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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 939 W. Main Street El Centro, CA 92243

PETITIONER:

RESPONDENT: REQUEST FOR HEARING CASE NUMBER:

HEARING DATE: ___________________

TIME: ___________________________

DEPT: ___________________________

Check one of the following:

Default Dissolution Default Civil (Prove Up Hearing)

Adoption Hearing Petition to Declare Free from Parental Control

Petition for Minor’s Compromise Petition for Grandparent Visitation

Request for Recall of Bench Warrant Issued on:

Ex Parte Hearing Re:

Other:

Date:

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Type or Print Name Signature of Party or Attorney

• Note: This form must be served 16 Court Days before the hearing date set.

Form Approved for Optional Use GN-01 (Adopted 07/01/07, Revised 01/01/12, 01/01/13, 01/01/16) REQUEST FOR HEARING