Information Sheet {800}

Form 800 INFORMATION SHEET Vermont Superior Court Family Division Plaintiff: Name Street Address Apt. or P.O. Box Number City Telephone Numbers Daytime: Email: Nighttime: State Zip Unit Docket Number Defendant: DOB / / vs. Name Street Address Apt. or P.O. Box Number City Telephone Numbers Daytime: Email: Nighttime: State DOB / / Zip Attorney Name and Phone Number Attorney Name and Phone Number Check if this form is being filed by OCS. 1. PUBLIC ASSISTANCE from Department of Economic Services (such as Reach-Up, Dr. Dynasaur, Medicaid, Post Secondary Education Stipend [PSE]) I receive Public Assistance. 2. ASSISTANCE FROM THE OFFICE OF CHILD SUPPORT (OCS) I receive assistance from OCS. The other party receives assistance from OCS (leave this box blank if you are unsure). The Office of Child Support can help people with child support. If you would like to have OCS help you, you can call the Toll-Free Help Line: 1-800-786-3214 or TTY Access No. 1-800-253-0191. 3. OTHER FAMILY/JUVENILE/PROBATE COURT PROCEEDINGS None Cases involving yourself, the other party and/or your children (list below) County State Name of Court (Family, Probate, etc.) For Family Court Staff: Filing Fee Paid:$ Service Fee Paid:$ Receipt #: IFP? American LegalNet, Inc. www.FormsWorkFlow.com