Form DC3:03 "Confidential Address Information" - Nebraska

What Is Form DC3:03?

This is a legal form that was released by the United States District Court for the District of Nebraska - a government authority operating within Nebraska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2018;
  • The latest edition provided by the United States District Court for the District of Nebraska;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DC3:03 by clicking the link below or browse more documents and templates provided by the United States District Court for the District of Nebraska.

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Download Form DC3:03 "Confidential Address Information" - Nebraska

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Nebraska State Court Form
CONFIDENTIAL ADDRESS
DC 3:03
NEW 09/18
INFORMATION
Neb. Rev. Stat. §§ 42-1201-
42-1210, 29-4303
IN THE
COURT OF __________________COUNTY, NEBRASKA
_________________________________________
(County or District)
______________________________________,
Petitioner,
Case No. ____________________
vs.
CONFIDENTIAL ADDRESS
__________________________________,
INFORMATION
Respondent,
THIS INFORMATION IS CONFIDENTIAL
I, _______________________________, am the petitioner in the above-entitled action.
I have received address protection from the Secretary of State pursuant to the Address
Confidentiality Act (Neb. Rev. Stat. §§ 42-1201- 42-1210)
I currently reside at a safe house, abuse shelter, or other facility that provided temporary
emergency shelter and am bound by the limitation of disclosure as set forth in Neb. Rev. Stat. §
29-4303(2).
The address where the court may mail information regarding my case is listed below. I
understand that the below information will be kept confidential by the court.
Date
Signature
Name
Street Address/P.O. Box
City/State/ZIP Code
Phone
E-mail Address
Page 1 of 1
Confidential Address Information
DC 3:03 NEW 09/18
Nebraska State Court Form
CONFIDENTIAL ADDRESS
DC 3:03
NEW 09/18
INFORMATION
Neb. Rev. Stat. §§ 42-1201-
42-1210, 29-4303
IN THE
COURT OF __________________COUNTY, NEBRASKA
_________________________________________
(County or District)
______________________________________,
Petitioner,
Case No. ____________________
vs.
CONFIDENTIAL ADDRESS
__________________________________,
INFORMATION
Respondent,
THIS INFORMATION IS CONFIDENTIAL
I, _______________________________, am the petitioner in the above-entitled action.
I have received address protection from the Secretary of State pursuant to the Address
Confidentiality Act (Neb. Rev. Stat. §§ 42-1201- 42-1210)
I currently reside at a safe house, abuse shelter, or other facility that provided temporary
emergency shelter and am bound by the limitation of disclosure as set forth in Neb. Rev. Stat. §
29-4303(2).
The address where the court may mail information regarding my case is listed below. I
understand that the below information will be kept confidential by the court.
Date
Signature
Name
Street Address/P.O. Box
City/State/ZIP Code
Phone
E-mail Address
Page 1 of 1
Confidential Address Information
DC 3:03 NEW 09/18