F o r m A pp r oved f or Mandatory Use C T - 143 FAMILY LAW COVERSHEET FOR ASSSIGNMENT TO DISTRICT Page 1 of 1 ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: (Name and address) TELEPHONE NO.: FAX NO. (Optional) : EMAIL ADDRESS (Optional) : ATTORNEY FOR (N ame): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE STREET ADDRESS: 341 The City Drive South MAILING ADDRESS: P.O. Box 14169 CITY AND ZIP CODE: Orange, Ca. 92863 - 1569 BRANCH NAME Lamoreaux Justice Center PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: FAMILY LAW COVERSHEET FOR ASSIGNMENT DISTRICT CASE NUMBER: This form is REQUIRED for any Family Law case NOT already assigned to a judge or commissioner and MUST be submitted with a form requesting an initial Court hearing. Do not use this form if the hearing is for Special Immigrant Juvenile Findings, Department of Child Support Services , Adoption, or Domestic Violence requests. 1. Select one of the following cities where the Filing Party resides . The party who files the first document requesting a a. North Justice Center : Brea Buena Park Fullerton La Habra La Palma Placentia Yorba Linda b. Harbor Justice Center: Coto de Caza Dana Point Ladera Ranch Laguna Beach Laguna Hills Laguna Niguel Laguna W oods Lake Forest Mission Viejo Newport Beach Rancho Santa Margarita San Clemente San Juan Capistrano c. West Justice Center: Cypress Fountain Valley Garden Grove Huntington Beach Los Alamitos Midway City Rossmoor Seal Beach Stanton Westminster d. None of the above cities : 2. F iling P arty address (if address is confidential , provide mailing address) : 3. Does any party require an interpreter? : Petitioner Language: Respondent Language: I declare under penalty of perjury under the laws of the State of California that the forgoing is true and correct. Date: (TYPE OR PRINT NAME ) (SIGNATURE OF DECLARANT) American LegalNet, Inc. www.FormsWorkFlow.com