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Virginia Addendum for Protecting Identifying Information Form

Listed in this form are the divorcing spouses’ respective social security numbers. Bank and credit card numbers, either for separate or joint accounts, are also listed.Download

Extracted Text for Proper Search

ADDENDUM FOR PROTECTED  Case No. 	........................................................................\
..	 
IDENTIFYING INFORMATION— 
CONFIDENTIAL	
  
Commonwealth of Virginia	
 	 
In the Circuit Court of the  [  ]  City   [  ] County of 	........................................................................\
............................. 	  	
 
........................................................................\
................ 	v. 	........................................................................\
.............	 
This addendum is filed with and incorporated by  reference in the document(s) indicated below, from 
which the protected identifying information containe d herein has been removed by the attorney or party 
whose signature appears below. This addendum shall  be used to distribute such information only as 
required by law, and may be made available only to the  parties, to their attorneys, and to other person(s) 
as the court may allow. 
[  ] Complaint  [  ] Petition  [  ] Motion  [   ] Order  [  ] Decree  [  ] Other Pleading: 	
................................................ 	
[  ] Agreement(s) of the Parties  [  ] Transcripts  [  ] Other: 	........................................................................\
............. 
 
. .........	
           	PARTY NAME (LAST, FIRST, MIDDLE)                                                 PARTY NAME (LAST, FIRST, MIDDLE) 	........... .................................................................	 	........................................................................\
................	 
 	
.. ...............                	SOCIAL SECURITY NUMBER                                                            SOCIAL SECURITY NUMBER 	.......... ...........................................................	 	........................................................................\
................	 	
  
NAME OF ASSET, 
LIABILITY, 
ACCOUNT,  
CREDIT CARD  IDENTIFYING ACCOUNT NO. 	 	NAME OF ASSET, 
LIABILITY, 
ACCOUNT,  
CREDIT CARD  IDENTIFYING ACCOUNT NO.  	
  
    
       
       
       
       
       
       
       
       
 
. ...........
             	CHILD NAME (LAST, FIRST, MIDDLE)                             SOCIAL SECURITY NUMBER 	........... ...............................................................	 	........................................................................\
......................	 
 	
.. ...........            	CHILD NAME (LAST, FIRST, MIDDLE)                             SOCIAL SECURITY NUMBER	 
.......... ...............................................................	 	........................................................................\
......................	 	
Attach additional sheet(s) for 
other information, as needed. 
 
...............................................	    _________________________________________________________      	
  	           DATE  	  	                           	[  ]	    PARTY             	[  ]	   ATTORNEY 	
 
 
........................................................................\
............................................................................................................	
 	      PRINT NAME	                             	ADDRESS /TELEPHONE NUMBER OF  SUBSCRIBER
Next: Vermont Marital Settlement Agreement Form Previous: Vermont Notice and Acknowledgment Form
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