Form 843 STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION Unit Docket No. Plaintiff Defendant v. NOTICE OF APPEARANCE and INTENT TO REPRESENT MYSELF I understand thatIT IS MY RESPONSIBILITY TO: 1.Notify the Court in writing if I change my address or phone number;and 2.Send copies of any papers I file with the Court to the other party in this case.All court papers may be mailed to me by first class mail at the address listed below. MOTION TO MODIFY PARENTAL RIGHTS AND RESPONSIBILITIES and/or PARENT CHILD CONTACT 1. 037 0372. American LegalNet, Inc. www.FormsWorkFlow.com 3.MediationPLEASE NOTE: If there is a provision in your current order that requires mediation, you must try to resolve your dispute through mediation before returning to court unless there is immediate danger to your child(ren) that requires immediate intervention by the Court. 4. 5.Parental Rights and Responsibilitiesnot6.Parent Child Contact Schedulenot American LegalNet, Inc. www.FormsWorkFlow.com 7.Parent Child Contact Conditions8.Change in CircumstancesbrieflyYOU MUST ATTACH A SEPARATE AFFIDAVIT THAT DESCRIBES THE FACTS THAT SUPPORT YOUR REASONS FOR REQUESTING A CHANGE INCLUDING THE CHANGE IN CIRCUMSTANCES DESCRIBED IN PARAGRAPH . REQUEST TO THE COURT I request that the court: American LegalNet, Inc. www.FormsWorkFlow.com I hereby swear or affirm that the information above is true to the best of my knowledge and belief. Signed and sworn to before me: American LegalNet, Inc. www.FormsWorkFlow.com