Initial Information – Paternity Step 1 of 2 50% This information is necessary to file your initial pleadings and the process cannot begin until we have this information fully completed.Name(Required) First Middle Last Preferred Name (if different) First Middle Last Address(Required) Street Address City State / Province / Region ZIP / Postal Code SSN(Required)This information is stored securely. DOB(Required) Month Day Year Birthplace(Required)Include city, county and stateHow long have you lived in Nebraska/Iowa?(Required)Has there been emotional or physical abuse in the relationship?(Required) Yes No If yes, please explain(Required) INFORMATION ABOUT CO-PARENTCo-Parent's Name(Required) First Middle Last Email(Required) Address(Required) Street Address City State / Province / Region ZIP / Postal Code SSN(Required)Information Stored SecurelyDate of Birth Month Day Year BirthplaceInclude City County StateAgePhone NumberWhat needs to be modified and why (ex: child support, custody?)INFORMATION ABOUT YOUR CHILDREN: (Minor Children only. If needed, Social Security numbers can be found on your previous tax returns.)Name First Last Date of Birth MM slash DD slash YYYY SSNGenderMaleFemaleName First Last Date of Birth MM slash DD slash YYYY SSNGenderMaleFemaleName First Last Date of Birth MM slash DD slash YYYY SSNGenderMaleFemaleName First Last Date of Birth MM slash DD slash YYYY SSNGenderMaleFemaleWhose name is listed on the child’s birth certificate?Please state all addresses where your children have lived for the last five years including the dates that the children were at each location (this and other information is requested by the Bureau of Vital Statistics for all divorces in Nebraska):Current Address(Required) Street Address City State / Province / Region ZIP / Postal Code With whom lived at this addressDates at this AddressPrevious Address Street Address City State / Province / Region ZIP / Postal Code With whom lived at this addressDates at this AddressPrevious Address Street Address City State / Province / Region ZIP / Postal Code With whom lived at this addressDates at this AddressAre you now, or have you ever been, involved in any other Court proceedings regarding your children?YesNoIf yes, please explain those proceedings including which County and a case number if you have itDoes anyone, other than you or your co-parent, claim any rights to visitation or custody of your children?YesNoIf yes, please explainHave there ever been any other custody actions regarding your children or protection orders against you or your co-parent?YesNoIf yes, please explainAre you or your co-parent currently in the military:YesNoIf yes, please explain (include rank, dates and any other relevant information)Have you or the co-parent ever been convicted of a crime?YesNoIf yes, please explainWho covers health insurance for the children? I Do Co-Parent N/A What custody arrangements are you seeking? Joint Primary In some cases, the judge could order, or the parties could agree, that one person will pay some of the attorney fees of the other. This request should be included in the initial filing documents that we will prepare. Just requesting this will not guarantee that it will be ordered or agreed. Do you want us to include a request for some of your attorney fees to be paid by the other party in your case? Yes No Δ
