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JUD INE RE UEST F RM E ON

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___
_
P
-v-
___
_
D
or I
n
I co
n
for t
h
my
r
MOTION TITLE: __________________________________________________________________________
Pa
ym
MA
I
_
_________
_
P
laintiff,
_
_________
_
D
efendant,
n
the Matter
n
tacted and
h
e date and
t
r
equest on _
_
REQUESTING PARTY: ______________________________________________
EVENT TYPE: ________________________
(i.e. Settlement Conference, Status Conference, Motion, Pretrial
EVENT DATE: ________________
CONTACT PHONE NUMBER: _________________________________
m
ent Cont
a
I
L TO: Th
e
At
t
12
0
Po
n
24
8
_
________
_
_
________
_
of, ______
_
r
eceived ap
p
t
ime stated
i
_
________
_
a
ct Name:
__
e
Circuit Co
u
n:
Case Ma
n
0
0 N. Teleg
r
n
tiac, MI 48
3
8
-858-0351
JUD
G
_
_________
_
_
_________
_
_
_________
_
p
roval from
_
i
n this reque
_
(date and tim
Sign
e
__________
u
rt for the
C
n
agement, J
U
r
aph Rd., D
e
3
41-0404
G
E ON –
L
_
_______
_
_______
_
________
_
Reque
s
_
________
_
st. I notifie
d
e).
N
O REF
U
e
d:_______
_
Re
q
___________
C
ounty of O
a
U
DGE ON-
L
pt. 404
L
INE RE
Q
Case No
:
Hon. __
_
Referee
_
_
_________
_
s
t: Judge O
n
_
____ in jud
g
d
opposing c
o
U
NDS WILL
B
_
________
_
q
uesting Pa
r
__________
PLEASE SUBMIT
BY MAIL
,
a
klan
d
F
L
INE
E
Q
UEST F
O
:
________
_
_
_________
_
_
________
_
_
________
_
n
-Line.
g
e’s chamb
e
o
unsel, ___
_
B
E GIVEN AF
T
_
_________
_
r
ty
EVENT TIME: _________________
_
,
FAX OR
E
F
AX TO: 2
4
E
MAIL TO
O
RM
_
_________
_
_
________
_
_
_________
_
_
_________
_
e
rs/referee’s
_
________
_
T
ER PAYME
N
_
___
(Landlines are preferred. If a cellular phone call is dropped, the Court will attempt to call you a second time. If that fails, you
must pay the other party's Judge On-Line fees, and all re-scheduling fees).
PAYMENT METHOD: CASH CHECK CREDIT CARD
Phone Number:__________________
E
MAIL
4
8-858-957
3
: JUDGEO
N
_
____
_
___
_
___
_
________
_
office on _
_
_
_________
_
N
T IS PROC
E
3
N
LINE@O
A
_
_________
_
_
_________
_
________
o
E
SSED.
A
KGOV.C
O
_
__
o
f
M
$30 Fee per Participating Phone Number Must be Paid to Case Management Office (Cash Payment must be made in person,
Checks or Money Orders in person or by mail - payable to Oakland County Circuit Court. Credit Card payments will be
taken on line at: https://payments.g2gcloud.com/occircuit/611 ).
NO REFUNDS WILL BE GIVEN ONCE PAYMENT IS PROCESSED.
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JUD INE RE UEST F RM E ON

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Completed 18 July 2020

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