Vermont Civil Cover Sheet Form

This form must accompany the divorce complaint filed with the court clerk. Through this sheet, the court is informed of the type of case. Moreover, the format of the sheet allows for the immediate identification of the parties involved.Download

Extracted Text for Proper Search

Rev. 1/06 SML

Form 800


Docket Number

Vermont 
County

COVER
SHEET 
Family Court 
The Other Party's Name

Your Name 
Street Address

Street Address 
Zip Code
Town/City
Zip Code

Town/City 
Telephone Numbers
Telephone Numbers

Home:

Work: Date of Birth

Date of Birth

SEE INSTRUCTIONS ON BACK OF THIS COVER SHEET 
State

State

Mailing Address

Mailing Address

Cell:

1. Filing fee I am enclosing $Because of my financial circumstances, I am asking that the filing fee be waived.  IFP attached.
This form is being filed by OCS.
2. Service Fee
3. Public Assistance (e.g. Reach-Up; Dr. Dynosaur; Medicaid; Post Secondary Education Stipend (PSE)) a. I receive public assistanceb. The other party receives public assistance
a. I receive assistance from OCS b. The other party receives assistance from OCS
4. Assistance from Office of Child Support (OCS) 
Cell:

as my filing fee.
Because of my financial circumstances, I am asking that the filing fee be waived.  IFP attached. I am enclosing $
to pay for service.
A service fee is not required.
yesno
yesno
yes no
yesno
The Office of Child Support can help people with child support.  If you would like to have OCS help you,
you can call the Toll-Free Help Line: 1-800-786-3214 or TTY Access Number 1-800-253-0191.

5. Other Family/Probate/Juvenile Court Proceedings
There are other court proceedings involving myself, and the other party, and/or cases involving our children.
If so, please provide the following information:
 Name of Court (e.g. Probate, Family,
and Juvenile) County
State
To be filled out by Family Court Staff: Amount rec'd: $ Type of MPR filed:
Service Option:
Personal Service
1st Class Mail
Service Complete Check
Cash
Money Order
Party/Atty will serve
MPR #: 
Work:

Home:

don't know don't know
IFP Filed
Complete sections 3 and 4 if you have minor children.
Certified Mail

Instructions

2. Service Fee

Rev. 1/06 SML 
Service is a way of documenting that the other party has actually received the paperwork.  There are several
methods of service.  The clerk can help you choose which method is best for you.  You must pay a fee for service
unless the court has found that you are financially unable to pay the filing fee. In that case, the court will pay for
service.  If you have questions, ask the clerk or consult the judiciary website at: www.vermontjudiciary.org.

Case with minor children:  If you are filing a case involving minor children or seeking relief related to child
support, the court clerk is responsible for serving the summons, complaint, or petition and notice of hearing on
the other party at your expense, unless you qualify for a waiver of the fee.

Cases without minor children:  If you are filing a new case which does not involve minor children or if you are
seeking relief not related to child support, you are responsible for serving the other party.  Ask the clerk for
information about "service of process."

If you are represented by an attorney, your attorney may choose to serve all paperwork on the other party.


Check the box for Public Assistance if you receive any of the following: Reach-Up; Dr. Dynosaur; Medicaid;
Post Secondary Education Stipend (PSE).  Do not check the box if you only receive food stamps and/or fuel
assistance.
 
 You must list all other court proceedings involving yourself, and the other party or cases involving your children.
3.  Public Assistance a) Amount of fee:  The amount of the filing fee varies depending on what you are filing.  If you don't know
the amount of the fee, ask the clerk or consult the judiciary website at: www.vermontjudiciary.org.

b) Checks:  Make checks payable to Vermont Family Court.

c) IFP:  If you cannot afford the fee, you may ask the Court to waive the fee by filing an IFP (in forma
pauperis) application.  Ask the clerk for the application or consult the judiciary website at:
www.vermontjudiciary.org.

1.  Filing Fee
The Office of Child Support Services can help people to choose the best method for collecting child support,
prepare court forms, prepare financial affidavits, locate absent parents, and assist persons at a child support
hearing before a Magistrate. If you would like their assistance and services; please call: 1-800-786-3214.
4.  Office of Child Support
5.  Other Family/Probate/Juvenile Fill in all of the information in the top box (name through date of birth).  You must provide information both about
yourself and about the party on the other side of your case.