_______________________________ Plaintiff | : | IN THE COURT OF COMMON PLEAS DAUPHIN COUNTY, PENNSYLVANIA |
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v. | : | NO. ______ CV ______ |
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_______________________________ Defendant | : | CIVIL ACTION IN DIVORCE |
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(ATTORNEY FOR MOVING PARTY)(SELF-REPRESENTED MOVING PARTY):
Name: _____________________________________________
Address: ___________________________________________
Phone: _______________ FAX: ___________________ E-Mail: __________________
(ATTORNEY FOR NON-MOVING PARTY) (SELF-REPRESENTED NON-MOVING PARTY):
Name: _____________________________________________
Address: ___________________________________________
Phone: ________________ FAX: ___________________ E-Mail: ____________________
REQUEST FOR ASSIGNMENT TO DIVORCE HEARING OFFICER OR JUDGE
Date Petition for Special Relief/Advance Distribution/Post-Divorce Relief was filed: _________________
Date Rule to Show Cause was issued: _________________
Date Response was filed: ___________________
The matter is ready for assignment to a Judge or Divorce Hearing Officer.
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Date
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Signature
Daup. Cnty. Pa. 1920.43