VIRGINIA: IN THE CIRCUIT COURT OF THE CITY OF VIRGINIA BEACH ___________________________ Complainant v. Case No.: ______________________ ___________________________ 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 totally 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 (at least 2 copies) Original Separation Agreement Proof of Service of Bill of Complaint, and/or waiver Original Completed VS-4 Form Self-addressed, stamped envelope (only required if proceeding without an attorney) Order for restoration of former name Other: _____________________________________________________ I am the Complainant, Defendant. Defendant, VSB # if an attorney ______________ Counsel for Complainant, or Counsel for ________________________________ Print Name ______________________________________________________________________ STREET ADDRESS, City/State/Zip __________________________ Daytime Phone Number Certificate of Mailing I certify that I mailed a true copy of this request to ____________________________________ on ___________________. _________________________________________ SIGNATURE American LegalNet, Inc. www.FormsWorkflow.com