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Washington Sealed Financial Source Document Form

This form functions as a cover sheet for any confidential document to be submitted to the Court. Confidential documents can be bank statements or any of the forms that Petitioners and Defendants file with the Court Clerk.

Extracted Text for Proper Search

Sealed Fin Source Doc (SEALFN) - Page 1 of 1 
WPF DRPSCU 09.0220 (6/2006) - GR 22(b)(8). (f))	
Superior Court of Washington 
County of	 	
In re:	 	
Sealed Financial Source 
(Cover Sheet)	 	
Clerk’s Action Required  	
Sealed Financial Source Documents 	
(List documents below and write "Sealed" at least one in ch from the top of the first page of each document.) 
[ ]  Income Tax records 
[ ]  Pay Stubs 
[ ]  Credit Card Statements 
[ ]  Bank statements 
[ ]  Checks or the equivalent 
[ ]  Check registers 
[ ]  Loan application documents 
[ ]  Retirement plan orders 
[ ]  Other 
 Submitted by: 	
Notice:  The other party will have access to these financial source documents.  If you are 
concerned for your safety or the safety of the children, you may redact (block out or 
delete) information that identifies your location.
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