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Maine Social Security Number Confidential Disclosure Form

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Maine Social Security Number Confidential Disclosure Form
Maine Social Security Number Confidential Disclosure Form
STATE OF MAINE
SUPERIOR COURT DISTRICT COURT
___________________________, ss. Location______________________
Docket No. ____________________ Docket No. ___________________
STATE OF MAINE/___________________________
Plaintiff
v. SOCIAL SECURITY NUMBER
CONFIDENTIAL DISCLOSURE
FORM
_____________________________________________
Defendant
My Social Security account number is _____________ - ______ - _______________.
Date: ____________________ ____________________________________
Plaintiff/Defendant
If this case is a Family Matter case (divorce, parental rights & responsibilities) the child(ren) involved must also
have their Social Security Number disclosed:
Child’s Name
Social Security Number
This form is confidential and shall not be disclosed unless ordered by the court.
CV/CR/FM/PC-200, Rev, 02/09
Maine Social Security Number Confidential Disclosure Form