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1/2019 Page 1 of 2 Person Filing: ________________________________________________ Mailing Address: ______________________________________________ City, State, Zip Code: __________________________________________ Telephone Number: ____________________________________________ Atlas Number (if applicable) _____________________________________ Representing Self (No Attorney) OR Represented by Attorney If Attorney, Bar Number: ________________________________________ SUPERIOR COURT OF ARIZONA MOHAVE COUNTY _______________________________________ (Name of Petitioner/Plaintiff) AND _______________________________________ (Name of Respondent/Defendant) Case Number: ________________________ MOTION: __________________________ _____________________________________ _____________________________________ (Title of Form) COMES NOW ______________________________ in the above captioned case to request the Court to: (Name) _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ For the following reason(s): _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Continued on next page For Clerk’s Use Only

SUPERIOR COURT OF ARIZONA MOHAVE COUNTY › court forms › Clerks Office...1/2019 Page 1 of 2 Person Filing: _____ Mailing Address: _____ City, State, Zip Code: _____ Telephone Number:

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Page 1: SUPERIOR COURT OF ARIZONA MOHAVE COUNTY › court forms › Clerks Office...1/2019 Page 1 of 2 Person Filing: _____ Mailing Address: _____ City, State, Zip Code: _____ Telephone Number:

1/2019 Page 1 of 2

Person Filing: ________________________________________________

Mailing Address: ______________________________________________

City, State, Zip Code: __________________________________________

Telephone Number: ____________________________________________

Atlas Number (if applicable) _____________________________________

Representing Self (No Attorney) OR Represented by Attorney

If Attorney, Bar Number: ________________________________________

SUPERIOR COURT OF ARIZONA MOHAVE COUNTY

_______________________________________ (Name of Petitioner/Plaintiff)

AND

_______________________________________

(Name of Respondent/Defendant)

Case Number: ________________________

MOTION: __________________________

_____________________________________

_____________________________________

(Title of Form)

COMES NOW ______________________________ in the above captioned case to request the Court to: (Name)

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

For the following reason(s):

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

Continued on next page

For Clerk’s Use Only

Page 2: SUPERIOR COURT OF ARIZONA MOHAVE COUNTY › court forms › Clerks Office...1/2019 Page 1 of 2 Person Filing: _____ Mailing Address: _____ City, State, Zip Code: _____ Telephone Number:

1/2019 Page 2 of 2

Case No._____________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ I declare under penalty of perjury that the foregoing is true and correct.

Signature: ________________________________________ Date: _______________ Copy sent to:

____________________________________________ (other party)

____________________________________________ (address)

____________________________________________ (city, state, zip)

on: _________________________________________ (date)