Name:______________________________________ Address:___________________________
___________________________
Telephone No.:_______________________
CUSTODY EVALUATOR
IN THE FAMILY COURT OF THE FIRST CIRCUIT STATE OF HAWAI`I ) ) ) ) ) ) ) ) )
) )
FC-____ No. __________________ NOTICE THAT PROPOSED CUSTODY EVALUATOR HAS DECLINED
,
Plaintiff/Petitioner
vs.
,
Defendant/Respondent.
NOTICE THAT PROPOSED CUSTODY EVALUATOR HAS DECLINED I, ___________________________________________________, a licensed ___________________________ in the State of Hawai`i, acknowledge receipt of the Custody Evaluation Appointment Order, filed on ____________________________. I decline this appointment.
Dated: Honolulu, Hawai`i ______________________________________.
_____________________________________ Custody Evaluator's Signature
INSTRUCTIONS: This form should be typewritten. Within 10 days of receiving the Custody Evaluation Appointment Order, please complete this form and send or deliver it to the court clerk noted in the Order at Family Court, P. O. Box 3498, Honolulu, HI, 96811-3498. Send an un-filed copy to each attorney and pro se party.
Appendix 3 Effective 09/07
Reprographics (10/07)1F 1F-P-734
CLEAR