Form Ud-13 - Uncontested Matrimonial Request For Judicial Intervention Form
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1UNCONTESTED MATRIMONIAL
For Court Clerk Use Only:
UD-13
IAS Entry Date
REQUEST FOR JUDICIAL INTERVENTION
(rev. 5/2011)
________________________COURT,
_________________________COUNTY
Judge Assigned
Index No: _____________________
Date Index Issued:______/______/__________
RJI Date
CAPTION:
Enter the complete case caption. Do not use et al or et ano.
Plaintiff
-against-
Defendant
STATUS OF ACTION OR PROCEEDING:
Answer YES or NO, and provide additional information where indicated.
YES
NO
G
G
Has a summons been filed?
If yes, date filed: ________/________/____________
G
G
Has a summons been served?
If yes, date served: ________/________/____________
G
G
Are there children of the marriage under the age of 18?
If yes, complete and attach the MATRIMONIAL RJI Addendum (UCS-840M).
NATURE OF JUDICIAL INTERVENTION:
EX PARTE APPLICATION FOR THE DISSOLUTION OF MARRIAGE
ADDITIONAL RELIEF: Check all that apply
G
Poor Person Application
G
Application for Alternate Service
G
Other (specify): _____________________________________________________________________________________________________________
PARTIES:
For parties without an attorney, check "Un-Rep" box AND enter party address, phone number and e-mail address in "Attorneys" space.
Parties
Attorneys
Issue
Un-
Joined
Rep
List party names.
Provide attorney name, firm name, business address, phone number and e-mail address.
(Y/N):
Name:
G
N/A
Role: PLAINTIFF
Name:
G
G
YES
G
NO
Role: DEFENDANT
RELATED CASES:
List any related cases, include any related criminal and/or Family Court cases.
Case Title
Index/Case No.
Court
Judge (if assigned)
Relationship to Instant Case
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, TO MY KNOWLEDGE, OTHER THAN AS NOTED ABOVE, THERE ARE AND HAVE
BEEN NO RELATED ACTIONS OR PROCEEDINGS, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION PREVIOUSLY BEEN FILED IN
THIS ACTION OR PROCEEDING.
________________________________________________
Dated: ________/________/____________
SIGNATURE
________________________________________________
________________________________________________
ATTORNEY REGISTRATION NUMBER
PRINT OR TYPE NAME
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