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Fill and Sign the State of South Carolina in the Court of Common Pleas Form

Fill and Sign the State of South Carolina in the Court of Common Pleas Form

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SCCA 410 (12/2009) Plaintiff’s Attorney: ____________________________________________________________ Mailing Address: ____________________________________________________________ Telephone: ___________________ ext. _________________ Fax: ______________ Email: ____________________________________________________________ Defendant’s Attorney:____________________________________________________________ Mailing Address: ____________________________________________________________ Telephone: ___________________ ext. _________________ Fax: ______________ Email: ____________________________________________________________ Guardian ad Litem: ____________________________________________________________ Mailing Address: ____________________________________________________________ Telephone: ___________________ ext. _________________ Fax: ______________ Email: ____________________________________________________________ Type of Hearing: ____________________________________________________________ Time Needed: ____________________________________________________________ Dates and Times Unavailable: _____________________________________________________ Child Custody at Issue: Yes No Are Other Issues Contested Yes No If yes, explain: ___________ ______________________________________________________________________________ If yes to either above, submit a mediation report. Comments and Issues: ______________________________________________________ Hearing Requested by: __________________________ Date: _____________________, 20___ For: Plaintiff Defendant ****Section below to be completed by Clerk of Court. **** The hearing in this matter is scheduled for ____ day of ___________________20___, at ___:___ a.m./p.m., Courtroom _______________________, before the Honorable _________________________________ for ____________________________ (length of time). STATE OF SOUTH CAROLINA ) IN THE FAMILY COURT ) _____JUDICIAL CIRCUIT COUNTY OF ___________________________ ) ) ) ) REQUEST FOR HEARING Plaintiff, ) vs. ) ) ) Defendant. ) Docket No. _____________________________

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