Full Name of Party Filing Document

Mailing Address (Street or Post Office Box)

City, State and Zip Code

Telephone

Email Address (If any)

IN THE DISTRICT COURT FOR THE 		 JUDICIAL DISTRICT
FOR THE STATE OF IDAHO, IN AND FOR THE COUNTY OF 				

State Of Idaho, Department of Health and
Welfare, Division of Child Support Enforcement,

		Petitioner,
	vs.

and 						,
		Co-Respondents.
	
Case No. 					

NOTICE OF HEARING ON
MOTION FOR 
INTERVENTION	

NOTICE IS GIVEN that the Motion for Intervention will come before the court for hearing on the 	 day of 				, 20	            , at the hour of 		 	.m., at the 						County Courthouse, (street address, city and state of courthouse) 																		.

Date: 				

												
Typed/printed name					Signature 

CERTIFICATE OF SERVICE

I certify that on (date) 			, I served a copy to: (name all parties in the case other than yourself)

State of Idaho, Department of Health
And Welfare, Division of Child Support 
Enforcement

(Street or Post Office Address)	

(City, State, and Zip Code)
	
•	By mail
•	By personal delivery
•	By fax (number) 			

						
(Name)	

(Street or Post Office Address)

(City, State, and Zip Code)

•	By mail
•	By personal delivery
•	By fax (number) 			

(Name)

(Street or Post Office Address)

(City, State, and Zip Code)
	 
•	By mail 
•	By personal delivery
•	By fax (number) 			

						
Typed/printed name

Signature