State of Minnesota	District Court
County	Judicial District:
Court File Number:
Case Type:

Plaintiff/Petitioner,

Notice to Remove

vs.

Defendant/Respondent.

TO: THE ABOVE NAMED COURT:

The undersigned removes Judge	pursuant to Rule 26.03 Subd. 14 (4) of Minnesota Criminal Procedure; Minnesota Rules of Civil Procedure, Rule 63.03; Minnesota Rules of Juvenile Protection Procedure, Rule 7; Minnesota Rules of Juvenile Procedure, Rule 22; or Minnesota General Rules of Practice, Rules 106, 107.

Dated:

Name:

Address:

City/State/Zip:

Telephone: (	)