IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF CHURCHILL

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Case No. Dept. No. The undersigned hereby affirms that this document does not contain the social security number of any person. 1 1 1 1 1 1 1 0 1 IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA v. Plaintiff, Defendant. IN AND FOR THE COUNTY OF CHURCHILL / MOTION I,, in proper person, hereby moves this (Your name) Court for an Order granting the following: (State what you want the Court to Order. If you have more than one request, clearly list and number reach request. Do not explain your requests in detail, just list them.) 1

1 1 1 1 1 1 1 0 1 This Motion is made for the following reasons: Fully explain why you believe you should be granted your request(s). List and number each request. Be specific and give details

If you need more space, you may attach additional sheets of paper. Be sure to write only on one side of the sheet. 1 Date: _ 1 1 1 1 1 1 0 (Print Name) (Signature) (Telephone number) 1

1 1 1 1 1 1 1 0 1 STATE OF NEVADA ) ) ss: COUNTY OF ) (Your name) AFFIDAVIT IN SUPPORT OF MOTION I,, being first duly sworn, under penalties of perjury, deposes and says: I am the Plaintiff/Petitioner in the above-entitled action; that I have read the foregoing Motion and am competent to testify of its contents of my own knowledge and the contents are true of my own knowledge except for those matters stated therein on information and belief, and, as to those matters, I believe them to be true. SUBSCRIBED and SWORN to before me This day of,. NOTARY PUBLIC STATE OF NEVADA ) ) ss: COUNTY OF ) (Signature) On this day of,, personally appeared before me, the undersigned, a Notary Public in and for the County of, State of Nevada, _, personally known to me or proved to me, to be the person whose name is subscribed to the attached instrument who acknowledged that (he/she) executed the attached instrument. NOTARY PUBLIC

1 1 1 1 1 1 1 0 1 IMPORTANT YOU HAVE BEEN SERVED WITH A LEGAL MOTION TO CHANGE OR CLARIFY AN ORDER, TO RECONSIDER AN ORDER, TO TAKE ACTION OR FOR OTHER REASONS. IF YOU DO NOT FILE A WRITTEN RESPONSE TO THIS MOTION WITHIN A CERTAIN TIME, THE COURT MAY MAKE RULINGS AGAINST YOUR INTERESTS IN THIS CASE. **** If you were served by mail, you have thirteen () days from the postmarked date on the envelope in which to file a written response with the Court. If you were served in person, you have ten () days from the date of service in which to file a written response with the Court. Your response must be filed with the Court Clerk s office located at N. Maine Street, Suite B, Fallon, NV 0, on the second floor. There may be a filing fee to file your response. You can contact the Court Clerk s office at () -0 or go to the Court s website at www.churchillcounty.org to view the fee schedule. If you have any questions on how to file a response to this Motion, contact a private attorney.

1 CERTIFICATE OF SERVICE The undersigned hereby certifies that they are 1 years of age or older, and on this date served a true and correct copy of the document/s entitled: (Clearly list all documents you served In the following way: (check the appropriate blank, and fill in the appropriate information) IF THE DOCUMENTS WERE SERVED BY MAIL: by placing a copy enclosed in a sealed envelope upon which first class postage was fully prepaid by placing a copy enclosed in a sealed envelope and mailing it certified, return receipt requested The envelope was addressed to: (Name) at 1 1 1 1 1 1 0 1 And that there is regular communication by mail between the place of mailing and the place addressed. IF THE DOCUMENTS WERE PERSONALLY SERVED: (Name) by personally serving: at DATED: This day of,. (Signature of person who performed service)

Case No. Dept. No. The undersigned hereby affirms that this document does not contain the social security number of any person. IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF CHURCHILL 1 1 1 Plaintiff vs. Defendant REQUEST FOR SUBMISSION 1 / 1 1 1 0 1 I,, the in this matter, (Your Name) (Plaintiff or Defendant) request the filed on (Title of Document you want submitted to the Court) (Date document filed) in this case be submitted to the Judge for consideration and determination. Dated: Your Signature: _ Name (Printed): _ Address: Phone:

Case No. Dept. No. The undersigned hereby affirms that this document does not contain the social security number of any person. IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF CHURCHILL 1 1 1 Plaintiff vs. Defendant ORDER 1 1 1 1 0 1 / It appears to the satisfaction of the Court from the Motion (Name of Motion), filed on, and the Court hereby finds, (Date Motion filed) and good cause appearing, IT IS HEREBY ORDERED that (note exactly what you want the Court to Order.) Dated: This day of, _. _ DISTRICT COURT JUDGE

1 CERTIFICATE OF SERVICE The undersigned hereby certifies that they are 1 years of age or older, and on this date served a true and correct copy of the document/s entitled: (Clearly list all documents you served In the following way: (check the appropriate blank, and fill in the appropriate information) IF THE DOCUMENTS WERE SERVED BY MAIL: by placing a copy enclosed in a sealed envelope upon which first class postage was fully prepaid by placing a copy enclosed in a sealed envelope and mailing it certified, return receipt requested The envelope was addressed to: (Name) at 1 1 1 1 1 1 0 1 And that there is regular communication by mail between the place of mailing and the place addressed. IF THE DOCUMENTS WERE PERSONALLY SERVED: (Name) by personally serving: at DATED: This day of,. (Signature of person who performed service)

Case No. Dept. No. The undersigned hereby affirms that this document does not contain the social security number of any person. 1 1 1 1 1 1 1 0 1 IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA v. Plaintiff, Defendant. IN AND FOR THE COUNTY OF CHURCHILL / REPLY TO OPPOSTION TO MOTION I,, in proper person, responds to the (Your name) Opposition filed by on as follows: (Name of other party) (date Opposition filed) (State very specifically your reply to the other party s response or opposition.) 1

1 1 1 1 1 1 1 0 1 If you need more space, you may attach additional sheets of paper. Be sure to write only on one side of the sheet. I, request a hearing on this matter. (do or do not) If a hearing is requested, please state why you feel a hearing is necessary: Date: _ (Print Name) (Signature) (Telephone number)

1 CERTIFICATE OF SERVICE The undersigned hereby certifies that they are 1 years of age or older, and on this date served a true and correct copy of the document/s entitled: (Clearly list all documents you served In the following way: (check the appropriate blank, and fill in the appropriate information) IF THE DOCUMENTS WERE SERVED BY MAIL: by placing a copy enclosed in a sealed envelope upon which first class postage was fully prepaid by placing a copy enclosed in a sealed envelope and mailing it certified, return receipt requested The envelope was addressed to: (Name) at 1 1 1 1 1 1 0 1 And that there is regular communication by mail between the place of mailing and the place addressed. IF THE DOCUMENTS WERE PERSONALLY SERVED: (Name) by personally serving: at DATED: This day of,. (Signature of person who performed service) 1

Case No. Dept. No. The undersigned hereby affirms that this document does not contain the social security number of any person. IN THE TENTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF CHURCHILL 1 1 1 Plaintiff vs. Defendant REQUEST FOR SUBMISSION 1 / 1 1 1 0 1 I,, the in this matter, (Your Name) (Plaintiff or Defendant) request the filed on (Title of Document you want submitted to the Court) (Date document filed) in this case be submitted to the Judge for consideration and determination. Dated: Your Signature: _ Name (Printed): _ Address: Phone: