Request for Judicial Intervention

REQUEST FOR JUDICIAL INTERVENTION

_________________

INDEX #: __________ DATE PURCHASED ________________

PLAINTIFF(S): IAS entry date

________________

Judge Assigned

DEFENDANT(S):

________________

_______________________ RJI Date

Date issue joined: __________ Bill of particulars

served: [ ] Yes [ ] No

NATURE OF JUDICIAL INTERVENTION

(check ONE box only AND enter information)

[ ] Request for preliminary [ ] Notice of petition (return date

conference __________)

[ ] Note of issue and/or Relief sought __________

certificate of readiness [ ] Notice of medical or dental

[ ] Notice of motion (return malpractice action (specify

date __________) __________)

Relief sought __________ [ ] Statement of net worth

[ ] Order to show cause [ ] Writ of habeas corpus

(clerk enter return date [ ] Other (specify __________)

__________) _________________________)

Relief sought __________

[ ] Other ex parte applica-

tion (specify __________)

NATURE OF ACTION OR PROCEEDING (Check ONE box only)

MATRIMONIAL TORTS

[ ] Contested –CM Malpractice

[ ] Uncontested –UM [ ] Medical/Podiatric -MM

COMMERCIAL [ ] Dental -DM

[ ] Contract –CONT [ ] *Other Professional

________ -OPM

[ ] Corporate –CORP...