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Decatur, Georgia 30030
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Court
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State
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Case Style
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Case Number
*
Petitioner Address
*
Street Address
Address Line 2
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State
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Petitioner Phone
*
Respondent Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
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New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Respondent Phone
*
ATTORNEY INFORMATION: (please complete if party is unrepresented)
Petitioner OR Petitioner’s Attorney:
Name
*
First
Last
Georgia Bar Number:
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Facsimile
Email
*
ATTORNEY INFORMATION: (please complete if party is unrepresented)
Respondent OR Respondent’s Attorney:
Name
*
First
Last
Georgia Bar Number
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Facsimile
Email
*
Type of Case
*
Contract dispute
Tax Appeal
Personal Injury
Probate – Administration of Estates/Probate of Wills
Probate – Guardianship
Probate – Year’s Support
Brief description of the case including what relief, damages, or special damages that are being sought:
*
Pursuant to the DRC Rules, parties are given the option to choose their desired method of dispute resolution. Please indicate your choice below:
*
Non-binding Arbitration
Mediation
Case Evaluation
I would like to discuss these options in more detail.
Are there any special circumstances which need to be taken into consideration? (i.e., physical limitations, etc.)
*
Please provide any information or special requests to assist with scheduling. (i.e., preferred dates and times, conflicts, etc.) If the session should be held before or after a certain date, such as to allow time for discovery or to precede a scheduled court date, please so indicate.
*
Signature
*
Phone
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