1. 3. Factual and Legal Issues for Resolution:
Issues(ConCM)
  1. 4. Are you requesting a home study of your house? YES NO
Check Box1(ConCM)
Check Box2(ConCM)
  1. 5. Are you requesting a home study of the other party's house? YES NO
Check Box3(ConCM)
Check Box4(ConCM)
  1. 6. Are you requesting a custody evaluation? YES NO
Check Box5(ConCM)
Check Box6(ConCM)
  • 7. A proposed resolution of all matters, which may be in the form of a Parenting Plan:
Resolution(ConCM)

CERTIFICATE OF COMPLIANCE

I certify that this filing complies with the provisions of the Case Records Public Access Policy of the Unified Judicial System of Pennsylvania that require filing confidential information and documents differently than non-confidential information and documents.

The quick brown fox jumps over the lazy dog.

DATE(ConCM)

Respectfully Submitted,

DATE: ___

_____

City State Zip Code

City(ConCM)
State(ConCM)
Zip Code(ConCM)
Telephone Number(ConCM)

Signature

Printed Name(ConCM)

Printed Name

Street Address

Street Address/P.O. Box(ConCM)

City State Zip Code

Street Address/P.O. Box

Telephone Number