In the superior court for the state of alaska




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You must use black ink to fill out this form.

Plaintiff’s Name:

Mailing Address:



Telephone: Message phone:
Defendant’s Name:

Mailing Address:



Telephone: Message phone:
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA

AT


City or Town where the Court is located


)

)

Plaintiff, )

)

vs. )


)

)

Defendant. )



) Your Case No.
AGREEMENT AND ORDER FOR

What it is you want
We, , hereby stipulate and agree as follows:





























 More pages are attached and incorporated by reference.


I swear or affirm that the above is true to the best of my knowledge.


Date Plaintiff’s Signature (In blue ink if possible)
Subscribed and sworn to or affirmed before me at , Alaska on . Name of City, Town or Village

Date

Notary Public or other person authorized to administer oaths.

My commission expires on

********

I swear or affirm that the above is true to the best of my knowledge.




Date Defendant’s Signature (In blue ink if possible)
Subscribed and sworn to or affirmed before me at , Alaska on . Name of City, Town or Village

Date

Notary Public or other person authorized to administer oaths.

My commission expires on

ORDER

This Agreement totaling _______ pages is APPROVED.

IT IS HEREBY ORDERED that the parties are bound by the terms of this Agreement.
Signed this ____ day of ____________, 20_____ at _____________________, Alaska.

Judge ___________________of the Superior Court

I certify that on a copy

of the above was mailed to each of the following

at their addresses of record.

Deputy Clerk / Secretary



AGREEMENT & ORDER

Page _____ of _____



SHC-1061 (03/13)




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