§ 15-15a-a

APPENDIX A. APPENDIX OF FORMS 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.

______________________________________ 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.

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.