90fdce07-c6ae-4263-92db-680eed562b05_PreTrialStatementConfInfoFormParentingPlanHistoryVerificationPacket080524_need_help-artifacted.pdf — PaddleOCR-VL (Baidu)

Abuse Victim Addendum Additional page (if necessary)

Divorce, Annulment, Dissolution of Marriage Support	Paternity	Child Custody Protection from Abuse
Type of Family Court Action
This Information Pertains to:	Confidential Information:	References in Filing:
	AV Address:	Alternative Reference:AV ___ Address
(full name of abuse victim)	AV Employer's Name & Address:	Alternative Reference:AV ___ Employer's Name & Address
Docket/Case No. of Protection Order	AV Work Schedule:	Alternative Reference:AV ___ Work Schedule
Court/County	AV Other contact information:	Alternative Reference:AV ___ Other contact information
Type of Family Court Action
Divorce, Annulment, Dissolution of Marriage Support	Child Custody Protection from Abuse
This Information Pertains to:	Confidential Information:	References in Filing:
	AV Address:	Alternative Reference:AV ___ Address
(full name of abuse victim)	AV Employer's Name & Address:	Alternative Reference:AV ___ Employer's Name & Address
Docket/Case No. of Protection Order	AV Work Schedule:	Alternative Reference:AV ___ Work Schedule
Court/County	AV Other contact information:	Alternative Reference:AV ___ Other contact information

check if divorce, annulment or dissolution of marriage2

check if child custody2

check if paternity2

check if support2

check if protection from abuse2

alternative reference number2 address

Abuse victim2 address

Full name of abuse victim2

alternative reference number2 employer name and address

Abuse victim2 employer name and address

Docket/Case No. of Protection Order2

alternative reference number2 work schedule

Abuse victim2 work schedule

County/Court2

alternative reference number2 other contact information

Abuse victim2 other contact information

check if child custody3

Check if divorce, annulment or dissolution of marriage3

check if paternity3

check if support3

check if protection from abuse3

alternative reference number3

Abuse victim3 address

Full name of abuse victim3

alternative reference number3 employer name and address

Abuse victim 3 employer name and address

Docket/Case No. of Protection Order3

alternative reference number 3 work schedule

Abuse victim3 work schedule

Court/County3

alternative reference number3 other contact information

Abuse victim 3 other contact information