This is our old site, has been decommissioned, and has not been updated since December 31, 2012. 
Forms
This page provides access to the forms currently available to the legal community, local courts and the public through the Administrative Office of the Courts. These forms are from Supreme Court rules, the Administrative Office of the Courts, the Nebraska Supreme Court Committee on Pro Se Litigation and other organizations. They are organized under the court in which they are used, or you may enter the topic or title of the form in the search box above for quicker access.
If you are interested in representing yourself in court, there are a number of forms designed specifically for your use. The Self Help page of this Web site contains forms, instructions and resources.
Supreme Court and Court of Appeals Forms
Judicial Branch Education Forms
Supreme Court and Court of Appeals Forms
- Motions/Stipulations *
- County Attorney Summary *
- Fax Cover Page *
- Request for Confidential Record
- Sample Certificates *
- Certificate of Civil Appeal, County Court (based on Appendix 2), (Fill-in format)
- Certificate of Civil Appeal, District Court (based on Appendix 5), (Fill-in format)
- Certificate of Criminal Appeal (based on Appendix 6), (Fill-in format)
* These forms are part of the Nebraska Supreme Court Rules.
District Court Forms
Administrative
- Criminal Homicide Report Form *
- Statistical Reporting Instructions
- Certificate of Authentication, DC 1:1
- Verified Motion for Continuance and Notice of Hearing, DC 1:2
- Instructions for Motion for Continuance and Notice of Hearing, DC 1:2(a)
- Order for Continuance, DC 1:2(2)
- Instructions for Order for Continuance, DC 1:2(2a)
Appeals
Bonds
- Appearance Bond, DC 3:1
- Bond Assignment, DC 3:2
- Notice of Rights Of An In Custody Defendant (in both Spanish and English)
- Notice of Right To Post Bond (in both Spanish and English)
- Affidavit In Support Of Personal Recognizance Bond (in both Spanish and English)
- Memo & Court Order to Sheriff, Jailer, Others (in English only)
- Guidelines For Implementing Bilingual Bail/Bond Documents (in English only)
Child Support
- Worksheet 1 (basic net income and support calculation), DC 6:1(1) *
- Worksheet 2 (split custody calculation), DC 6:1(2) *
- Worksheet 3 (joint physical custody calculation), DC 6:1(3) *
- Worksheet 4 (number of children calculation), DC 6:1(4) *
- Worksheet 5 (deviations to Child Support Guidelines), DC 6:1(5) *
- Worksheet 6 (imputation of Childcare Tax Credit), DC 6:1(6) *
- Table 1 (income shares formula table), DC 6:1(7) *
- Child Support Termination Application and Affidavit, DC 6:2
- Instructions for Child Support Termination Application and Affidavit, DC 6:2a)
- Waiver of Notice on Termination of Child Support, DC 6:2(1)
- Instructions for Waiver of Notice on Termination of Child Support, DC 6:2(1a)
- Order Terminating Child Support, DC 6:2(2)
- Instructions for Order Terminating Child Support, DC 6:2(2a)
Civil
- Application of Continuing Lien, DC 4:1
- Order of Continuing Lien, DC 4:2
- Certificate of Cancellation of Tax Sale Certificate, DC 4:4
- Subpoena for Production of Documents, DC 4:5 (must also attach Neb. Ct. R. § 6-334(A): www.supremecourt.ne.gov/rules/html/Ch6/art3/6-334A.shtml
- Notice of Registration of Order, DC 4:6
- Motion to Dismiss, DC 4:7
- Instructions for Motion to Dismiss, DC 4:7(a)
- Order of Dismissal, DC 4:7(1)
- Instructions for Order of Dismissal, DC 4:7(1a)
Confidential Information
Criminal
- Correctional Center Cover Sheet, DC 6:8
- Criminal Homicide Report Form *
- Financial Affidavit, CC 6:1A
- Sex Offender Registration Form, CC 6:9 (effective 01-01-2010)
- Notice Upon Conviction of a Misdemeanor Crime Involving Domestic Violence, CC 6:10
Delegation of Parental Powers
- Temporary Delegations of Parental Powers Form, DC 6:10(1) (Fill-in format)
- DC 6:10(1) (Arabic)
- DC 6:10(1) (Spanish)
- DC 6:10(1) (Vietnamese)
- Instructions for Filling and General Instructions, DC 6:10(1a)
- DC 6:10(1a) (Arabic)
- DC 6:10(1a) (Spanish)
- DC 6:10(1a) (Vietnamese)
Divorce
- Simple Divorce Forms and Instructions
- With No Children or Property Disputes Involved , DC 6:4(1) through DC 6:4(6)
- With Children But No Custody Disputes, No Visitation Disputes or No Property Disputes, DC 6:5(1) through DC 6:5(12)
- Service by Publication Forms and Instructions, DC 6:6 through DC 6:6(7)
- In Forma Pauperis Forms and Instructions (Divorce), DC 6:7 through DC 6:7(2)
- Confidential Party and Social Security, Gender, Birthdate(s) Forms and Instructions, DC 6:5(11) through 6:5(12a)
- Answer and Counterclaim for Dissolution of Marriage
- Enforcement
- Parenting Act Forms (required by N.R.S. 43-2920, et seq. (2007)
- Attorney Certificate of Providing Parenting Act Information, DC 6:5(9)
- Certificate of Clerk's Dissemination of Parenting Plan Information Material, DC 6:5(15)
- Parenting Plan, Parent-Created, DC 6:5(6)
- Instructions for Parenting Plan, DC 6:5(6a)
- Parenting Plan, Court-Created, DC 6:5(7)
- Parenting Plan, Absent Parent, Court Use, DC 6:5(13)
- Parenting Plan, Absent Parent, Plaintiff's Use, DC 6:5(14)
- Instructions for Parenting Plan, Absent Parent, DC 6:5(14a)
- Temporary Child Information Affidavit, DC 6:5(8)
- Certificate of Completion of Parenting Education Course, DC 6:5(5)
- Parenting Education Approval Packet
Jury
- Nebraska Juror Qualification Form *
- Petit Jury Summons, DC 8:2
- Waiver of Payment for Jury Duty, DC 8:3
- Grand Jury Forms and Procedures
Name Change
- Adult Name Change Forms and Instructions, DC 6:9(1) through DC 6:9(3a)
- Child(ren) Name Change Forms and Instructions, DC 6:11(a) through DC 6:11(6)]
Power of Attorney
- Power of Attorney (General), DC 6:12
- Instructions for Power of Attorney (General), DC 6:12(a)
- Power of Attorney for Health Care, DC 6:13
- Instructions for Power of Attorney for Health Care, DC 6:13(a)
Probation Order
- Order of Probation, DC5:2 (WORD format)
Protection Orders
- Praecipe, DC 19:1
- Petition and Affidavit to Obtain Harassment Protection Order, DC 19:2
- Protection Order Information (Harassment), DC 19:3
- Harassment Protection Order (Ex Parte), DC 19:4 (Fill-in format)
- Harassment Protection Order (After Hearing, Ex Parte Order Issued), DC 19:5
- Harassment Protection Order (After Hearing No Ex Parte Order Issued), 19:6
- Protection Order – Order to Show Cause – Harassment, DC 19:7 (Fill-in format)
- Petition and Affidavit to Obtain Domestic Abuse Protection Order, DC 19:8
- Protection Order Information (Domestic Abuse), DC 19:9
- Ex Parte Domestic Abuse Protection Order, DC 19:10
- Modified Domestic Abuse Protection Order, DC 19:11B
- Domestic Abuse Protection Order, DC 19:12
- Order to Show Cause – Domestic Abuse, DC 19:13
- Request for Hearing (Provided with all Ex Parte Orders), 19:14
- Notice of Hearing (Used when a request for hearing form is filed in a Harassment Protection Order), DC 19:15
- Order Dismissing Petition Without Hearing, DC 19:16
- Motion to Vacate and Set Aside and to Dismiss, DC 19:18
- Request for Modification to Domestic Abuse Protection Order, DC 19:19
- Order Affirming Domestic Abuse Protection Order, DC 19:20
- Order Dismissing Ex Parte Domestic Abuse Protection Order, DC 19:21.1
- Order Dismissing Petition and Affidavit to Obtain Domestic Abuse Protection Order, DC 19:21.2
- Order to Grant Dismissal Domestic Abuse Protection Order, DC 19:21.3
- Order Dismissing Ex Parte Harassment Protection Order, DC 19:22.1
- Order Dismissing Petition and Affidavit to ObtainHarassment Protection Order, DC 19:22.2
- Order to Grant Dismissal Harassment Protection Order, DC 19:22.3
- Request for a Modification to a Harassment Protection Order, DC 19:23
- Social Security, Gender, Birth Date(s), DC 6:5(12) (Fill-in format)
- DC 6:5(12) (Spanish)
Juvenile Court Forms
- Summons, JC 14:1
- Notice in Lieu of Summons -- Juvenile First Appearance, JC 14:1A
- Subpoena, JC 14:2
- Order for Hearing, JC 14:4
- Guardian Ad Litem Checklist, JC 14:5
- JC 14:5 (Spanish)
- Abuse Neglect Cases, Journal Entries and Orders for, JC 14:11(1) through JC 14:11(10) plus additional Through the Eyes Initiative forms
- Waiver of Parental Consent for Abortion for Minors, JC 14:6 through JC 14:10
- Seal a Juvenile Record, Motion and Orders for, JC 15:1(a) through JC 15:4(a)
Probation Order
- Order of Probation, JC14:12 (WORD format)
County Court Forms
Administrative
Adoptions
- Record of Disclosure, CC 17:1
- Order Directing Investigation, CC 17:2
- Journal Entry, CC 17:3
- Notice of Adoptive Placement of an Indian Child, CC 17:4
- Notice of Adoption -- Medical History, CC 17:5
- Certification of Adoption, CC 17:6
- Request to Open adoption Records, CC 17:7
- Adoption Records Order, CC 17:7(1)
- Adoption Medical History (DHHS form)
Appeals
- Appeal Recognizance, CC 9:1
- Notice of Appeal (Small Claims), CC 9:2
- Appeal Bond (Small Claims), CC 9:3
- Supersedeas Bond, CC 9:4
- County Court Appeal to District Court, Certificate of Transript *
- Praecipe for Transcript (Small Claims), CC 9:6
- Praecipe for Bill of Exceptions (Small Claims), CC 9:7
- Order Permitting Small Claims Appeal In Forma Pauperis, CC 9:8
Bonds
- Appearance Bond, CC 13:1
- Assignment of Bond, CC 13:2
- Bond Review Hearing, CC 13:3
- Declaration of Forfeiture of Bail, CC 13:4
- Order to Set Aside Forfeiture of Bail, CC 13:5
- Judgment of Default and Execution, CC 13:6
- Order Deducting Fines and Costs from Bond, CC 13:7
Civil
- Order for Hearing, CC 3:1
- Summons, CC 3:2
- Summons for Restitution of Premises, CC 3:3
- CC 3:3 (Spanish)
- Summons -- Replevin, CC 3:4
- Temporary Order in Replevin and Notice for Hearing, CC 3:5
- Garnishments, CC 3:6 through CC 3:8E
- Praecipe for Execution, CC 3:9
- Execution, CC 3:10
- Execution -- Notice of Exemptions, CC 3:11
- Subpoena Duces Tecum, CC 3:12
- Fence Dispute Complaint, CC 3:13
- Guide to Mediation of Fence Disputes (No specific form number, may be photocopied on back of complaint or given separately)
- Certified Mail Instructions for Fence Disputes, Guide to Mediation of Fence Disputes, CC 3:14
- Personal and Financial Information of Parties (general civil cases), CC 16:13
Criminal
- Subpoena, CC 6:2
- Order to Show Cause, CC 6:4
- Commitment to County Jail, CC 6:5
- Mittimus, CC 6:5A
- Citation in Lieu of Arrest, CC 6:6
- Certificate of Transcript, CC 6:7
- Waiver of Extradition, CC 6:8
- Sex Offender Registration Form, CC 6:9 (effective 01-01-2010)
- Notice Upon Conviction of a Misdemeanor Crime Involving Domestic Violence, CC 6:10
- Motion to Set Aside Criminal Conviction, CC 6:11
- Instructions for Motion to Set Aside Criminal Conviction, CC 6:11(a)
- Order Setting Aside a Criminal Conviction, CC 6:11(2)
- Instructions for Order Setting Aside a Criminal Conviction, CC 6:11(2a)
Guardianships/Conservatorships
- Orders of Appointment
- Acceptances of Appointment
- Letters
- Reporting and Information Forms
- Forms for Discharge of Guardian/Conservator
Jury
- Request for Jury, CC 7:1
- Order to Appear for Jury Service After Summons, CC 7:2
- Voir Dire, CC 7:3
- Jury List, CC 7:4
- Verdict of Jury
- Jury Fee List, CC 7:7
Probate/Estates
Probation Order
- Order of Probation, CC6:10 (WORD format)
Small Claims
- Plaintiff's Claim and Notice to Defendant, CC 4:1 (Fill-in format)
- Counterclaim or Setoff of Defendant, CC 4:2 (Fill-in format)
- Notice of Transfer to Civil Docket and Pretrial Order, CC 4:3
- Small Claims Judgment, CC 4:4
- Certified Mail Instruction and Return, CC 4:5
- Praecipe for Subpoena, CC 4:6
- Dismissal, CC 4:7
- Satisfaction of Judgment, CC 4:8
- Motion to Set Aside Default Judgment and Application for New Trial, CC 4:9
- Order on Motion to Set Aside Default Judgment and Application for New Trial, CC 4:10
Traffic
Warrants
* These forms are part of the Nebraska Supreme Court Rules.
Human Resources Forms
-
First Report of Alleged Occupational Injury or Illness (Workers' Compensation Court form)
-
Physician’s/Practitioner’s Certification Form (for Catastrophic Leave)
- Timesheets
- Tuition Reimbursement Request Form
Judicial Branch Education Forms
-
Request for Commitment of Funds, Attendance at Non-Sponsored JBE Program (Fill-in format)
-
Request for Credit, Non-JBE Sponsored Program (Fill-in format)
Administrative Forms
Audio Copy Request, County Court
- Request Form for Copy of Digital Audio Record * (Uniform County Court Rules of Pratice and Procedure, Appendix 9)
Attorney Forms
- Trust Accounts and Blanket Bonds * (Trust Accounts and Blanket Bonds Rules, Appendix 1)
Affidavit to be filed annually with the NSBA.
- Approved Financial Institution List
- Trust Accounts and Blanket Bonds Rule *
Complaint Against Judges
Court Security Incident Reporting Form
FAX Cover Page * (Rules for Use of Fax Machines in State Courts, Appendix 1). FAX Cover sheet for use in Nebraska Courts – use only for documents to be filed in the court file. Rules for the Use of FAX Machines in State Courts *
Interpreters Forms for Payments
Judges' Forms *
- Judicial Financial Interest Statement
- Report of Cases Under Advisement
Judicial Vacancy Application Package
Juvenile Civil Citation *
This file last modified Friday, 16-Nov-2012 14:13:35 CST