Mandatory Use Form #L0918 (Rev. 12/02/16) REQUEST FOR STATUS OR FAMILY CENTERED CASE RESOLUTION CONFERENCE California Rule of Court 5.83(g)(

E) Local Rule 701.1 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): BAR NO.: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE JUSTICE CENTER: Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045 Lamoreaux - 341 The City Drive South, Orange, CA 92868-3205 PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: REQUEST FOR STATUS FAMILY CENTERED CASE RESOLUTION CONFERENCE CASE NUMBER: This form is to be used only to request a specific case resolution plan and/or case management orders.

The conference is not intended to be an evidentiary hearing. 1. This conference is being requested for the following reasons: 2. A completed Case Information-Family Law (form FL-172) is attached. 3.

Declaration A copy of this Request for Status or Family Centered Case Resolution Conference, including a completed Case Information-Family Law form and an envelope with sufficient postage, was provided to the court clerk, with the envelope addressed as follows (address of the other party’s attorney or, if none, the party’s last known address): I declare under penalty of perjury under the laws of the State of California the forgoing is true and correct.

Date: ________________________ ______________________________________ ___________________________________________ (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) For Court Use Only Request for Status or Family Centered Case Resolution Conference mailed to the non-requesting party on (date): __________ The above case has been set on the calendar in Department______________ on _______________at_________ A.M./P.M. at the Central Lamoreaux Justice Center Requesting party notified on ____________________ David H. Yamasaki, Clerk of the Court By: ___________________________ Deputy Clerk