"Juvenile Cover Sheet" - Kansas

Juvenile Cover Sheet is a legal document that was released by the Kansas Judicial Branch - a government authority operating within Kansas.

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  • Released on December 10, 2014;
  • The latest edition currently provided by the Kansas Judicial Branch;
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JUVENILE COVER SHEET
For Office Use Only
The juvenile cover sheet neither replaces nor supplements the filing and service of pleadings or other papers as required
by law. This form is required for use by the Clerk of the District Court for the purposes of initiating the juvenile docket
sheet. This information will not be available to the public and this document will be stored in a separate location from the
case file and then destroyed within a reasonable time. A new case will not be accepted without a cover sheet attached.
(THIS FORM MUST BE TYPED OR PRINTED LEGIBLY). This form can be found at www.kscourts.org.
JUVENILE
NATURE OF SUIT (Mark only one.)
❐ JUVENILE OFFENDER
CHILD IN NEED OF CARE
❐ Abuse
Neglect
Dependent (no fault)
Termination of Parental Rights
Other Dependency/Child Victim
Status Offense/Petition
CHILD’S INFORMATION
OTHER PARTY’S INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
DL OR STATE ID NO:
DL OR STATE ID NO:
State and Number
State and Number
SSN:
DOB:
SSN:
DOB:
RACE:
RELATIONSHIP TO CHILD:
WHITE
BLACK
ASIAN
PACIFIC ISLAND
AMERICAN INDIAN/ALASKAN
UNKNOWN
GRANDPARENT(S)
CUSTODIAN
FOSTER PARENT(S)
GUARDIAN
PARENT
OTHER
ETHNICITY:
HISPANIC
NON-HISPANIC
UNKNOWN
SEX:
PHONE:
SEX:
ALIAS NAMES USED:
CELL PHONE:
E-MAIL ADDRESS:
KDR TRANSACTION NUMBER:
ALIAS NAMES USED:
ATTORNEYS
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
KDR TRANSACTION NUMBER:
ATTORNEYS (IF KNOWN)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
The requirement that Social Security numbers be included on juvenile cases is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
12/10/2014
JUVENILE COVER SHEET
For Office Use Only
The juvenile cover sheet neither replaces nor supplements the filing and service of pleadings or other papers as required
by law. This form is required for use by the Clerk of the District Court for the purposes of initiating the juvenile docket
sheet. This information will not be available to the public and this document will be stored in a separate location from the
case file and then destroyed within a reasonable time. A new case will not be accepted without a cover sheet attached.
(THIS FORM MUST BE TYPED OR PRINTED LEGIBLY). This form can be found at www.kscourts.org.
JUVENILE
NATURE OF SUIT (Mark only one.)
❐ JUVENILE OFFENDER
CHILD IN NEED OF CARE
❐ Abuse
Neglect
Dependent (no fault)
Termination of Parental Rights
Other Dependency/Child Victim
Status Offense/Petition
CHILD’S INFORMATION
OTHER PARTY’S INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
DL OR STATE ID NO:
DL OR STATE ID NO:
State and Number
State and Number
SSN:
DOB:
SSN:
DOB:
RACE:
RELATIONSHIP TO CHILD:
WHITE
BLACK
ASIAN
PACIFIC ISLAND
AMERICAN INDIAN/ALASKAN
UNKNOWN
GRANDPARENT(S)
CUSTODIAN
FOSTER PARENT(S)
GUARDIAN
PARENT
OTHER
ETHNICITY:
HISPANIC
NON-HISPANIC
UNKNOWN
SEX:
PHONE:
SEX:
ALIAS NAMES USED:
CELL PHONE:
E-MAIL ADDRESS:
KDR TRANSACTION NUMBER:
ALIAS NAMES USED:
ATTORNEYS
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
KDR TRANSACTION NUMBER:
ATTORNEYS (IF KNOWN)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
The requirement that Social Security numbers be included on juvenile cases is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
12/10/2014
ADDITIONAL JUVENILE PARTY INFORMATION
OTHER PARTY’S INFORMATION
OTHER PARTY’S INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
DL OR STATE ID NO:
DL OR STATE ID NO:
State and Number
State and Number
SSN:
DOB:
SSN:
DOB:
RELATIONSHIP TO CHILD:
RELATIONSHIP TO CHILD:
GRANDPARENT(S)
GRANDPARENT(S)
CUSTODIAN
FOSTER PARENT(S)
CUSTODIAN
FOSTER PARENT(S)
GUARDIAN
PARENT
OTHER
GUARDIAN
PARENT
OTHER
PHONE:
SEX:
PHONE:
SEX:
CELL PHONE:
CELL PHONE:
E-MAIL ADDRESS:
E-MAIL ADDRESS:
ALIAS NAMES USED:
ALIAS NAMES USED:
KDR TRANSACTION NUMBER:
KDR TRANSACTION NUMBER:
ATTORNEYS
ATTORNEYS
(IF KNOWN)
(IF KNOWN)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
The requirement that Social Security numbers be included on juvenile cases is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
12/10/2014
ADDITIONAL JUVENILE PARTY INFORMATION
OTHER PARTY’S INFORMATION
OTHER PARTY’S INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
DL OR STATE ID NO:
DL OR STATE ID NO:
State and Number
State and Number
SSN:
DOB:
SSN:
DOB:
RELATIONSHIP TO CHILD:
RELATIONSHIP TO CHILD:
GRANDPARENT(S)
GRANDPARENT(S)
CUSTODIAN
FOSTER PARENT(S)
CUSTODIAN
FOSTER PARENT(S)
GUARDIAN
PARENT
OTHER
GUARDIAN
PARENT
OTHER
PHONE:
SEX:
PHONE:
SEX:
CELL PHONE:
CELL PHONE:
E-MAIL ADDRESS:
E-MAIL ADDRESS:
ALIAS NAMES USED:
ALIAS NAMES USED:
KDR TRANSACTION NUMBER:
KDR TRANSACTION NUMBER:
ATTORNEYS
ATTORNEYS
(IF KNOWN)
(IF KNOWN)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
The requirement that Social Security numbers be included on juvenile cases is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
12/10/2014
ADDITIONAL JUVENILE PARTY INFORMATION
OTHER PARTY’S INFORMATION
OTHER PARTY’S INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
DL OR STATE ID NO:
DL OR STATE ID NO:
State and Number
State and Number
SSN:
DOB:
SSN:
DOB:
RELATIONSHIP TO CHILD:
RELATIONSHIP TO CHILD:
GRANDPARENT(S)
GRANDPARENT(S)
CUSTODIAN
FOSTER PARENT(S)
CUSTODIAN
FOSTER PARENT(S)
GUARDIAN
PARENT
OTHER
GUARDIAN
PARENT
OTHER
PHONE:
SEX:
PHONE:
SEX:
CELL PHONE:
CELL PHONE:
E-MAIL ADDRESS:
E-MAIL ADDRESS:
ALIAS NAMES USED:
ALIAS NAMES USED:
KDR TRANSACTION NUMBER:
KDR TRANSACTION NUMBER:
ATTORNEYS
ATTORNEYS
(IF KNOWN)
(IF KNOWN)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
(FIRM NAME, ADDRESS, TELEPHONE NUMBER AND SUPREME COURT ID NUMBER)
The requirement that Social Security numbers be included on juvenile cases is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
12/10/2014
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