MPC 302 (5/30/11) APP
of
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APPLICATION FOR PERMISSION TO
PROVIDE INFORMATION
Commonwealth of Massachusetts
The Trial Court
Probate and Family Court
Docket No.
1.
Name of applicant:
Last Name
First Name
Middle Initial
(Address)
(City/Town)
(State)
(Zip)
(Apt, Unit, No. etc.)
2.
My relationship to Respondent is:
3.
I believe the information would be helpful to the Court because:
In the Interests of:
Last Name
First Name
Middle Name
Respondent
Division
I have attached a written statement of the information to this application. I understand that the attached written
statement is not evidence and that I may be requested to testify at Court. I attest under the penalties of perjury
that the information contained in this application and the attached statement of information are true to the best of my
knowledge and belief.
Date
Signature of Requesting Party
After
making a determination without a hearing, the best interests of the Respondent
hearing
Denied.
Granted.
Granted subject to the following conditions:
will not
will
be served by the granting of this application. Therefore, the application is:
COURT USE ONLY
Deferred. The applicant shall serve the parties by regular mail with a copy of the application and attachment,
subject to the following conditions:
Date
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