES ON THE ISLAND OF O`AHU, HAWAI`I OR KAUA`I, THAT PARENT MAY ATTEND
THAT ISLAND'S SEPARATION/DIVORCE EDUCATION PROGRAM. FOR FURTHER INSTRUCTIONS CALL: O`AHU - FAMILY COURT ADULT SERVICES 538-5878, HAWAI`I 959-5054/933-0571 OR KAUA`I 246-3350
Reprographics (01/09) KIDS FIRST INFORMATION SHEET 2F-P-345

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