IN THE COURT OF COMMON PLEAS OF CHESTER COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: {use initials only} Case Number: ___________________________ MOTION TO IMPOUND RECORDS AND NOW, the undersigned attor ney, ________________________, Esquire, makes the following Motion in these proceedings: 1. Petitioners, _______________________ and _____________________ , rsuant to the Penns ylvania Department of rations" procedur e to have themselv es husband and wife, have filed a Petition pu Health's " Assisted Conception Birth Regist declared the legal parent s of [CHILD'S NAME], born [D/O/B ], by a gestational carrier, and to have the originally issued certificate of birth reflect said parentage. 2. Petitioners request that any and all rec ords relating to these proceedings , the petition and all rela ted papers and writings, be including without limitation, impounded and withheld from ins pection by anyone other than at torneys for the parties to these proceedings, except upon an order of court granted upon cause shown. Respectfully submitted, Attorney Date:______________________ ______________________________________ for Petitioners American LegalNet, Inc. www.FormsWorkFlow.com