JDF 1333 R 5 /1 8 REQUEST FOR A TTORNEY WITHDRAWAL DOMESTIC POST DECREE MATTERS ONLY District Court Denver Juvenile Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petiti oner: and Co - Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Numbe r: Division Courtroom REQUEST FOR ATTORNEY WITHDRAWAL DOMESTIC POST DECREE MATTERS ONLY I, (name of party) as the Petitioner or Co - Petitioner/Respondent in this case, request that this Court allow the withdrawal of the attorney of record and state the following: 1. At this time, I am no longer represented by an attorney and plan to file any future motions with this C ourt by representing myself. 2. I understand that the attorney of record failed to file a notice to withdrawal in accordance with Rule 121, 1 - 1(3) of the Colorado Rules of Civil Procedure at the conclusion of this case . 3. The Final Decree or Final Order was entered by th is Court on (date). 4. My current address and contact information is as follows: Address: City: State: Zip Code: Home Phone #: Work Phone #: Cell #: By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. Date: Petitioner or Co - Petitioner/Respondent CERTIFICATE OF SERVICE I certify that on (date) the original was filed with the Court and a true and accurate copy of the REQUEST FOR ATTORNEY WITHDRAWAL was served on the other party and the attorney of record by: Hand Delivery, E - filed, Faxed to this number: , or by placing it in the United States mail, postage pre - paid, and addressed to the following: To: Your signature American LegalNet, Inc. www.FormsWorkFlow.com