The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

LIT Lab Home | About The Explorer | Find & Compare | Explore: Michigan Lists

Here is the text we could read:

To the Clerk: For FOC office

Complete this form and sign on page 5.

YOUR GENERAL INFORMATION

1. Your full name

2. Date of birth

3. Place of birth: city and state

4. Address City State Zip

5. Home telephone

6. Work telephone

7. Social security number

8. Driver’s license no.

9. Professional license, type and no.

10. Cell phone

11. E-mail address

13. Eye color

14. Hair color

15. Height

16. Weight

17. Race

18. Scars, tattoos, etc.

12. Sex
M

F
19. Your father’s full name

20. Your mother’s full maiden name

21. Children in common with other parent in this case

Birthdate

Gender

SSN

Current
grade
level

Anticipated month
and year of high
school graduation

No. of overnights
you have with
child annually

22. Names of other biological/adopted minor children
you support

Birthdate

Address

23. Are you pregnant?

a. When is the child due?

Yes

b. Is the other party in this case the biological parent of the

expected child?

Yes

24. Are you presently married?

Yes

YOUR INCOME, MEDICAL, EDUCATIONAL, AND HEALTH INSURANCE INFORMATION

25. Your occupation

26. Your employer (if unemployed, name of last employer)

27. Employer’s address City State Zip

28. Date hired

29. Gross earnings per pay period (earnings before taxes)
weekly

biweekly

31. Hourly pay rate (including shift premium and
COLA)

bimonthly

monthly

32. Total regular hours worked per pay period

30. Filing status

single
married

dependents claimed

head of household

33. Average overtime hours for past 12
months

Approved, SCAO
Form FOC 39, Rev. 6/22
Page 1 of 5

STATE OF MICHIGANJUDICIAL CIRCUITCOUNTYFRIEND OF THE COURTCASE QUESTIONNAIRECASE NO. and JUDGEFriend of the court addressTelephone no.PlaintiffvDefendantFriend of the Court - Case Questionnaire
Page 2 of 5

(6/22)

Case No.

YOUR INCOME, MEDICAL, EDUCATIONAL, AND HEALTH INSURANCE INFORMATION (continued)

34. Second job

35. Employer

36. Employer’s address City State Zip

37. Date hired

38. Gross earnings per pay period (earnings before taxes)
weekly

biweekly

bimonthly

monthly

39. Hourly pay rate 40. Average hours worked per pay

period since hire date

41. If unemployed and not receiving unemployment or worker’s compensation benefits, or working part-time only, provide the following information:

Name of last full-time employer

Address of last full-time employer

Position held at last place of full-time employment

Last day employed full-time

Length of time employed in last full-time position

Reason for leaving last full-time employment

Gross earings per pay period (earnings before taxes)

weekly

biweekly

bimonthly

monthly

42. List MONTHLY income from all other sources, such as:

Commissions

Bonuses

Profit Sharing

Interest

Dividends

Annuities

Pensions/Longevity

Deferred Comp./IRA

Trust Funds

Unemp. Benefits

Strike Pay

SUB Pay

Sick Benefits

Workers’ Comp.

Soc. Sec. Benefits

VA Benefits

Disability Insurance

GI Benefits

Nat’l Guard & Res. Drill Pay

Armed Services

Allowance for Rent

Rental Income

Spousal Support/Alimony

State Disability Assistance

Supp. Security Income SSI

F I P

Other

43. Do you have any spousal support/alimony orders involving another person not a parent in this case?

If so, complete a. b. and c.

Yes, as payer

Yes, as recipient

a. Amount of order (do not include arrearages)

b. Type of order/Case no.

c. City, county, and state

44. Do any of the children listed on item 21 and 22 receive payments from the Social Security Administration?

Yes

Child’s
Name

Amount
(monthly)

Type of benefit (check one)

SSI

Dependent benefit

Source of dependent benefit
(mother, father, stepparent)

45. Attach your four most recent paycheck stubs, or a statement from your employer(s) of wages and deductions, and year-to-date earnings, and a copy
of your last federal and state income tax returns, including all schedules. If self-employed, also attach a copy of your three most recent business
tax returns and/or corporation returns.
46. Do you have any medical conditions/restrictions that affect your ability to work?
If yes, please explain medical condition/restriction:

Yes

47. What is your educational background? (Check one)

less than high school
Associate’s degree

High school graduate
Bachelor’s degree

Trade school graduate
Graduate degree

Friend of the Court - Case Questionnaire
Page 3 of 5

(6/22)

Case No.

YOUR INCOME, MEDICAL, EDUCATIONAL, AND HEALTH INSURANCE INFORMATION (continued)

48. Medical insurance company name, address, telephone no. Policy/Group number Beginning date, if known

49. Dental insurance company name, address, telephone no. Policy/Group number Beginning date, if known

50. Optical insurance company name, address, telephone no. Policy/Group number Beginning date, if known

51. What dependent coverage is available to you without cost?

Medical

Dental

Optical

per

Medical

52. What dependent coverage is available by payment of an additional premium? (Specify cost per pay period.)

53. Individuals currently covered by your insurance
Name Birthdate Relationship Medical ( ) Dental ( ) Optical ( )

Optical

per

Dental

per

YOUR CHILD-CARE INFORMATION

54. Do you have child-care expenses for the minor children in this domestic relations case during any time of the year?
If yes, complete the following information.
Name of child-care provider

Names of children receiving child care

Yes

Number of weeks provided during last calendar year

Estimated number of weeks of child care provided in this calendar year

Current weekly child-care cost.

Amount of child-care credit received on last year’s federal I.R.S. tax return.

Does a federal or state agency or a public or private entity contribute all or a portion of the cost of child-care services? If yes, please explain.

55. Check the reason(s) which explain why you need child care and estimate the number of hours child care is received for each.
Reason Estimated number of hours per week

improve employment opportunities

Work related
Looking for employment
Enrolled in educational program to

56. If your reason for child care is education related, provide the following information.

Name of educational institution

Total classroom hours per week

Educational goal

Projected graduation date

57. List any additional information about you or the other parent that would be useful to the court in making a support recommendation. For example:
education, disability, or work history.

ADDITIONAL INFORMATION

Friend of the Court - Case Questionnaire
Page 4 of 5

(6/22)

Case No.

INFORMATION REGARDING THE OTHER PARENT IN THIS CASE (if known)

58. Full name

59. Date of birth

60. Place of birth: city and state

61. Address City State Zip

62. Home telephone

63. Work telephone

64. Social security number

65. Driver’s license no.

66. Professional license, type and no.

67. Cell phone

68. E-mail address

70. Eye color

71. Hair color

72. Height

73. Weight

74. Race

75. Scars, tattoos, etc.

69. Sex
M

76. Father’s full name

77. Mother’s full maiden name

78. Names of other biological/adopted minor children
he/she supports

Birthdate

Address

79. Is this party pregnant? a. When is the child due? b. Is the party in this case the biological parent of the expected child? 80. Is this party married?

Yes

81. Occupation

Yes

82. Employer (if unemployed, name of last employer)

Yes

83. Employer’s address City State Zip

84. Date hired

85. Gross earnings per pay period (earnings before taxes)

86. Average overtime hours for past 12 months

87. Medical insurance company name, address, telephone no. Policy/Group number Beginning date, if known

88. Dental insurance company name, address, telephone no. Policy/Group number Beginning date, if known

89. Optical insurance company name, address, telephone no. Policy/Group number Beginning date, if known

Medical

90. What dependent coverage is available to the other parent without cost?

91. What dependent coverage is available by payment of an additional premium? (Specify cost per pay period.)

92. Individuals currently covered by other parent’s insurance
Name Birthdate Relationship Medical ( ) Dental ( ) Optical ( )

Medical

Dental

Optical

per

Dental

Optical

per

Friend of the Court - Case Questionnaire
Page 5 of 5

(6/22)

Case No.

If you want friend of the court services, you must check the box below.

I request child-support services pursuant to the child-support enforcement program of Title IV-D of the Social

Security Act.

I declare under the penalties of perjury that this questionnaire has been examined by me and that its contents are true to
the best of my information, knowledge, and belief.

Date

Signature

Reminder List

• Have you signed this questionnaire?

• Have you completed item 21 regarding the number of overnights you have with the child annually? Failure to specify
will result in the friend of the court estimating the number of overnights.

• Have you attached your four most recent paycheck stubs, or a statement from your employer(s) of wages and
deductions and year-to-date earnings?

• Have you attached a copy of your last federal and state income tax returns, including all schedules, W-2s, and 1099s?
If self-employed, also attach a copy of your three most recent business tax returns and/or corporation returns.

• Attach any additional information that may be useful to the friend of the court in making a support recommendation.
Make sure you use enough postage to cover these additional items.

• Have you attached the Child Care Verification (form FOC 39e) if you are asking for reimbursement of child-care
expenses?

• Make a copy of this form for your own records.

• Send the original form, completed and signed, to the friend of the court office.

FOC 39, Friend of the Court, Case Questionnaire

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/Domestic-Relations (2023-03)
Page(s): 5
Fields(s): 321
Average fields per page: 64
Reading Level: Grade 8
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

plaintiff was Plaintiff (1.00 conf)
defendant was Defendant (1.00 conf)
full_name__1 was 1 Your full name (0.40 conf)
date_birth__1 was 2 Date of birth (0.35 conf)
place_birth_city_state__1 was 3 Place of birth city and state (0.43 conf)
address_city_state_zip__1 was 4 Address City State Zip (0.32 conf)
home_telephone__1 was 5 Home telephone (0.49 conf)
work_telephone__1 was 6 Work telephone (0.49 conf)
social_security_number__1 was 7 Social security number (0.39 conf)
drivers_license__1 was 8 Drivers license no (0.50 conf)
professional_license_type__1 was 9 Professional license type and no (0.39 conf)
cell_phone__1 was 10 Cell phone (0.39 conf)
email_address__1 was 11 Email address (0.41 conf)
eye_color__1 was 13 Eye color (0.33 conf)
hair_color__1 was 14 Hair color (0.33 conf)
height__1 was 15 Height (0.34 conf)
weight__1 was 16 Weight (0.34 conf)
race__1 was 17 Race (0.35 conf)
scars_tattoos_etc__1 was 18 Scars tattoos etc (0.36 conf)
fathers_full_name__1 was 19 Your fathers full name (0.43 conf)
mothers_full_maiden_name__1 was 20 Your mothers full maiden name (0.32 conf)
common_parent_case_row__1 was 21 Children in common with other parent in this caseRow1 (0.40 conf)
birthdate_row__1 was BirthdateRow1 (0.24 conf)
gender_row__1 was GenderRow1 (0.38 conf)
ssn_row__1 was SSNRow1 (0.34 conf)
current_grade_level_row__1 was Current grade levelRow1 (0.39 conf)
month_year_school_graduation_row__1 was Anticipated month and year of high school graduationRow1 (0.30 conf)
child_annually_row__1 was No of overnights you have with child annuallyRow1 (0.33 conf)
common_parent_case_row__2 was 21 Children in common with other parent in this caseRow2 (0.40 conf)
birthdate_row__2 was BirthdateRow2 (0.24 conf)
gender_row__2 was GenderRow2 (0.38 conf)
ssn_row__2 was SSNRow2 (0.34 conf)
current_grade_level_row__2 was Current grade levelRow2 (0.39 conf)
month_year_school_graduation_row__2 was Anticipated month and year of high school graduationRow2 (0.30 conf)
child_annually_row__2 was No of overnights you have with child annuallyRow2 (0.33 conf)
common_parent_case_row__3 was 21 Children in common with other parent in this caseRow3 (0.40 conf)
birthdate_row__3 was BirthdateRow3 (0.24 conf)
gender_row__3 was GenderRow3 (0.38 conf)
ssn_row__3 was SSNRow3 (0.34 conf)
current_grade_level_row__3 was Current grade levelRow3 (0.39 conf)
month_year_school_graduation_row__3 was Anticipated month and year of high school graduationRow3 (0.30 conf)
child_annually_row__3 was No of overnights you have with child annuallyRow3 (0.33 conf)
minor_support_row__1 was 22 Names of other biologicaladopted minor children you supportRow1 (0.42 conf)
birthdate_row__4 was BirthdateRow1_2 (0.27 conf)
address_row__1 was AddressRow1 (0.36 conf)
minor_support_row__2 was 22 Names of other biologicaladopted minor children you supportRow2 (0.42 conf)
birthdate_row__5 was BirthdateRow2_2 (0.27 conf)
address_row__2 was AddressRow2 (0.36 conf)
minor_support_row__3 was 22 Names of other biologicaladopted minor children you supportRow3 (0.42 conf)
birthdate_row__6 was BirthdateRow3_2 (0.27 conf)
address_row__3 was AddressRow3 (0.36 conf)
occupation__1 was 25 Your occupation (0.40 conf)
employer_unemployed_last__1 was 26 Your employer if unemployed name of last employer (0.37 conf)
employers_address_city_state__1 was 27 Employers address City State Zip (0.36 conf)
date_hired__1 was 28 Date hired (0.37 conf)
weekly__1 was weekly (0.28 conf)
bimonthly__1 was bimonthly (0.32 conf)
monthly__1 was monthly (0.28 conf)
dependents_claimed was dependents claimed (0.47 conf)
married was married (0.36 conf)
single was single (0.32 conf)
head_household was head of household (0.45 conf)
total_regular_per_pay_period was 32 Total regular hours worked per pay period (0.27 conf)
circuit was Circuit (0.33 conf)
county was County (0.39 conf)
judge was Judge (0.39 conf)
telephone was Telephone no (0.44 conf)
friend_court_address was Friend of the court address (0.41 conf)
biweekly__1 was biweekly (0.32 conf)
yes__1 was yes2 (0.35 conf)
no2 was no2 (0.39 conf)
yes__2 was yes1 (0.35 conf)
no1 was no1 (0.42 conf)
text__1 was Text5 (0.35 conf)
text__2 was Text6 (0.35 conf)
text__3 was Text7 (0.35 conf)
text__4 was Text8 (0.35 conf)
yes__3 was yes3 (0.35 conf)
no3 was no3 (0.39 conf)
male__1 was male (0.40 conf)
female__1 was female (0.38 conf)
second_job was 34 Second job (0.33 conf)
employer was 35 Employer (0.33 conf)
employers_address_city_state__2 was 36 Employers address City State Zip (0.36 conf)
date_hired__2 was 37 Date hired (0.38 conf)
weekly__2 was weekly_2 (0.28 conf)
biweekly__2 was biweekly_2 (0.33 conf)
bimonthly__2 was bimonthly_2 (0.33 conf)
monthly__2 was monthly_2 (0.28 conf)
hourly_pay_rate was 39 Hourly pay rate (0.31 conf)
average_per_pay_hire_date was 40 Average hours worked per pay period since hire date (0.32 conf)
unemployed_unemployment_workers was 41 If unemployed and not receiving unemployment or workers compensation benefits or working parttime only provide the following information (0.42 conf)
name_last_fulltime_employer was Name of last fulltime employer (0.40 conf)
last_fulltime_employer was Address of last fulltime employer (0.42 conf)
held_place_employment was Postition held at last place of fulltime employment (0.38 conf)
last_day_employed_fulltime was Last day employed fulltime (0.30 conf)
time_last_position was Length of time employed in last fulltime position (0.30 conf)
reason_leaving_last was Reason for leaving last fulltime employment (0.34 conf)
pay_earnings_weekly_monthly was Gross earings per pay period earnings before taxes weekly biweekly bimonthly monthly (0.39 conf)
undefined__1 was undefined (0.38 conf)
undefined__2 was undefined_2 (0.39 conf)
undefined__3 was undefined_3 (0.39 conf)
undefined__4 was undefined_4 (0.39 conf)
unemp_benefits was Unemp Benefits (0.42 conf)
commissions__1 was Commissions 1 (0.44 conf)
commissions__2 was Commissions 2 (0.44 conf)
armed_services was Armed Services (0.41 conf)
allowance_rent was Allowance for Rent (0.52 conf)
sick_benefits was Sick Benefits (0.40 conf)
natl_guard_res_drill_pay__1 was Natl Guard Res Drill Pay 1 (0.37 conf)
natl_guard_res_drill_pay__2 was Natl Guard Res Drill Pay 2 (0.37 conf)
natl_guard_res_drill_pay__3 was Natl Guard Res Drill Pay 3 (0.37 conf)
natl_guard_res_drill_pay__4 was Natl Guard Res Drill Pay 4 (0.37 conf)
profit_sharing__1 was Profit Sharing 1 (0.36 conf)
profit_sharing__2 was Profit Sharing 2 (0.36 conf)
profit_sharing__3 was Profit Sharing 3 (0.36 conf)
profit_sharing__4 was Profit Sharing 4 (0.36 conf)
workers_comp was Workers Comp (0.45 conf)
spousal_support_alimony was Spousal SupportAlimony (0.40 conf)
soc_sec_benefits was Soc Sec Benefits (0.37 conf)
pensions_longevity was PensionsLongevity (0.36 conf)
v_benefits was VA Benefits (0.36 conf)
state_disability_assistance__1 was State Disability Assistance 1 (0.45 conf)
state_disability_assistance__2 was State Disability Assistance 2 (0.45 conf)
deferred_comp_ir__1 was Deferred CompIRA 1 (0.44 conf)
deferred_comp_ir__2 was Deferred CompIRA 2 (0.44 conf)
disability_insurance was Disability Insurance (0.38 conf)
other was Other (0.43 conf)
supp_security_income_ss__1 was Supp Security Income SSI 1 (0.42 conf)
supp_security_income_ss__2 was Supp Security Income SSI 2 (0.42 conf)
no_4 was No_4 (0.39 conf)
yes_payer was Yes as payer (0.52 conf)
yes_recipient was Yes as recipient (0.44 conf)
amount_order_include was a Amount of order do not include arrearages (0.39 conf)
b_type_order_case was b Type of orderCase no (0.40 conf)
c_city_county_state was c City county and state (0.42 conf)
childs_name_row__1 was Childs NameRow1 (0.33 conf)
amount_monthly_row__1 was Amount monthlyRow1 (0.29 conf)
dependent_benefit_row__1 was Source of dependent benefit mother father stepparentRow1 (0.42 conf)
childs_name_row__2 was Childs NameRow2 (0.33 conf)
amount_monthly_row__2 was Amount monthlyRow2 (0.29 conf)
dependent_benefit_row__2 was Source of dependent benefit mother father stepparentRow2 (0.42 conf)
childs_name_row__3 was Childs NameRow3 (0.33 conf)
amount_monthly_row__3 was Amount monthlyRow3 (0.29 conf)
dependent_benefit_row__3 was Source of dependent benefit mother father stepparentRow3 (0.42 conf)
work_yes_please was 46 Do you have any medical conditionsrestrictions that affect your ability to work If yes please explain medical conditionrestriction Yes No (0.44 conf)
undefined__5 was undefined_6 (0.39 conf)
undefined__6 was undefined_7 (0.39 conf)
less_high_school was less than high school (0.32 conf)
high_school_graduate was High school graduate (0.37 conf)
trade_school_graduate was Trade school graduate (0.27 conf)
associates_degree was Associates degree (0.32 conf)
bachelors_degree was Bachelors degree (0.32 conf)
graduate_degree was Graduate degree (0.38 conf)
text__5 was Text9 (0.35 conf)
text__6 was Text10 (0.35 conf)
ss_row__1 was SSI_row1 (0.42 conf)
dependent_row__1 was Dependent_row1 (0.38 conf)
ss_row__2 was SSI_row2 (0.42 conf)
dependent_row__2 was Dependent_row2 (0.38 conf)
ss_row__3 was SSI_row3 (0.42 conf)
dependent_row__3 was Dependent_row3 (0.38 conf)
yes__4 was yes4 (0.35 conf)
no4 was no4 (0.36 conf)
insurance_number_date__1 was 48 Medical insurance company name address telephone no PolicyGroup number Beginning date if known (0.44 conf)
policy_number_date__1 was 49 Dental insurance company name address telephone no PolicyGroup number Beginning date if known (0.43 conf)
policy_number_date__2 was 50 Optical insurance company name address telephone no PolicyGroup number Beginning date if known (0.48 conf)
medical__1 was Medical (0.41 conf)
optical__1 was Optical (0.42 conf)
available_cost_pay__1 was 52 What dependent coverage is available by payment of an additional premium Specify cost per pay period (0.36 conf)
per__1 was per (0.32 conf)
undefined__7 was undefined_8 (0.39 conf)
per__2 was per_2 (0.23 conf)
medical__2 was Medical_2 (0.37 conf)
dental__1 was Dental_2 (0.34 conf)
optical__2 was Optical_2 (0.43 conf)
undefined__8 was undefined_9 (0.39 conf)
per__3 was per_3 (0.23 conf)
name_childcare_provider was Name of childcare provider (0.37 conf)
children_receiving_child_care was Names of children receiving child care (0.42 conf)
number_provided_calendar_year__1 was Number of weeks provided during last calendar year (0.29 conf)
number_provided_calendar_year__2 was Estimated number of weeks of child care provided in this calendar year (0.28 conf)
weekly_childcare_cost was Current weekly childcare cost (0.43 conf)
amount_childcare_federal_tax was Amount of childcare credit received on last years federal IRS tax return (0.47 conf)
agency_public_private_entity was Does a federal or state agency or a public or private entity contribute all or a portion of the cost of childcare services If yes please explain (0.45 conf)
work_related was Work related (0.38 conf)
looking_employment was Looking for employment (0.40 conf)
enrolled_educational_program was Enrolled in educational program to (0.37 conf)
estimated_number_hours_per__1 was Estimated number of hours per week 1 (0.36 conf)
estimated_number_hours_per__2 was Estimated number of hours per week 2 (0.36 conf)
estimated_number_hours_per__3 was Estimated number of hours per week 3 (0.36 conf)
total_classroom_hours_per_week was Total classroom hours per week (0.32 conf)
educational_goal was Educational goal (0.35 conf)
unknown__1 was 1 (0.38 conf)
unknown__2 was 2 (0.38 conf)
text__7 was Text14 (0.35 conf)
text__8 was Text15 (0.35 conf)
yes__5 was yes5 (0.35 conf)
no5 was no5 (0.39 conf)
policy_groupno__1 was Policy/groupno_1 (0.33 conf)
beginning_date__1 was beginning date_3 (0.42 conf)
beginning_date__2 was beginning date_1 (0.42 conf)
policy_groupno__2 was Policy/groupno_2 (0.33 conf)
beginning_date__3 was beginning date_2 (0.42 conf)
policy_groupno__3 was Policy/groupno_3 (0.33 conf)
dental__2 was Dental (0.37 conf)
name_row__1 was Name_row1 (0.43 conf)
optical_row__1 was Optical_row4 (0.42 conf)
medical_row__1 was Medical_row1 (0.41 conf)
birthdate_row__7 was birthdate_row1 (0.24 conf)
relationship_row__1 was Relationship_row1 (0.39 conf)
dental_row__1 was Dental_row1 (0.37 conf)
optical_row__2 was Optical_row1 (0.42 conf)
name_row__2 was Name_row2 (0.43 conf)
birthdate_row__8 was birthdate_row2 (0.24 conf)
relationship_row__2 was Relationship_row2 (0.39 conf)
medical_row__2 was Medical_row2 (0.41 conf)
dental_row__2 was Dental_row2 (0.37 conf)
optical_row__3 was Optical_row2 (0.42 conf)
name_row__3 was Name_row3 (0.43 conf)
birthdate_row__9 was birthdate_row3 (0.24 conf)
relationship_row__3 was Relationship_row3 (0.39 conf)
medical_row__3 was Medical_row3 (0.41 conf)
dental_row__3 was Dental_row3 (0.37 conf)
optical_row__4 was Optical_row3 (0.42 conf)
name_row__4 was Name_row4 (0.43 conf)
birthdate_row__10 was birthdate_row4 (0.24 conf)
relationship_row__4 was Relationship_row4 (0.39 conf)
medical_row__4 was Medical_row4 (0.41 conf)
dental_row__4 was Dental_row4 (0.37 conf)
full_name__2 was 58 Full name (0.40 conf)
date_birth__2 was 59 Date of birth (0.43 conf)
place_birth_city_state__2 was 60 Place of birth city and state (0.41 conf)
address_city_state_zip__2 was 61 Address City State Zip (0.28 conf)
home_telephone__2 was 62 Home telephone (0.49 conf)
work_telephone__2 was 63 Work telephone (0.48 conf)
social_security_number__2 was 64 Social security number (0.40 conf)
drivers_license__2 was 65 Drivers license no (0.50 conf)
professional_license_type__2 was 66 Professional license type and no (0.40 conf)
cell_phone__2 was 67 Cell phone (0.41 conf)
email_address__2 was 68 Email address (0.44 conf)
eye_color__2 was 70 Eye color (0.34 conf)
hair_color__2 was 71 Hair color (0.34 conf)
height__2 was 72 Height (0.39 conf)
weight__2 was 73 Weight (0.39 conf)
race__2 was 74 Race (0.30 conf)
scars_tattoos_etc__2 was 75 Scars tattoos etc (0.41 conf)
fathers_full_name__2 was 76 Fathers full name (0.37 conf)
mothers_full_maiden_name__2 was 77 Mothers full maiden name (0.36 conf)
minor_children_row__1 was 78 Names of other biologicaladopted minor children heshe supportsRow1 (0.47 conf)
birthdate_row__11 was BirthdateRow1_3 (0.27 conf)
address_row__4 was AddressRow1_2 (0.35 conf)
minor_children_row__2 was 78 Names of other biologicaladopted minor children heshe supportsRow2 (0.47 conf)
birthdate_row__12 was BirthdateRow2_3 (0.27 conf)
address_row__5 was AddressRow2_2 (0.35 conf)
minor_children_row__3 was 78 Names of other biologicaladopted minor children heshe supportsRow3 (0.47 conf)
birthdate_row__13 was BirthdateRow3_3 (0.27 conf)
address_row__6 was AddressRow3_2 (0.35 conf)
occupation__2 was 81 Occupation (0.36 conf)
employer_unemployed_last__2 was 82 Employer if unemployed name of last employer (0.41 conf)
employers_address_city_state__3 was 83 Employers address City State Zip (0.34 conf)
date_hired__3 was 84 Date hired (0.38 conf)
gross_earnings_per_pay_taxes was 85 Gross earnings per pay period earnings before taxes (0.42 conf)
average_hours_past_months was 86 Average overtime hours for past 12 months (0.33 conf)
insurance_number_date__2 was 87 Medical insurance company name address telephone no PolicyGroup number Beginning date if known (0.44 conf)
policy_number_date__3 was 88 Dental insurance company name address telephone no PolicyGroup number Beginning date if known (0.43 conf)
policy_number_date__4 was 89 Optical insurance company name address telephone no PolicyGroup number Beginning date if known (0.46 conf)
medical__3 was Medical_3 (0.37 conf)
dental__3 was Dental_3 (0.34 conf)
optical__3 was Optical_3 (0.43 conf)
available_cost_pay__2 was 91 What dependent coverage is available by payment of an additional premium Specify cost per pay period (0.36 conf)
per__4 was per_4 (0.23 conf)
undefined__9 was undefined_13 (0.39 conf)
per__5 was per_5 (0.23 conf)
medical__4 was Medical_4 (0.37 conf)
dental__4 was Dental_4 (0.34 conf)
optical__4 was Optical_4 (0.43 conf)
undefined__10 was undefined_14 (0.39 conf)
per__6 was per_6 (0.23 conf)
male__2 was male2 (0.35 conf)
female__2 was female2 (0.35 conf)
yes__6 was yes6 (0.35 conf)
no6 was no6 (0.35 conf)
yes__7 was yes7 (0.35 conf)
no7 was no7 (0.42 conf)
yes__8 was yes8 (0.35 conf)
no8 was no8 (0.37 conf)
text__9 was Text16 (0.35 conf)
policy_groupno__4 was Policy/groupno_4 (0.33 conf)
beginning_date__4 was beginning date_4 (0.42 conf)
policy_groupno__5 was Policy/groupno_5 (0.33 conf)
beginning_date__5 was beginning date_5 (0.42 conf)
policy_groupno__6 was Policy/groupno_6 (0.33 conf)
beginning_date__6 was beginning date_6 (0.42 conf)
name_row__5 was Name_row5 (0.43 conf)
birthdate_row__14 was birthdate_row5 (0.24 conf)
relationship_row__5 was Relationship_row5 (0.39 conf)
medical_row__5 was Medical_row5 (0.41 conf)
dental_row__5 was Dental_row5 (0.37 conf)
optical_row__5 was Optical_row5 (0.42 conf)
name_row__6 was Name_row6 (0.43 conf)
birthdate_row__15 was birthdate_row6 (0.24 conf)
relationship_row__6 was Relationship_row6 (0.39 conf)
medical_row__6 was Medical_row6 (0.41 conf)
dental_row__6 was Dental_row6 (0.37 conf)
optical_row__6 was Optical_row6 (0.42 conf)
name_row__7 was Name_row7 (0.43 conf)
birthdate_row__16 was birthdate_row7 (0.24 conf)
relationship_row__7 was Relationship_row7 (0.39 conf)
medical_row__7 was Medical_row7 (0.41 conf)
dental_row__7 was Dental_row7 (0.37 conf)
optical_row__7 was Optical_row7 (0.42 conf)
name_row__8 was Name_row8 (0.43 conf)
birthdate_row__17 was birthdate_row8 (0.24 conf)
relationship_row__8 was Relationship_row8 (0.39 conf)
medical_row__8 was Medical_row8 (0.41 conf)
dental_row__8 was Dental_row8 (0.37 conf)
optical_row__8 was Optical_row8 (0.42 conf)
request_pursuant_enforcement was I request childsupport services pursuant to the childsupport enforcement program of Title IVD of the Social (0.40 conf)
signature_date was Date (1.00 conf)
text__10 was Text21 (0.35 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

plaintiff
defendant
full_name__1
date_birth__1
place_birth_city_state__1
address_city_state_zip__1
home_telephone__1
work_telephone__1
social_security_number__1
drivers_license__1
professional_license_type__1
cell_phone__1
email_address__1
eye_color__1
hair_color__1
height__1
weight__1
race__1
scars_tattoos_etc__1
fathers_full_name__1
mothers_full_maiden_name__1
common_parent_case_row__1
birthdate_row__1
gender_row__1
ssn_row__1
current_grade_level_row__1
month_year_school_graduation_row__1
child_annually_row__1
common_parent_case_row__2
birthdate_row__2
gender_row__2
ssn_row__2
current_grade_level_row__2
month_year_school_graduation_row__2
child_annually_row__2
common_parent_case_row__3
birthdate_row__3
gender_row__3
ssn_row__3
current_grade_level_row__3
month_year_school_graduation_row__3
child_annually_row__3
minor_support_row__1
birthdate_row__4
address_row__1
minor_support_row__2
birthdate_row__5
address_row__2
minor_support_row__3
birthdate_row__6
address_row__3
occupation__1
employer_unemployed_last__1
employers_address_city_state__1
date_hired__1
weekly__1
bimonthly__1
monthly__1
dependents_claimed
married
single
head_household
total_regular_per_pay_period
circuit
county
judge
telephone
friend_court_address
biweekly__1
yes__1
no2
yes__2
no1
text__1
text__2
text__3
text__4
yes__3
no3
male__1
female__1
second_job
employer
employers_address_city_state__2
date_hired__2
weekly__2
biweekly__2
bimonthly__2
monthly__2
hourly_pay_rate
average_per_pay_hire_date
unemployed_unemployment_workers
name_last_fulltime_employer
last_fulltime_employer
held_place_employment
last_day_employed_fulltime
time_last_position
reason_leaving_last
pay_earnings_weekly_monthly
undefined__1
undefined__2
undefined__3
undefined__4
unemp_benefits
commissions__1
commissions__2
armed_services
allowance_rent
sick_benefits
natl_guard_res_drill_pay__1
natl_guard_res_drill_pay__2
natl_guard_res_drill_pay__3
natl_guard_res_drill_pay__4
profit_sharing__1
profit_sharing__2
profit_sharing__3
profit_sharing__4
workers_comp
spousal_support_alimony
soc_sec_benefits
pensions_longevity
v_benefits
state_disability_assistance__1
state_disability_assistance__2
deferred_comp_ir__1
deferred_comp_ir__2
disability_insurance
other
supp_security_income_ss__1
supp_security_income_ss__2
no_4
yes_payer
yes_recipient
amount_order_include
b_type_order_case
c_city_county_state
childs_name_row__1
amount_monthly_row__1
dependent_benefit_row__1
childs_name_row__2
amount_monthly_row__2
dependent_benefit_row__2
childs_name_row__3
amount_monthly_row__3
dependent_benefit_row__3
work_yes_please
undefined__5
undefined__6
less_high_school
high_school_graduate
trade_school_graduate
associates_degree
bachelors_degree
graduate_degree
text__5
text__6
ss_row__1
dependent_row__1
ss_row__2
dependent_row__2
ss_row__3
dependent_row__3
yes__4
no4
insurance_number_date__1
policy_number_date__1
policy_number_date__2
medical__1
optical__1
available_cost_pay__1
per__1
undefined__7
per__2
medical__2
dental__1
optical__2
undefined__8
per__3
name_childcare_provider
children_receiving_child_care
number_provided_calendar_year__1
number_provided_calendar_year__2
weekly_childcare_cost
amount_childcare_federal_tax
agency_public_private_entity
work_related
looking_employment
enrolled_educational_program
estimated_number_hours_per__1
estimated_number_hours_per__2
estimated_number_hours_per__3
total_classroom_hours_per_week
educational_goal
unknown__1
unknown__2
text__7
text__8
yes__5
no5
policy_groupno__1
beginning_date__1
beginning_date__2
policy_groupno__2
beginning_date__3
policy_groupno__3
dental__2
name_row__1
optical_row__1
medical_row__1
birthdate_row__7
relationship_row__1
dental_row__1
optical_row__2
name_row__2
birthdate_row__8
relationship_row__2
medical_row__2
dental_row__2
optical_row__3
name_row__3
birthdate_row__9
relationship_row__3
medical_row__3
dental_row__3
optical_row__4
name_row__4
birthdate_row__10
relationship_row__4
medical_row__4
dental_row__4
full_name__2
date_birth__2
place_birth_city_state__2
address_city_state_zip__2
home_telephone__2
work_telephone__2
social_security_number__2
drivers_license__2
professional_license_type__2
cell_phone__2
email_address__2
eye_color__2
hair_color__2
height__2
weight__2
race__2
scars_tattoos_etc__2
fathers_full_name__2
mothers_full_maiden_name__2
minor_children_row__1
birthdate_row__11
address_row__4
minor_children_row__2
birthdate_row__12
address_row__5
minor_children_row__3
birthdate_row__13
address_row__6
occupation__2
employer_unemployed_last__2
employers_address_city_state__3
date_hired__3
gross_earnings_per_pay_taxes
average_hours_past_months
insurance_number_date__2
policy_number_date__3
policy_number_date__4
medical__3
dental__3
optical__3
available_cost_pay__2
per__4
undefined__9
per__5
medical__4
dental__4
optical__4
undefined__10
per__6
male__2
female__2
yes__6
no6
yes__7
no7
yes__8
no8
text__9
policy_groupno__4
beginning_date__4
policy_groupno__5
beginning_date__5
policy_groupno__6
beginning_date__6
name_row__5
birthdate_row__14
relationship_row__5
medical_row__5
dental_row__5
optical_row__5
name_row__6
birthdate_row__15
relationship_row__6
medical_row__6
dental_row__6
optical_row__6
name_row__7
birthdate_row__16
relationship_row__7
medical_row__7
dental_row__7
optical_row__7
name_row__8
birthdate_row__17
relationship_row__8
medical_row__8
dental_row__8
optical_row__8
request_pursuant_enforcement
signature_date
text__10

Create an Interactive Version of this Form:

The Weaver creates a draft guided interview from a template form, like the one provided here. To learn more, read "Weaving" your form into a draft interview.

The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

FOC 39, Friend of the Court, Case Questionnaire

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02