Warren-Forest Court of Common Pleas Thirty Seventh Judicial District
of the Commonwealth of Pennsylvania

                    IN THE COURT OF COMMON PLEAS
            OF THE 37TH JUDICIAL DISTRICT OF PENNSYLVANIA
                         CIVIL ACTION-LAW

	______________________________
	Plaintiff 
	       vs.		A.D. ____ of ______
	______________________________
	Defendant 
				56
___________________________,    Esq., for Plaintiff
____________________________,    Esq., for Defendant
(of record or consulted)


                    MOTION FOR APPOINTMENT OF 
                     COURT HEARING OFFICER
                          IN DIVORCE


	AND  NOW,___________________ ,_____,____________ 
moves the Court to appoint the Court Hearing Officer with respect to the
following claims:
 (    )  Divorce           (    )   Distribution of Property
 (    )  Annulment         (    )   Support
 (    )  Alimony           (    )   Counsel Fees
 (    )  Alimony Pendente  (    )   Costs and Expenses Lite
and in support of the motion states:
(1)  Discovery is complete as to the claim(s) for which the appointment of
the Court Hearing Officer is requested.
(2)  The statutory ground(s) for divorce (is) (are)
___________________________________________________________
___________________________________________________________

	(a)  If 3301(c), affidavit of consent filed by
Plaintiff________________________,___________
					(date)
Defendant. _____________________,_________________
	                                                               (date)
	(b)  If 3301(d), Plaintiff's affidavit filed ________________,
						 (date)
Defendant's counter affidavit, if any, filed _____________________,
				                          (date)

(3)  Delete the inapplicable paragraph(s):
	(a)  The action is not contested.
	(b)  An agreement has been reached with respect to the following claims:
__________________________________________________________
__________________________________________________________	
(c)  The action is contested with respect to the following
claims:_________________________________________________
(4)  The action (involves) (does not involve) complex issues of law or
fact.
(5)  The hearing is expected to take___________(hours) (days).
(6)  The Complaint was filed______ and served _______.
(7)  Matters at issue under the pleadings which are not to be referred to
the Court Hearing Officer:
_________________________________________________________
_________________________________________________________
(8)  Attached hereto is the completed form required by Pa. R.C.P. No.
1920.46.
(9)  I hereby certify that Pa. R.C.P. No. 1920.31(a) is _____applicable,
______not applicable, and the income and expense statements have been
filed as follows:
Plaintiff_____________________      Date_____________________  
Defendant___________________       Date____________________
(10) I hereby certify that Pa. R.C.P. No. 1920.33(a) is
_____applicable,_____not applicable, and the inventories have been filed
as follows:
Plaintiff________________________  Date____________________ 
Defendant______________________   Date____________________
(11) Approximate monthly take home income of:
Plaintiff________________________  Date___________________
Defendant_____________________
Date ___________________
(12) If applicable, approximate value of marital assets to be distributed:
From Plaintiff's inventory__________________________________
From Defendant's inventory_________________________________


(13) Approximate value of assets as to which there is a dispute as to
whether they are marital assets:  $___________________
(14) Additional information, if any, relevant to the
motion:_________________________________________________
________________________________________________________
(15) I hereby certify that all Court Hearing Officer's fees required to be
paid have been paid.
		Date:_________________________ ________________
				Attorney for:___________________

             ORDER APPOINTING COURT HEARING OFFICER

	AND NOW, ___________ ,_____, ______________Esq., is appointed Court
Hearing Officer in respect to the following claims:
	If not filed already the parties are ordered to file their pre-hearing
statements within twenty (20) days from this date.
			Per Curiam,

			___________________________
			Judge

Received of Plaintiff $________________ 
____________________  _____________
Prothonotary		          Date

Received of Defendant $______________
____________________  _____________
Prothonotary		          Date