IN THE JUVENILE COURT OF MEMPHIS AND SHELBY COUNTY, TENNESSEE _______________________________________________ Petitioner Docket Number ____________________________ V. _______________________________________________ Defendant REQUEST FOR HEARING BEFORE THE JUDGE To the Honorable Judge of the Juvenile Court of Memphis and Shelby County, Tennessee: Your Petitioner respectfully requests a hearing before the Presiding Judge, this matter having heretofore been heard by a Referee on the ________ day of ___________________________________________, 20 _______. ________________________________________ Petitioner Sworn to and subscribed before me this _______ day of _________________________________, 20 _______. STEVE STAMSON, Clerk of Court By __________________________________ D.C. ORDER It appearing to the Court that this matter was duly heard in the first instance by a Referee of this Court, and that the Petitioner, a proper party in the matter, has requested a hearing by the Judge as prescribed by law. IT IS THEREFORE ORDERED that the requested rehearing be and is hereby allowed. This _______ day of ___________________, 20 ______ ______________________________________________ Juvenile Court Judge 6/15/03 JC-58B American LegalNet, Inc. www.USCourtForms.com