Merced — MSC-FL-021

Source: https://www.merced.courts.ca.gov/system/files/forms-and-filings/msc-fl-021-ex-parte-request-and-order-re-disqualification-ccrc-or-evaluator-ada-comp.pdf

MSC-FL-021 Attorney or Party without Attorney FOR COURT USE ONLY

Name:

Street Address:

Mailing Address:

City and Zip Code:

Telephone No: Fax No:

Attorney for: (Name) SUPERIOR COURT OF CALIFORNIA, COUNTY OF MERCED STREET ADDRESS: 2260 N Street MAILING ADDRESS: 627 W. 21ST Street CITY AND ZIP CODE: Merced, CA 95340 Branch Name: Family Law Division PETITIONER:

RESPONDENT:

CLAIMANT: EX PARTE REQUEST AND ORDER Case Number: RE: DISQUALIFICATION OF CCRC OR EVALUATOR

1.) I am the Petitioner Respondent Other: in the action herein.

2.) I move to disqualify to act as Child Custody Recommending Counselor (CCRC) or Evaluator in the matter herein for the following reasons:

a.) Conflict of Interest. Please state all facts which support this claim. You may attach additional pages as needed.

b.) Other. Please state all facts which support this claim. You may attach additional pages as needed.

Date: PETITIONER/RESPONDENT/OTHER

EX-PARTE REQUEST AND ORDER RE: DISQUALIFICATION OF CCRC OR EVALUATOR

For Optional Use Page 1 of 2 MSC-FL-021 [Rev. July 1, 2018]

MSC-FL-021 PETITIONER: CASE NUMBER: RESPONDENT: CLAIMANT:

ORDER

The Court hereby:

Denies the Order requested: Grants the Order requested:

It is so ordered.

Dated: JUDGE/COMMISSIONER OF THE SUPERIOR COURT

PROOF OF SERVICE BY MAIL

On I served the above Ex-Parte Request and Order Re: Disqualification or CCRC or Evaluator by depositing a copy thereof, enclosed in a sealed envelope with postage prepaid, in the United States mail, to the following parties and/or their attorney of record at the following addresses:

At the time of service, I was at least 18 years of age and not a party to the action. My address is:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and this declaration is executed on in , California.

SIGN

SignaturePrinted Name

EX-PARTE REQUEST AND ORDER RE: DISQUALIFICATION OF CCRC OR EVALUATOR

For Optional Use Page 2 of 2 MSC-FL-021 [Rev. July 1, 2018]