Request to Enter Default Template

IN THE [NAME OF COURT] COURT OF [COUNTY], [STATE]
Case No.: __________________________

In the Matter of:
Petitioner: __________________________
Respondent: __________________________

1. Request to Enter Default

Petitioner respectfully requests that the Clerk of the Court enter the default of Respondent, [Respondent’s Name], in this action for [type of case, e.g., Dissolution of Marriage, Legal Separation, Custody].

Respondent was duly served with the Petition and Summons on [Date of Service] and has failed to file a response or make an appearance within the time prescribed by law.

2. Case Information

Date Petition Filed: __________________________
Date Respondent Served: __________________________
Method of Service: ☐ Personal ☐ Substituted ☐ Mail ☐ Publication
Proof of Service Filed: ☐ Yes ☐ No
Date Proof of Service Filed: __________________________

3. Default Request Basis

☐ Default without agreement (no response filed and no appearance made)
☐ Default with written agreement attached (parties reached a stipulated judgment)

4. Relief Requested

Petitioner requests that the Court proceed with a default hearing or judgment granting the relief requested in the Petition, including:

• Dissolution of marriage or legal separation

• Division of property and debts

• Custody and visitation orders

• Child and spousal support orders

• Any additional relief deemed appropriate by the Court

5. Supporting Documentation

Attached hereto are the following documents in support of this request:
☐ Proof of Service of Summons and Petition
☐ Declaration of Petitioner
☐ Proposed Judgment or Decree
☐ Income and Expense Declaration (if applicable)
☐ Property Declarations or Financial Disclosure Forms

6. Declaration

I declare under penalty of perjury under the laws of the State of [State] that the foregoing is true and correct.

Executed on this _____ day of ____________, 20____, at [City], [State].

Signature: __________________________
Printed Name: __________________________
Petitioner

7. Clerk’s Entry of Default (For Court Use Only)

Default entered as requested on __________________________
Clerk’s Signature: __________________________
Deputy Clerk: __________________________