Objection to Magistrate’s Decision – Fairfield County Court of Common Pleas Domestic Relations Division (Fillable)

Plaintiff or Petitioner 1 name Plaintiff or Petitioner 1 street address Plaintiff or Petitioner 1 city, state, and zip code Case number Defendant or Petitioner 2 or Respondent name Magistrate Defendant or Petitioner 2 or Respondent street address Defendant or Petitioner 2 or Respondent city, state, and zip code Objecting party name Date magistrate decision was filed Specific grounds of the objections line 1 Specific grounds of the objections line 2 Specific grounds of the objections line 3

Continuation of objections line 1 Continuation of objections line 2 Continuation of objections line 3 Continuation of objections line 4 Continuation of objections line 5 Continuation of objections line 6 Continuation of objections line 7 Continuation of objections line 8 Continuation of objections line 9 Continuation of objections line 10 Continuation of objections line 11 Continuation of objections line 12 Continuation of objections line 13 Continuation of objections line 14 Continuation of objections line 15 Signature Printed name Street address City, state, and zip code Phone number Email

Certificate of service date Name of the other party or attorney line 1 Name of the other party or attorney line 2 Mailing addresses, email addresses, or fax numbers line 1 Mailing addresses, email addresses, or fax numbers line 2 Other certificate of service method line 1 Other certificate of service method line 2 Printed name

Certificate of service delivery method

Certificate of service delivery method: As instructed in the Request for Service (Uniform Domestic Relations Form 31 or Uniform Juvenile Form 10) filed with the Clerk of Courts Certificate of service delivery method: Regular U.S. Mail Certificate of service delivery method: Email Certificate of service delivery method: Fax Certificate of service delivery method: Hand Delivery Certificate of service delivery method: Other