CUYAHOGA COUNTY DOMESTIC RELATIONS COURT
CASE NO. DR: ______________________
PERSONAL JURISDICTION DETERMINATION
1. Does Defendant/Petitioner-02 have an out-of-state address?� YES � NO
2. Has the Defendant/Petitioner-02 ever lived in Ohio? � YES � NOIf yes, for how long? _____
3. Have the Parties lived in Ohio as a married couple? � YES � NO
4. Is Plaintiff/Petitioner-01 seeking child support or spousal support fromDefendant/Petitioner-02? � YES � NO
SUPPORT DETERMINATION
1. Is either spouse pregnant? � YES � NO
2. Are there minor child(ren) living in Ohio? � YES � NO
3. Is there a Temporary Domestic Relations Court Order forchild/spousal support? � YES � NO
4. Is there a Juvenile Court Order for child support/custody?� YES � NO
5. Is there a CSEA Administrative Order for child support?� YES � NO
6. Is there a current case filed in Bankruptcy Court? � YES � NOIf yes, provide Bankruptcy Court Case Number: ___________Chapter 7 � or Chapter 13 �