Fill and Sign the Judicial Intervention Application Form

(Form UD-13 - Rev. 5/99) REQUEST FOR JUDICIAL INTERVENTION UNCONTESTED DIVORCE SUPREME COURT,       COUNTY INDEX #:       DATE PURCHASED:       -----------------------------------------------------------X       Plaintiff, -against-       Defendant. -----------------------------------------------------------X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NATURE OF JUDICIAL INTERVENTION - EX PARTE APPLICATION FOR THE DISSOLUTION OF MARRIAGE. ATTORNEY(S) FOR PLAINTIFF : Name:       Address:       Phone No.       Name:       Address:       Phone No.       ATTORNEY(S) FOR DEFENDANT : Name:       Address:       Phone No.       Name       Address       Phone No.       Parties appearing without an attorney should enter information in the space provided above for attorneys. RELATED CASES: (If none, write “NONE” below) Title Index # Court Nature of Relationship                                                                         I affirm under penalty of perjury that, to my knowledge, other than as noted above, there are and have been no related actions or proceedings, nor has a request for judicial intervention previously been filed in this action or proceeding. Dated:       (Signature)       (Print or type name) _________________________________________ Attorney for       FOR CLERK USE ONLY __________________ IAS ENTRY DATE JUDGE ASSIGNED RJI DATE __________________ RJI NUMBER ___________________ _