New Hampshire Personal Data Sheet Form

The Personal Data Sheet is a form that is used for telling the court the exact type of case being filed in addition to the Petitioner and Defendant in that case.

Extracted Text for Proper Search

NHJB-2077-FS (12/27/2007) Page 1 of 1 	
 
 	THE STATE OF NEW HAMPSHIRE	 	
JUDICIAL BRANCH 
http://www.courts.state.nh.us	 	
 	
Court Name:  
Case Name: 
Case Number: 
  (if known)  	
 
 
 	
PERSONAL DATA SHEET 	
1. Name of person(s) completing this form           	 	
 (Check if applicable) Because I believe that my safety , or the safety of my children is at risk, I request 
that the information contained in this Personal Data Sheet not be disclosed to the other party.  The 
reasons are:              	
 
2.  Type of case filed today:  	
 Petition for Divorce 	 Petition for Legal Separation 	 Joint Petition for Legal Separation 	
 Joint Petition for Divorce 	 Domestic Violence Petition 	
 Petition for Civil Union Dissolution 	 Parenting Petition 	
 Joint Petition for Civil Union Dissolution 	 Paternity/Legitimation 	
 Petition to Change Court Order/Modification 	 Other:      	 
3. Name of Petitioner        	
 Date of Birth        	 
State of Birth       	
 Social Security Number        	 
Residence Address             
 
Mailing Address (if different)            
 
Phone number (home)       	
 (work)      	 
E-mail Address              
 
Employer’s Name and Address            
 
4. Name of Respondent        	
 Date of Birth        	 
State of Birth       	
 Social Security Number        	 
Residence Address             
 
Mailing Address (if different)            
 
Phone number (home)       	
 (work)      	 
E-mail Address              
 
Employer’s Name and Address            
 
5.  Child(ren)’s Full Name(s)    Date of Birth    Social Security #    State of Birth                 
 
               
 
               
 
     	
          	 	
Date       Signature 
     	          	 	
Date       Signature (if joint petition)