Financial Disclosure Form · Step 1 of 4

Parties & Case Info

Name: Write your full name here. This is the person filling out the form. Address: Write the street address where you live or get mail. Phone: Write a phone number where the court can reach you. Email: Write an email address where you can be contacted. Attorney for Name the person the attorney represents. Leave blank if you have no lawyer. Nevada State Bar No. Enter the lawyer's Nevada State Bar number. Leave blank if you have no lawyer. _________ Judicial District Court Write the number of the judicial district court handling your case. _____________________, Nevada Write the city or county in Nevada where the court is located. Plaintiff, Write the name of the person who started the case. Defendant. Write the name of the person the case is filed against. Case No. Write the case number given by the court. Check your court papers if unsure. Dept. Write the department number listed on your court papers. What is your full name? (first, middle, last) Write your complete name in order: first, middle, then last. How old are you? Write how old you are in years. What is your date of birth? Write the day, month, and year you were born. What is your highest level of education? Write the highest grade or degree you finished, like high school or college.

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