849e5f8c-eeec-4727-806a-bf86f58de6f7_1eed3669-3d6e-4a0d-9d4d-98a4d82a14eb_PreTrialStatementConfInfoFormParentingPlanHistoryVerificationPacket080524_needs_help-remediated-artifacted.pdf — PaddleOCR-VL (Baidu)

CONFIDENTIAL INFORMATION FORM

Additional page (if necessary)

This Information Pertains to:	Confidential Information:	References in Filing:
	Social Security Number (SSN):	Alternative Reference:SSN ___
(full name of adult)ORThis information pertains to a minor with the initials of ___ and the full name of	Financial Account Number (FAN):	Alternative Reference:FAN ___
	Driver License Number (DLN):	Alternative Reference:DLN ___
(full name of minor)and date of birth: ___	State of Issuance:	Alternative Reference:SID ___
(full name of minor)and date of birth: ___	State Identification Number (SID):	Alternative Reference:SID ___
	Social Security Number (SSN):	Alternative Reference:SSN ___
(full name of adult)ORThis information pertains to a minor with the initials of ___ and the full name of	Financial Account Number (FAN):	Alternative Reference:FAN ___
	Driver License Number (DLN):	Alternative Reference:DLN ___
(full name of minor)and date of birth: ___	State of Issuance:	Alternative Reference:SID ___
(full name of minor)and date of birth: ___	State Identification Number (SID):	Alternative Reference:SID ___
	Social Security Number (SSN):	Alternative Reference:SSN ___
(full name of adult)ORThis information pertains to a minor with the initials of ___ and the full name of	Financial Account Number (FAN):	Alternative Reference:FAN ___
	Driver License Number (DLN):	Alternative Reference:DLN ___
(full name of minor)and date of birth: ___	State of Issuance:	Alternative Reference:SID ___
(full name of minor)and date of birth: ___	State Identification Number (SID):	Alternative Reference:SID ___

full name of additional adult

alternative reference number for third additional (format: numeric)

Social Security Number SSN for third (format: numeric)

and the full name of

alternative reference number for third additional (format: numeric)

Financial Account Number for third (format: numeric)

minor with the initials of

alternative reference number for third additional (format: numeric)

Driver’s License Number for third (format: numeric)

State of Issuance for third

full name of minor (format: mm/dd/yyyy)

alternative reference number for third additional (format: numeric)

State Identification Number for third (format: numeric)

full name of additional adult

alternative reference number for fourth additional (format: numeric)

Social Security Number for additional (format: numeric)

full name of additional minor

alternative reference number for fourth additional (format: numeric)

Financial Account Number for additional (format: numeric)

initials of additonal minor

alternative reference number for fourth additional (format: numeric)

Drivers License Number for additional (format: numeric)

State of Issuance for third

date of birth of additional minor

alternative reference number for fourth additional (format: numeric)

State Identification Number for additional (format: numeric)

Text Field: full name of adult5

Text Field: SSNalternative reference number5 (format: numeric)

Text Field: Social Security Number5 (format: numeric)

Text Field: full name of minor5

Text Field: FANalternative reference number5 (format: numeric)

Text Field: Financial Account Number5 (format: numeric)

Text Field: minors' initials5

Text Field: DLNalternative reference number5 (format: numeric)

Text Field: Drivers License Number5 (format: numeric)

Text Field: minor's date of birth5

Text Field: State of Issuance5

Text Field: SIDalternative reference number5 (format: numeric)

Text Field: State Identification Number5 (format: numeric)