CONFIDENTIAL INFORMATION FORM (Required by SDCL 15-15A-9)

_______________________________      Case No. _______________
Plaintiff/Petitioner

_______________________________
Defendant/Respondent

The information on this form is protected and shall not be placed in a publicly accessible portion of the court record. The filing documents will be placed in the public part of the court record devoid of this information.

NAME	SOCIAL SECURITY NUMBER, EMPLOYER
	IDENTIFICATION NUMBER, TAXPAYER
	IDENTIFICATION NUMBER, AND
	FINANCIAL ACCOUNT NUMBERS

Plaintiff/Petitioner
1. ___________________________________________________________________________

Defendant/Respondent
1. ___________________________________________________________________________

Other Parties (including minor children)

1. ___________________________________________________________________________
2. ___________________________________________________________________________
3. ___________________________________________________________________________
4. ___________________________________________________________________________
5. ___________________________________________________________________________
6. ___________________________________________________________________________
7. ___________________________________________________________________________
8. ___________________________________________________________________________

Information supplied: ____________________

Signed: ____________________

Firm:
Address:
Date:

---

Documents to be recorded in the Register of Actions by caption as confidential.

Source: SL 2005, ch 291 (Supreme Court Rule 05-05), effective Feb. 25, 2005; SL 2006, ch 331 (Supreme Court Rule 06-57), eff. July 1, 2006.

CONFIDENTIAL FINANCIAL DOCUMENTS INFORMATION FORM
(Required by SDCL 15-15A-9)

_______________________________      Case No. ________________
Plaintiff/Petitioner

_______________________________
Defendant/Respondent

This form and the attached documents are protected and will be filed in a non-public part of the record.

	Document	Period Covered
	Income Tax Returns
	Financial Account Statements
	Wage Stubs
	Credit Card Account Statements
	W2's and Schedules
	Check Registers
	Other (list below)

Information supplied: ____________________

Signed: _____________________

Firm:
Address:
Date:

Documents to be recorded in the Register of Actions by caption as confidential.

Source: SL 2005, ch 291 (Supreme Court Rule 05-05), effective Feb. 25, 2005; SL 2006, ch 331 (Supreme Court Rule 06-57), eff. July 1, 2006.