1eed3669-3d6e-4a0d-9d4d-98a4d82a14eb_PreTrialStatementConfInfoFormParentingPlanHistoryVerificationPacket080524_needs_help-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

Social Security Number SSN for third

alternative reference number for third additional

Financial Account Number for third

minor with the initials of

alternative reference number for third additional

and the full name of

Driver’s License Number for third

full name of minor

State of Issuance for third

alternative reference number for third additional

State Identification Number for third

full name of additional adult

alternative reference number for fourth additional

Social Security Number for additional

alternative reference number for fourth additional

Financial Account Number for additional

initials of additonal minor

alternative reference number for fourth additional

Drivers License Number for additional

full name of additional minor

date of birth of additional minor

State of Issuance for third

alternative reference number for fourth additional

State Identification Number for additional

_____________________________

SSN ___

(full name of adult)

FAN ___

This information pertains to a

minor with the initials of ____

DLN ___

and the full name of

_____________________________

and date of birth: __________

State of Issuance:

SID ___

_____________________________