Information On Family Relationship Form PDF Details

Do you need to document and track your family's relationships? Are you looking for an easy-to-use form that can help you keep all the information organized? If so, then a family relationship form is just what you need! This article will provide information on how to create and use such a form to ensure your family’s history is properly documented. We'll go over the elements of creating a meaningful family relationship form, as well as several ways to effectively utilize it. Read on to learn more about how this helpful tool can make tracking and preserving your precious memories easier than ever.

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Form NameInformation On Family Relationship Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesVS 165 information on suit affecting the family relationship vital statistics vs 165

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WARNING: This is a governmental document. Texas Penal Code, Section 37.10, specifies penalties for making false entries or providing false information in this document. VS-165 REV 01/2006

INFORMATION ON SUIT AFFECTING THE FAMILY RELATIONSHIP

(EXCLUDING ADOPTIONS)

SECTION I GENERAL INFORMATION (REQUIRED)

STATE FILE NUMBER

1a. COUNTY __________________________

1b. COURT NO. ________________________

1c. CAUSE NO. ________________________

1d. DATE OF ORDER (mm/dd/yyyy) _________

2. HAS THERE BEEN A FINDING BY THE COURT OF: DOMESTIC VIOLENCE? CHILD ABUSE?

3. TYPE OF ORDER (CHECK ALL THAT APPLY):

 

 

DIVORCE/ANNULMENT WITH CHILDREN(SeC. 1,2,3,4)

DIVORCE/ANNULMENT WITHOUT CHILDREN(Sec 1,2)

PATERNITY WITH CHILD SUPPORT(Sec 1,3,4,5)

PATERNITY WITHOUT CHILD SUPPORT(SEC 1,3,5)

CHILD SUPPORT OBLIGATION/MODIFICATION(Sec 1,3,4)

TERMINATION OF RIGHTS (Sec 1,3,6)

CONSERVATORSHIP (SEC 1, 3)

 

OTHER (SPECIFY) ___________________________

TRANSFER TO (SEC 1, 3) COUNTY __________ COURT NO. ________ STATE COURT ID# ______________

 

4a. NAME OF ATTORNEY FOR PETITIONER

 

 

 

 

 

 

 

 

 

4b. ATTORNEY GENERAL ACCT/CASE #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4c. CURRENT MAILING ADDRESS

 

STREET & NO.

CITY

STATE

 

ZIP

 

4d. TELEPHONE NUMBER (including area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 2 (IF APPLICABLE) REPORT OF DIVORCE OR ANNULMENT OF MARRIAGE

 

 

 

 

 

 

 

 

5. FIRST NAME

MIDDLE

LAST

SUFFIX

 

 

 

 

 

 

 

 

6. DATE OF BIRTH (mm/dd/yyyy)

 

HUSBAND

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. PLACE OF BIRTH

 

CITY

 

STATE OR FOREIGN COUNTRY

 

8. RACE

 

 

9. SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. USUAL RESIDENCE

 

 

 

STREET NAME & NUMBER

 

 

 

 

CITY

STATE

 

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11. FIRST NAME

 

 

MIDDLE

LAST

 

 

 

 

MAIDEN

 

 

12. DATE OF BIRTH (mm/dd/yyyy)

 

WIFE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. PLACE OF BIRTH CITY STATE OR FOREIGN COUNTRY

 

 

 

 

 

14. RACE

 

 

15. SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16. USUAL RESIDENCE

 

 

STREET NAME & NUMBER

CITY

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17. NUMBER OF MINOR CHILDREN

18. DATE OF MARRIAGE (mm/dd/yyyy)

 

19. PLACE OF MARRIAGE City State

20. PETITIONER IS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HUSBAND

WIFE

 

SECTION 3 (IF APPLICABLE) CHILDREN AFFECTED BY THIS SUIT

 

 

 

 

 

 

 

 

 

 

 

 

 

21a. FIRST NAME

MIDDLE

 

LAST

 

 

SUFFIX

 

 

 

 

 

 

 

21b. DATE OF BIRTH (mm/dd/yyyy)

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILD

21c. SOCIAL SECURITY NUMBER

 

21d. SEX

 

 

21e. BIRTHPLACE

 

CITY

 

COUNTY

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21f. PRIOR NAME OF CHILD: FIRST MIDDLE LAST SUFFIX

 

 

 

 

21g. NEW NAME OF CHILD FIRST MIDDLE LAST SUFFIX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22a. FIRST NAME

MIDDLE

 

LAST

 

 

SUFFIX

 

 

 

 

 

 

 

22b. DATE OF BIRTH (mm/dd/yyyy)

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILD

22c. SOCIAL SECURITY NUMBER

 

22d. SEX

 

 

22e. BIRTHPLACE

CITY

COUNTY

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22f. PRIOR NAME OF CHILD:

 

FIRST MIDDLE LAST SUFFIX

 

 

 

 

22g. NEW NAME OF CHILD FIRST MIDDLE LAST SUFFIX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23a. FIRST NAME

MIDDLE

 

LAST

 

 

SUFFIX

 

 

 

 

 

 

 

23b. DATE OF BIRTH (mm/dd/yyyy)

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILD

23c. SOCIAL SECURITY NUMBER

 

23d. SEX

 

 

23e. BIRTHPLACE

 

CITY

COUNTY

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23f. PRIOR NAME OF CHILD FIRST MIDDLE LAST SUFFIX

 

 

 

 

23g. NEW NAME OF CHILD FIRST MIDDLE LAST SUFFIX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24a. FIRST NAME

MIDDLE

 

LAST

SUFFIX

 

 

 

 

 

 

 

24b. DATE OF BIRTH (mm/dd/yyyy)

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILD

24c. SOCIAL SECURITY NUMBER

 

24d. SEX

 

 

24e BIRTH

 

CITY

COUNTY

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24f. PRIOR NAME OF CHILD FIRST MIDDLE LAST SUFFIX

 

 

 

 

24g. NEW NAME OF CHILD FIRST MIDDLE LAST SUFFIX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

SECTION 4 (IF APPLICABLE) OBLIGEE/OBLIGOR INFORMATION

 

 

THIS PARTY TO THE SUIT IS (CHECK ONE)

25a. TDPRS

 

25b. NON-PARENT CONSERVATOR – COMPLETE 26 – 32

 

 

 

25c. HUSBAND AS SHOWN ON FRONT OF THIS FORM – COMPLETE 31 – 32 ONLY

25d. WIFE AS SHOWN ON FRONT OF THIS FORM – COMPLETE 31 – 32 ONLY

 

 

25e. BIOLOGICAL FATHER – COMPLETE 26 – 32

 

25f. BIOLOGICAL MOTHER – COMPLETE 26 – 32

 

 

 

 

26. FIRST NAME

MIDDLE

LAST

SUFFIX

 

 

 

MAIDEN

 

 

 

 

 

OBLIGEE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27. DATE OF BIRTH (mm/dd/yyyy)

 

28. PLACE OF BIRTH

CITY

STATE OR FOREIGN COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29. USUAL RESIDENCE

 

 

STREET NAME & NUMBER

CITY

COUNTY

 

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30. SOCIAL SECURITY NUMBER

 

31. DRIVER LICENSE NO & STATE

 

 

 

 

32. TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

(

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS PARTY TO THE SUIT IS (CHECK ONE)

 

 

33a. NON-PARENT CONSERVATOR – COMPLETE 34 – 43

 

 

 

 

33b. HUSBAND AS SHOWN ON FRONT OF THIS FORM – COMPLETE 39 – 43 ONLY

33c. WIFE AS SHOWN ON FRONT OF THIS FORM – COMPLETE 39 – 43 ONLY

 

 

33d. BIOLOGICAL FATHER – COMPLETE 34 – 43

33e. BIOLOGICAL MOTHER – COMPLETE 34 – 43

 

 

 

 

34. FIRST NAME

MIDDLE

LAST

 

SUFFIX

 

 

MAIDEN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#1

35. DATE OF BIRTH (mm/dd/yyyy)

 

36. PLACE OF BIRTH

 

CITY

STATE OR FOREIGN COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OBLIGOR

 

 

 

 

 

 

 

 

 

 

 

38. SOCIAL SECURITY NUMBER

39 DRIVER LICENSE NO. & STATE

CITY

 

 

40. TELEPHONE NUMBER

ZIP

 

 

37. USUAL RESIDENCE

 

 

STREET NAME & NUMBER

 

COUNTY

 

STATE

 

 

 

 

 

 

 

 

 

 

(

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

41. EMPLOYER NAME

 

 

 

 

 

 

 

 

42. EMPLOYER TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

43. EMPLOYER PAYROLL ADDRESS

STREET NAME & NUMBER

CITY

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS PARTY TO THE SUIT IS (CHECK ONE) 44a. NON-PARENT CONSERVATOR – COMPLETE 45 – 54

 

 

 

 

 

 

 

 

 

 

44b. HUSBAND AS SHOWN ON FRONT OF THIS FORM – COMPLETE 50 – 54 ONLY

44c. WIFE AS SHOWN ON FRONT OF THIS FORM – COMPLETE 45 – 54 ONLY

 

 

44d. BIOLOGICAL FATHER – COMPLETE 45 – 54

 

44e. BIOLOGICAL MOTHER – COMPLETE 45 – 54

 

 

 

 

45. FIRST NAME

MIDDLE

LAST

 

SUFFIX

 

 

MAIDEN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#2

46. DATE OF BIRTH (mm/dd/yyyy)

 

47. PLACE OF BIRTH

 

CITY

STATE OR FOREIGN COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OBLIGOR

 

 

 

 

 

 

 

 

 

 

 

49. SOCIAL SECURITY NUMBER

50. DRIVER LICENSE NO & STATE

CITY

 

 

51. TELEPHONE NUMBER

ZIP

 

 

48. USUAL RESIDENCE

 

 

STREET NAME & NUMBER

 

COUNTY

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

52. EMPLOYER NAME

 

 

 

 

 

 

 

 

53. EMPLOYER TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

54. EMPLOYER PAYROLL ADDRESS

STREET NAME & NUMBER

 

CITY

STATE

 

ZIP

 

 

 

 

 

 

 

 

SECTION 5 (IF APPLICABLE) FOR ORDERS CONCERNING PATERNITY ESTABLISHMENT OF BIOLOGICAL FATHER

 

 

55. BIOLOGICAL FATHER’S NAME

FIRST

MIDDLE

 

LAST

 

 

 

56. DATE OF BIRTH (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

57. SOCIAL SECURITY NUMBER

 

58. CURRENT MAILING ADDRESS

STREET NAME & NUMBER

 

CITY

STATE

ZIP

 

 

 

 

 

 

 

59. DOES THIS ORDER REMOVE INFORMATION PERTAINING TO A FATHER FROM A CHILD’S CERTIFICATE OF BIRTH? NO

YES

 

 

 

 

 

 

SECTION 6 TERMINATION OF RIGHTS – INFORMATION RELATED TO THE INDIVIDUAL(S) WHOSE RIGHTS ARE BEING TERMINATED IN THIS SUIT.

 

 

60a. FIRST NAME

MIDDLE NAME

LAST NAME

 

SUFFIX

 

 

 

 

 

60b. RELATIONSHIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

61a. FIRST NAME

MIDDLE NAME

LAST NAME

 

SUUFIX

 

 

 

 

 

61b. RELATIONSHIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

62a. FIRST NAME

MIDDLE NAME

LAST NAME

 

SUFFIX

 

 

 

 

 

62b. RELATIONSHIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMENTS: ___________________________________________________________________________

___________________________________________________________________________________

I CERTIFY THAT THE ABOVE ORDER WAS GRANTED ON THE

_____________________________________

DATE AND PLACE AS STATED.

SIGNATURE OF THE CLERK OF THE COURT

2

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