State of Minnesota County Select County
District Court Judicial District: Court File Number: Case Type:
In Re the Marriage of:
Plaintiff / Petitioner vs / and
Request to Remove Child Support Magistrate For Cause
Defendant / Respondent Intervenor TO: The Other Party or Attorney if Represented
First Street Address City State Middle Last Apt. No. Zip
County Attorney's Office
County Attorney Street Address City State Zip
Pursuant to Rule 368.02 of the Expedited Child Support Process, I,
(Name of party)
request the removal of
(Name of Child Support Magistrate, Referee, or Judge)
from presiding in these
proceedings in the expedited child support process. The reason I request removal is as follows (you must explain why the Judicial Officer assigned to your case is prejudiced in presiding over your case):
Dated: Signature Print Name: Address: City/State/Zip: Telephone: Attorney for:
CSX1802
State
ENG
Rev 12/06
www.mncourts.gov/forms
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