WAKE-DOM-02 Page 1 of 2 (Rev. 10/17) NORTH CAROLINA COUNTY OF WAKE IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION FILE NO. Assigned Judge: , Plaintiff, v. , Defendant. AFFIDAVIT FOR JUDICIAL ASSIGNMENT AND NOTICE OF HEARING The undersigned certifies the following: 1. That I am the . 2. That the attached Complaint Answer/Counterclaim Motion in the Cause Motion for Order to Show Cause is: A newly filed action/matter. A filing in which there is a pending action involving the same parties or family in this District. A filing in which there is a resolved action involving the same parties or family in this District. A filing in which there is a pending or resolved action involving the same parties or family in other districts in North Carolina or another state. A Motion for Order to Show Cause for violation of a Domestic Violence Protective Order. 3. Wake County District Court Judge is or was the assigned judge in a pending or prior and/or related family issues. 4. That the issue(s) in this Complaint/Answer/Counterclaim/Motion in the Cause/Motion to Show Cause is/are: (check all that apply) Custody Child Support Divorce from Bed & Board Post-Separation Support Alimony Divorce Equitable Distribution Interim Distribution Other: 5. An interpreter is needed to be present for court proceedings. YES NO If yes, what language(s) does the party speak? This the day of , 20. Plaintiff Defendant Attorney for Plaintiff Attorney for Defendant Daytime Telephone Number: Email Address: American LegalNet, Inc. www.FormsWorkFlow.com WAKE-DOM-02 Page 2 of 2 (Rev. 10/17) NOTICE OF HEARING PLEASE TAKE NOTICE THAT a hearing has been scheduled in this matter on the date and time indicated below, or as soon thereafter as the Court can hear this matter, in the courtroom indicated. FAMILY COURT COMPLETES THIS BOX Judge Assigned: Denning Hamadani Walczyk Worley Other: Temporary Hearing fo r Custody Date: Time: Courtroom: Temporary Hearing for Child Support Date: Time: Courtroom: Post - Separation Support Date: Time: Courtroom: Scheduling and Discovery Conference (ED) Date: Time: Room 1112 Other: Date: Time: Courtroom: FCCC: Date: CERTIFICATE OF SERVICE I hereby certify that a copy of this Affidavit for Judicial Assignment and Notice of Hearing has been served on the opposing party/counsel in the following manner: By depositing a copy in the US Mail in a properly addressed, postpaid envelope to: By hand delivery to: By facsimile to: Fax No.: Other: Date: Plaintiff Defendant Attorney for Plaintiff Attorney for Defendant American LegalNet, Inc. www.FormsWorkFlow.com