f the court order. PBSD 0636 (Rev. 03117/2004) page 1 of 2 EFTA01709716 PARENT/LEGAL GUARDIAN INFORMATION (33) FATHER OR LEGAL GUARDIAN (16's( (Mete MAIM 4430 (34) DATE OF BIRTH (44) MOTHER OR LEGAL GUARDIAN (w. middle Witt, last) (45) DATE OF BIRTH (35) ADDRESS Meet number snot aPartmeal number)