Transcription of PETITIONER'S CIVIL CASE INFORMATION STATEMENT …
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SCA-FC-103: PETITIONER'S CIVIL case INFORMATION STATEMENT - domestic relations Cases Review Date: 06/2014; Revision Date: 06/2014; WVSCA Approved: 06/17/2014 Page 1 of 2IN THE FAMILY COURT OF COUNTY, WEST VIRGINIAIN RE: The Marriage / Children Of: case :Petitioner (First/Middle/Last). andRespondent (First/Middle/Last), PETITIONER'S CIVIL case INFORMATION STATEMENT domestic relations CASESPETITIONER'S IDENTIFYING INFORMATIONIMPORTANT NOTICES treet AddressCity / State / Zip Code()-Phone NumberMale /Female--Social Security Number//Date of BirthRace:American Indian/Alaskan NativeAsian or Pacific IslanderUnknownHispanicBlackWhiteCheck this box if you wish to keep the INFORMATION in this box CONFIDENTIAL because you fear for your safety and/or the safety of your children.
SCA-FC-103: Petitioner's Civil Case Information Statement-Domestic Relations Cases Review Date: 06/2014; Revision Date: 06/2014; WVSCA Approved: 06/17/2014
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