Motion Cover Sheet Page 3
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3PHILADELPHIA COURT OF COMMON PLEAS
FAMILY DIVISION
MOTION COVER SHEET
:
________________________________
:
__________ Term, 20 ____, No. __________
Plaintiff
:
v.
:
DR No: _____________________________
________________________________
:
Defendant
:
PACSES No: _________________________
Name of Filing Party:
Status of Filing Party: “ Plaintiff
“ Defendant
“ Petitioner
“ Respondent
“ Support
“ Custody
“ Divorce
“ Domestic Violence
Type of Filing:
State Full Description of Motion:
CASE STATUS (Answer all questions)
I.
Has this case been listed before a Judge for any other Domestic Relations matter?
“ Yes “ No IF YES, identify the Judge(s)
II.
If a Decree in Divorce has been entered, identify the Judge who entered the Decree and the date of Decree.
III.
“ Yes
“ No
Has another Motion been decided in this case?
IF YES, identify the Judge and date of Order.
“ Yes
“ No
Is another Motion pending?
IF YES, identify the type of Motion and hearing date if assigned.
IV.
List name, address and telephone number of other counsel of record and any unrepresented parties. (Attach a self-addressed
stamped envelope for each attorney and any unrepresented party.)
I verify that the information listed above is true and correct and I understand that sanctions may be imposed for inaccurate or
incomplete answers.
_______________________________________
__________________________________________
Signature
Printed Name
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