Ariz. R. Fam. Law P. Form 3

As amended through December 6, 2023

Form 3 - Confidential Sensitive Data Form

Name:	______________________________
Mailing Address:	______________________________
City, State, Zip Code:	______________________________
Daytime Phone Number:	______________________________
Evening Phone Number:	______________________________
Representing:	[ ] Self [ ] Petitioner [ ] Respondent
State Bar Number:	______________________________

ARIZONA SUPERIOR COURT, COUNTY OF __________

Case No.

Petitioner

ATLAS No.

CONFIDENTIAL SENSITIVE DATA FORM

Respondent

A.	Personal Information:
Name	Date of Birth	Social Security Number
Petitioner:__________________________	_______________________	_______________________
Respondent:__________________	_______________________	_______________________
Child:_______________________	_______________________	_______________________
Child:_______________________	_______________________	_______________________
Child:_______________________	_______________________	_______________________
Child:_______________________	_______________________	_______________________

B.	Financial account numbers (including credit cards, financial institution accounts, investments, debts):
Financial Institution	Type of Account	Name(s) on Account	Account #
C.	Pension and retirement accounts (including IRAs, 401(k)s):
Financial Institution	Type of Account	Name(s) on Account	Account #
D.	Life insurance policies:
Insurance Company	Type of Policy	Name(s) on Policy	Policy #

Ariz. R. Fam. Law P. Form 3

Added Oct. 19, 2005, effective 1/1/2006. Amended Sept. 5, 2007, effective 1/1/2008.