. STATE OF NORTH CAROLINA Harnett County File Number In The General Court Of Justice District Court Division Name of Plaintiff(s) VERSUS Name of Defendant(s) PARENTING COORDINATOR'S MOTION FOR REVIEW OF PARENTING COORDINATOR'S REPORT Date of Separation: NOW COMES the undersigned Parenting Coordinator (PC) and moves this court for a review and hearing on the issue or issues raised in the attached PC report pursuant to N.C.G.S.§50-97 and hereby certifies that the attached report is a true and correct copy of the report prepared from records kept by the undersigned PC. Date: _______________________ PC ________________________________________(Signature) PC (Printed name) VERIFICATION , first being duly sworn, deposes and says that he/she is the Parenting Coordinator (PC) in the aboveentitled action; that he/she has prepared the attached report; that he/she knows the contents therein; and, that the same is true of his/her own knowledge, save except those matters and things stated herein upon information and belief, and as to those matters and things, he/she believes them to be true. Date:__________________ Parenting Coordinator ________________________________________________ (Signature) Parenting Coordinator (Printed name) Sworn to and subscribed before me this the ______ day of _________________, 20___. Notary Public: ___________________________________________ (SEAL) My commission expires: __________________ CERTIFICATE OF SERVICE I certify that on the date of mailing shown below, a copy of this MOTION was served on the at the address listed below by depositing a copy in a postage-paid, properly addressed envelope in a post office or official depository under the exclusive care and custody of the United States Postal Service. Address: Date of Mailing: ________________________________________________ Date of Certification: Signature of Parenting Coordinator: PC-5 (rev. 10/2014) District 11 ­ Parent Coordinator American LegalNet, Inc. www.FormsWorkFlow.com