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Commonwealth of Massachusetts PROBATE AND FAMILY COURT DEPARTMENT Gina L. DeRossi Register Bristol REQUEST FOR UNCONTESTED ASSIGNMENT Division Docket No Supplemental Probate Court Rule 401 requires a current financial statement be on file from a person requesting a hearing involving financial orders. Please assign for hearing Plaintiff V. Defendant Place of Hearing At the earliest convenient time and place At Fall River At New Bedford At Taunton Type of Case For ADA accommodation needs please call 508 672-4669 x204 The following papers must be on file before cases can be assigned for hearing Divorce If the ground for divorce is an irretrievable breakdown of marriage pursuant to M. G.L. C 208 1B then the submission of this form should not occur until after 6 months from the date of filing the original complaint for divorce Summons or Return of Service Separate Support Civil Action Contempt Modification Other Marriage Certificates Birth Certificate Statistical Form R408 Medical Certificate Affidavit of Petitioner Parenting Education Classes are complete and certificates are filed One of the parties requires interpreter services Yes Copy of this request has been mailed to the following named Attorneys / Pro Se Litigants in this action No No Language Country of Origin DATE Requested by Name Address Street City Zip Phone This form should not be used for mark-up of temporary orders and motions. Commonwealth of Massachusetts PROBATE AND FAMILY COURT DEPARTMENT Gina L* DeRossi Register Bristol REQUEST FOR UNCONTESTED ASSIGNMENT Division Docket No Supplemental Probate Court Rule 401 requires a current financial statement be on file from a person requesting a hearing involving financial orders. Please assign for hearing Plaintiff V. Defendant Place of Hearing At the earliest convenient time and place At Fall River At New Bedford At Taunton Type of Case For ADA accommodation needs please call 508 672-4669 x204 The following papers must be on file before cases can be assigned for hearing Divorce If the ground for divorce is an irretrievable breakdown of marriage pursuant to M. G*L* C 208 1B then the submission of this form should not occur until after 6 months from the date of filing the original complaint for divorce Summons or Return of Service Separate Support Civil Action Contempt Modification Other Marriage Certificates Birth Certificate Statistical Form R408 Medical Certificate Affidavit of Petitioner Parenting Education Classes are complete and certificates are filed One of the parties requires interpreter services Yes Copy of this request has been mailed to the following named Attorneys / Pro Se Litigants in this action No No Language Country of Origin DATE Requested by Name Address Street City Zip Phone This form should not be used for mark-up of temporary orders and motions. Instead affidavits of notice should be filed in accordance with the rules after an available time and place for hearing has been obtained from the Register s Office. FOR REGISTER S USE ONLY ACTION The above-entitled matter has been Assigned for Hearing at on20 Counsel notified by mail / telephone Date of notice Returned without action* Data incomplete.

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