STATE OF SOUTH CAROLINA ) ) COUNTY OF ___________________________ ) ) ) ) Plaintiff, ) vs. ) ) ) Defendant. ) IN THE FAMILY COURT _____JUDICIAL CIRCUIT REQUEST FOR HEARING Docket No. _____________________________ Plaintiff's Attorney: ____________________________________________________________ Mailing Address: Telephone: Email: Mailing Address: Telephone: Email: Guardian ad Litem: Mailing Address: Telephone: Email: Type of Hearing: Time Needed: ____________________________________________________________ ___________________ ext. _________________ Fax: ______________ ____________________________________________________________ ____________________________________________________________ ___________________ ext. _________________ Fax: ______________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ___________________ ext. _________________ Fax: ______________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Yes Yes No No If yes, explain: ___________ Defendant's Attorney:____________________________________________________________ Dates and Times Unavailable: _____________________________________________________ Child Custody at Issue: Are Other Issues Contested ______________________________________________________________________________ If yes to either above, submit a mediation report. Comments and Issues: For: ______________________________________________________ Plaintiff Defendant Hearing Requested by: __________________________ Date: _____________________, 20___ ****Section below to be completed by Clerk of Court. **** The hearing in this matter is scheduled for ____ day of ___________________20___, at ___:___ a.m./p.m., Courtroom _______________________, before the Honorable _________________________________ for ____________________________ (length of time). SCCA 410 (12/2009) American LegalNet, Inc. www.FormsWorkFlow.com