500-0042 226 Judicial Bureau Motion (0/2019) Page 1 of 1 Vermont Judicial Bureau PO Box 607 White River Junction, VT 05001 Phone: 802 - 295 - 8869 www.vermontjudiciary.org JUD.VJB@vermont.gov JUDICIAL BUREAU MOTION DEFENDANT INFORMATION Name: Mailing Address Street: City: State: Zip: Date of Birth: Phone: Email Address: COMPLAINT NUMBER: I, request the Court to consider the following request: Motion for Relief from Judgment.*Motion to Acknowledge Completion of Non-Monetary Penalty.Other Request* I submit the following information and facts to support my request: Date: Signature Required Printed Name *A $45.00 FILING FEE REQUIRED. American LegalNet, Inc. www.FormsWorkFlow.com