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E-mail address 8. Eye color 9. Hair color 15. Home telephone no. 10. Height 11. Weight 12. Race 16. Work telephone no. 13. Gender 14. Scars tattoos etc* 17. Occupation 18. Business/Employer s name and address 19. Gross weekly income 20. Did this parent apply for or receive public assistance If yes please specify kind and case number. Yes No 21. Other parent s last name 41. a* Name and sex of minor child in case M / F b. Birth date c* Age d. Soc* sec* no. e. Residential address c* Age d. Residen ...

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