VIRGINA: IN THE CIRCUIT COURT OF THE CITY OF CHESAPEAKE ________________________________, Complainant Vs ________________________________, Defendant HEARING REQUEST The undersigned party/counsel hereby requests that this matter be set for an uncontested divorce hearing before a judge. I certify that all issues are uncontested as required by the Court's procedures for these hearings. I am including or have previously filed the following documents: ___ ___ ___ ___ ___ ___ ___ Final Decree of Divorce Original Separation Agreement, if applicable Proof of Service of Bill of Complaint, and/or waiver Original completed VS-4 form Self-addressed stamped envelope Addendum � Identifying Information Other________________________________________________ In Chancery No. CH______________ I am the ___ Complainant, ___ Defendant, ___ Counsel for Complainant or ___ Counsel for Defendant. VSB# if an attorney_____________ Name________________________________ Address______________________________ _____________________________________ Phone number__________________________ Certificate I certify that I mailed a true copy of the foregoing to _______________________ on _________________________________, 20________ by first class mail with postage affixed. _____________________________________ Sign _____________________________________ Print Name American LegalNet, Inc. www.USCourtForms.com