___________________________________
___________________________________
___________________________________
Filing Party Name
Filing Party Mailing Address
Filing Party Telephone Number
IN THE CIRCUIT COURT OF THE ____________ CIRCUIT
_____________________________, ) Special Proceeding No. ________
)
Petitioner(s), )
)
v. )
)
_____________________________, )
)
Respondent(s). )
)
CERTIFIED CONVERSION PETITION
Petitioners ______________________________________________________________
[Name of Petitioners]
____________________________________________________________
assert for their cause:
1. Petitioners are the owners and occupants of a residential property located in the
__________________________________ at _________________________________________
[County] [Street Address]
____________________________________, identified as Tax Map Key No. _______________,
and Certificate of Title No. or Transfer Certificate of Title No. __________________________.
2. Respondent _______________________________________________________
[Name of Foreclosing Respondent]
_____________________________________________ has initiated a non-judicial foreclosure
on the property identified in paragraph 1.
Form A - Conversion Petition (05/11)
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SC-P-292
Reset Form
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
3. The notice of default and intent to foreclose was received by Petitioners on
_____________________________. A copy of the foreclosure notice that was served on
[Date]
Petitioners is attached.
4. The residential property identified in paragraph 1 is and has been Petitioners’
primary residence for at least 200 days prior to ____________________________________.
[Date in Paragraph 3]
5. Petitioners elect to convert the non-judicial foreclosure to a judicial foreclosure.
6. The following Respondents, also named in the caption above, are additional
owner-occupants and mortgagors of the property described in paragraph 1:
[Insert names]
7. The following Respondents, also named in the caption above, signed the
promissory note or other instrument evidencing the debt purportedly secured by the mortgage
being foreclosed:
[Insert names]
8. The Service Members Civil Relief Act, 50 U.S.C. App. § 501, may apply to the
following parties:
[Insert names. If none, write “None.”]
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SC-P-292
Form A - Conversion Petition (05/11)
____________________________________________________________
__________________________________________
__________________________________________
9. By signatures below, Petitioners certify, subject to penalties for perjury, they
(a) are owners-occupants of the property described in paragraph 1 above and
seek to convert a non-judicial foreclosure to a judicial foreclosure; and
(b) served a copy of this conversion petition upon
[Names of attorney identified in the foreclosure notice]
by _________________________________________________________.
[Means and Place of Service]
Wherefore, Petitioners pray for judgment requiring Respondent
___________________________________________________________________________ to
[Name of Foreclosing Party]
file a foreclosure action in the [check one]: ____ Circuit Court of the ____________ Circuit
____ Land Court of the State of Hawai'i,
no later than 30 days after entry of the judgment in this conversion action.
Dated: _________________________, Hawai'i, _______________________________.
[City] [Date]
[Signature of Filing Party]
[Typed Name of Filing Party]
In accordance with the Americans with Disability Act, and other applicable State and Federal laws, if you require an accommodation
for a disability when working with a court program, service or activity, please contact the Circuit Court Administration Office on
O
AHU: Phone No.539-4400, Fax 539-4402 , or TTY 539-4853; MAUI : Phone No. 244-2969, Fax 244-2932, or TTY 244-2865;
HAWAII: Phone No. 961-7424, Fax 961-7411, or TTY 961-7422; KAUAI: Phone No. 482-2365. Fax 482-2509, or TTY 482-2533,
at least 10 working days before your proceeding, hearing or appointment date.
Form A - Conversion Petition (05/11)
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SC-P-292