Nothing Special   »   [go: up one dir, main page]
Scribd Logo
Upload

Welcome to Scribd!

  • 70 views

    Aoc 034 PDF

    Uploaded by

    chris
    This document is a personal identifier data sheet used by Kentucky courts in mental health, disability, incompetency, and involuntary treatment cases. It requests identifying information about the respondent/defendant such as name, aliases, addresses, physical description details, and social security and driver's license numbers to be entered into the official court record. The person filling out the form is asked to verify the accuracy of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Aoc 034 PDF

    Uploaded by

    chris
    70 views1 page
    This document is a personal identifier data sheet used by Kentucky courts in mental health, disability, incompetency, and involuntary treatment cases. It requests identifying information about the respondent/defendant such as name, aliases, addresses, physical description details, and social security and driver's license numbers to be entered into the official court record. The person filling out the form is asked to verify the accuracy of the information provided.

    Original Title

    AOC-034.pdf

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a personal identifier data sheet used by Kentucky courts in mental health, disability, incompetency, and involuntary treatment cases. It requests identifying information about the respondent/defendant such as name, aliases, addresses, physical description details, and social security and driver's license numbers to be entered into the official court record. The person filling out the form is asked to verify the accuracy of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    70 views1 page

    Aoc 034 PDF

    Uploaded by

    chris
    This document is a personal identifier data sheet used by Kentucky courts in mental health, disability, incompetency, and involuntary treatment cases. It requests identifying information about the respondent/defendant such as name, aliases, addresses, physical description details, and social security and driver's license numbers to be entered into the official court record. The person filling out the form is asked to verify the accuracy of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    AOC-034

    Doc. Code: PIDMD


    Rev. 6-19 NW
    EA L TH OF KE
    Case No. ____________________

    NT
    O
    COMM

    UCKY
    Page 1 of 1 Court ________________________
    lex
    et
    justitia

    CO

    E
    U

    C
    RT TI
    OF JUS

    County ______________________
    Commonwealth of Kentucky
    Court of Justice www.courts.ky.gov personal identifier data sheet Division ______________________
    (Mental Health/Disability/Incompetency)

    ****For use in actions brought or proceedings conducted pursuant to KRS Chapters 202A (Involuntary hospitalization of the
    mentally ill); 202B (Involuntary intellectual disability admission); 222.430 et seq. (Involuntary treatment for a substance use
    disorder); 387.500 et seq. (Guardianship and conservatorship for disabled persons); 504 (Responsibility, incompetency/
    insanity/mental illness); and, 645 (Involuntary hospitalization of the mentally ill child).

    TO THE PETITIONER IN A MENTAL HEALTH OR DISABILITY PROCEEDING

    TO THE DEFENDANT OR HIS/HER ATTORNEY IN A CHAPTER 504 PROCEEDING

    The Court requires that you provide the following information about the Respondent/Defendant in this case:

    RESPONDENT/DEFENDANT: Please Print


    First Middle Last

    Also known as: __________________________________________________________________________________

    Street address: __________________________________________________________________________________

    Mailing address: _________________________________________________________________________________

    Respondent's/Defendant's Identifiers:

    Sex Race Date of Birth Height Weight Eyes Hair Social Security # Drivers License # State

    I understand that the information requested herein is intended to be entered into the official court record of this matter,
    and that its accuracy is of the utmost importance. The information I have provided above is true and accurate to the best
    of my knowledge and belief.

    _______________________________, 2______ ____________________________________________


    Date Signature

    ____________________________________________
    Printed Name

    Print Reset Form

    Original: Court file

    You might also like