ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): 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 Adoption Hearing Petition for Minor's Compromise Request for Recall of Bench Warrant Issued on: Ex Parte Hearing Re: Other: Default Civil (Prove Up Hearing) Petition to Declare Free from Parental Control Petition for Grandparent Visitation Date: ___________________________________ 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 American LegalNet, Inc. www.FormsWorkFlow.com