Superior Court of Washington

County of

To the Clerk of Court and to:

1.         Please note that this case will be placed on the non-contested dissolution calendar for hearing on ________________________________________________________, on the date set out below.

2.         A hearing has been set for the following date, time and place.

            Date:    ________________________________           Time:   ________________a.m./p.m.

Place:   ___________________________________     Room/Department:  ______________

Dated:                                                                                                                                              

                                                                  Signature of Requesting Party or Lawyer/WSBA No.

                                                                  Print or Type Name

                                                                                                Notice to party:  (you may list an address that is not your residential address where you agree to accept legal documents. Any time this address changes while this action is pending, you must notify the opposing parties in writing and file an updated Confidential Information Form (WPF DRPSCU 09.0200) with the court clerk.)

                                                                  _______________________________________________

                                                                  Address