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					                           SUPERIOR COURT OF ARIZONA - GILA COUNTY
                                 COVER SHEET – DOMESTIC RELATIONS

                                      Case No. DO -

                       Petitioner                                                  Respondent

Name:                                                       Name:
Mailing Address:                                            Mailing Address:
City and State:                                             City and State:
Telephone:                                                  Telephone:
Employer:                                                   Employer:
Mailing Address:                                            Mailing Address:
Telephone:                                                  Telephone:

                 Attorney(s) for Petitioner                               Attorney(s) for Respondent
Address:                                                   Address:
City, State, Zip:                                          City, State, Zip:
Telephone:                                                 Telephone:
State Bar No.                                              State Bar No.


                                                   Minor Children
                        Name                                                  Current Residence




   This Case Does Have A Related IV-D Case
   This Case Does Not Have A Related IV-D Case

   There Is Currently A Wage Assignment In Effect
   There Is Not Currently A Wage Assignment In Effect
                         (Please Check Appropriate Categories for type of Domestic Relations case)
    DO - Domestic Relations
      DO1 Dissolution with Children                                      D16 Foreign Judgment Other than Support
      DO2 Dissolution without Children                                   D17 URESA (from other jurisdiction)
      D11 Legal Separation                                               D23 URESA (initiating from our jurisdiction
      D12 Paternity/Maternity                                            D18 Out of County Judgment
      D13 Annulment                                                      D19 Establish Support
      D14 Custody                                                        D20 Habeas Corpus (custody)
      D15 Order Of Protection                                            D21 Visitation
      D40 Emergency Order of Protection                                  D30 Other Domestic Relations
                                                                                       Superior Court of Arizona, Gila County
                                                                                                       Form 101 (Rev. 02-11)

				
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posted:11/29/2011
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