IN THE CIRCUIT COURT IN AND FOR ESCAMBIA COUNTY, FLORIDA FAMILY LAW DIVISION ______________________________, Petitioner Case No. ______________________ and Division: '' '' ______________________________, Respondent REQUEST TO APPEAR TELEPHONICALLY I, ____________________________________ ( ) petitioner or ( ) respondent in the above referenced case, request that the Court enter an order allowing my appearance by telephone for the hearing scheduled for _________________________________on the grounds as follows: ( ) I am on active military duty stationed in another city/state. Travel to the hearing would create a hardship for me at work and/or financially. ( ) I am presently residing in another state/city, and travel to the hearing would create a financial hardship. ( ) I am incarcerated at ___________________________ jail/prison and will not be released prior to the hearing. ( ) Other: Date:_______________ ___________________________________ Signature ___________________________________ Name Printed or Typed ___________________________________ Street Address ___________________________________ City, Street, Zip Code I hereby certify that a copy of the foregoing was ( ) hand delivered, or ( ) mailed by U.S. regular mail to the other party at the address listed below on this _____day of _______________________, 200____. Name:_____________________________________________ Address:___________________________________________ American LegalNet, Inc. www.FormsWorkflow.com