Request To Change Child Custody Recommending Counselor {RI-FL065}

SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE BLYTHE 265 N. Broadway, Blythe, CA 92225 RIVERSIDE 4175 Main St., Riverside, CA 92501 HEMET 880 N. State St., Hemet, CA 92543 MURRIETA 30755 - D Auld Rd., Murrieta, CA 92563 INDIO 46 - 200 Oasis St., Indio, CA 92201 RI - FL 065 PARTY OR ATTORNEY MAKING REQUEST FOR COURT USE ONLY DO NOT FILE TELEPHONE NO ( Required ) : FAX NO. (Optional) : E - MAIL ADDRESS ( Optional): ATTORNEY FOR (Name): PETITIONER: RESPONDENT: CASE NUMBER: REQUEST TO CHANGE CHILD CUSTODY RECOMMENDING COUNSELOR Instructions: Requests to Change recommending counselors shall be submitted a minimum of seven (7) calendar days prior to the appointment. When you are done completing the form, please give the form to the family court services clerk. This form will not be placed i n the family law court file. I am the: Petitioner Respondent Attorney I am requesting a change of Child Custody Recommending Counselor prior to the scheduled appointment. The appointment is scheduled with: What is your specific concern? (SIGNATURE REQUIRED) (DATE) ---------------------------------------------------- FOR OFFICE USE ONLY ------------------------------------------------------ Last CCRC appointment: Next CCRC appointment: Next Hearing: Disposition: ( FAMILY COURT SERVICES DEPARTMENT HEAD ) (DATE) Page 1 of 1 Approved for Optional Use Riverside Superior C ourt Form RI - FL065 [ Rev. 11/08 /17 ] REQUEST TO CHANGE CHILD CUSTODY RECOMMENDING COUNSELOR riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com