In The Court of Common Pleas Dauphin County, Pennsylvania PRAECIPE/REQUEST FOR ASSIGNMENT To be filed with the Clerk of the Orphans’ Court IN RE: DOCKET # Estimated Hearing/Conference Time:_____ Day(s)_____Hours SPECIFIC MATTER TO BE ASSIGNED - Check Only One Category Assignment Proceedings and Conferences Adoptions Compel Accounting Sale of Real Estate Involuntary/Voluntary Termination Objections to Account Attorneys Fees Guardian of Incapacitated Person Proceedings Against Fiduciaries Status Conference Discharge Guardian Will Contest Argument Guardian of Minor Inheritance Tax Appeal Other (describe) Minor Settlement Terminate Trust Wrongful Death/Survival Dissolution of Corporation/Charity Name(s) and Judge(s) of related case(s) _______________________________________________________________________________ Docket number(s) of related case(s)________________________________________________ Date:____________________ __________________________________________ Attorney for Petitioner______Respondent________ NAMES, ADDRESSES, E-MAILS & TELEPHONE NUMBERS OF ALL COUNSEL INVOLVED (use back of form for additional names and addresses) For the Petitioner(s): Telephone No. For the Respondent(s): Telephone No. American LegalNet, Inc. www.USCourtForms.com