Fill and Sign the Delaware Order PDF Form

Form 455 Rev 2/18 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County REQUEST FOR REVIEW OF A COMMISSIONER’S ORDER Petitioner v. Respondent Name Name File Number             Street Address Street Address                   Apt. or P.O. Box Number Apt. or P.O. Box Number Petition Number             City State Zip Code City State Zip Code                                     Attorney Name and Phone Number Attorney Name and Phone Number                         (If party seeking the Review of a Commissioner’s Order is the Original Petitioner in a PROTECTION FROM ABUSE action, please DO NOT DISCLOSE YOUR ADDRESS above, as a copy of this request must be mailed to the Respondent.) 1. I am the original Petitioner Respondent in this action. 2. Nature of Proceedings: 3. 4. Objections to the Commissioner’s Order ( Please set forth specific objections to the Commissioner’s Order, and describe in detail the basis for each objection ):                                                       5. I hereby request that a transcript of the proceedings before the Commissioner be prepared I certify that I will pay all costs associated with the preparation of the transcript. I certify that I have completed and attached an Affidavit to Proceed In Forma Pauperis and Motion to Waive Transcript Fees       Date Petitioner/Petitioner’s Attorney 1 of 2                        , Petitioner herein, appeals the Order Entered by       Commissioner and dated       Form 455 Rev 2/18 VERIFICATION STATE OF DELAWARE ) ) ss.: COUNTY OF ) _______________________________________, being duly sworn, says: I ___________________________. Affirm that a true and correct copy of this Request for Review of a Commissioner’s Order was placed in the U.S. Mail on the ________ day of _________________, _____________ and sent to the last known address of the other party or attorney, being _______________________________________________________, first class postage prepaid. Subscribed and sworn before me on this date, Movant/Attorney/Court Staff Date Clerk of Court/Notary Public NOTE: IN PROTECTION FROM ABUSE CASES ONLY, THE AFFIDAVIT OF MAILING ONLY APPLIES WHEN THE REQUEST FOR REVIEW OF COMMISSIONER'S ORDER IS BEING FILED BY THE ORIGINAL PETITIONER. IF THE REQUEST FOR REVIEW OF COMMISSIONER'S ORDER IS BEING FILED BY THE ORIGINAL RESPONDENT IN THIS ACTION, A TRUE AND CORRECT COPY OF THE MOTION WILL BE SENT TO THE ORIGINAL PETITIONER BY COURT STAFF. 2 of 2