___________________________________ VS. _________________________________ PLAINTIFF / COMMONWEALTH On behalf of the Trial Court of Massachusetts District Court Department CASE DOCKET NO. MOTION TO THE COURT AND AFFIDAVIT DISTRICT COURT DEFENDANT Plaintiff Commonwealth Defendant in this case, I respectfully request the Court: Continuance: to continue this case which is presently scheduled for _________________________________________ Event on __________________________, until _________________________, for the reasons given on page 2 of this form. Remove default: to order that the default, default order, or default judgment that was entered on ____________________ be set aside, and that this case be restored to the court's calendar, for the reasons given on page 2 of this form. Remove dismissal: to order that the order for, or judgment of, dismissal that was entered on _____________________ be set aside, and that this case be restored to the court's calendar, for the reasons given on page 2 of this form. Speedy trial: to order that the complaints whose numbers are listed above be advanced for speedy trial, for the reasons given on page 2 of this form. New trial: to order that the court's judgment in this case dated ______________________ be vacated and a new trial ordered,for the reasons given on page 2 of this form. Date Revise or revoke sentence: to revise or revoke the sentence(s) imposed in this case on ____________________ for the reasons given on page 2 of this form. Date Amend or extend an abuse prevention order: to extend or amend the abuse prevention order under G.L. c. 209A dated __________________________ in the manner and for the reasons given on page 2 of this form. Withdraw from representation: to be permitted to withdraw from further representation of the _______________________ in this case for the reasons given on page 2 of this form. Party Other: (Specify what you are asking the Court to do and the reasons on a separate piece of paper and attach it to this form.) I have today mailed delivered a copy of this motion to all other parties to this case. Any statements of fact made in this motion are made under the penalties of perjury and of my own personal knowledge. DATE based on information that I believe is true. SIGNED X PRINT NAME ADDRESS PHONE NO. If motion is agreed to by other party, that party or attorney should sign here to indicate assent. DATE SIGNED PHONE NO. X FOR CLERK-MAGISTRATE'S USE ONLY This motion has been scheduled for hearing > before the Court on this date and time > DATE DATE OF HEARING TIME OF HEARING CLERK-MAGISTRATE OR DESIGNEE FOR JUDGE'S USE ONLY After hearing DATE Without a hearing this motion is Allowed. Denied. JUSTICE X American LegalNet, Inc. www.FormsWorkFlow.com (Rev 10/09) MOTION TO THE COURT AND AFFIDAVIT - PAGE 2 CASE DOCKET NO. Please note that you must comply with any court rules that govern your specific motion. Attach any materials you wish the Court to consider. Include all reasons for your motion; failing to include a reason may bar you from raising it later. As indicated on page one, note that any factual statements are made under the penalties of perjury. American LegalNet, Inc. www.FormsWorkFlow.com (Rev 10/09)