IN THE CIRCUIT COURT IN AND FOR SANTA ROSA COUNTY, FLORIDA THE STATE OF FLORIDA, on behalf of , Petitioner/Custodial Parent/Designated Relative Case No. v. . Respondent/Non-Custodial Parent MOTION FOR AUTHORITY TO PARTICIPATE BY TELEPHONE IN CHILD SUPPORT CASES HEARING (TITLE IV-D CASE) I, , move for authority to participate by telephone in the child support case hearing (Full Legal Name) scheduled on at for the following grounds (Provide explanation for (Date of Court) (Time and Place of Court) reason for requesting telephonic hearing and inability to appear personally for hearing): Please check one:If granted, I can cannot have a notary public available where I am present to swear me in. I CERTIFY that a copy of this motion has been faxed, mailed or hand delivered to the Santa Rosa County Clerk of SANTA ROSA County Court House in Milton, Florida this day of,20. Employer Name Signature of Requesting Party Printed Name Address Employer address City, State, ZIP Work phone number: Telephone No. to call you for hearing Fax No. ORDER ON MOTION TO PARTICIPATE BY TELEPHONE The above motion is GRANTED DENIED Date: Mark S. Rubin, Hearing Officer Notification of decision granting or denying this Motion has been provided to Requesting Party as follows: American LegalNet, Inc. www.FormsWorkFlow.com