Attorney or Party without Attorney—Name, Address, and Telephone No.: Attorney for: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SHASTA 1500 Court Street, Room 319, Redding, CA 96001 Plaintiff/Petitioner: Defendant/Respondent: DECLARATION OF NOTICE FOR EMERGENCY TEMPORARY ORDER Case Number: You must check 1a or 1b. 1a. I am the Plaintiff/Petitioner Defendant/Respondent . 1b. I am the attorney for the Plaintiff/ Petitioner Defendant/Respondent . You must complete 2, 3, 4, 5, and 6. 2. The specific relief that I am seeking is ______________________________________________________. 3. I have attached a written declaration based upon personal knowledge of immediate danger or irreparable harm that will occur if my request is not immediately granted. 4. The part(ies) to whom I gave notice responded as follows: . 5. I do do not expect opposition to my ex parte request. 6. I do do not expect the party to whom I gave notice to appear at the hearing. You must complete either 7a or 7b, or you must check 8a or 8b. I HAVE GIVEN NOTICE to _______________________________________ that I am asking the Court for an emergency temporary order, the specific relief I am seeking, and the date, time, and place of the ex parte hearing. 7a. This notice was given on (date) ______________ at (time)________a.m./p.m. by the following method: (1) telephone text message fax To telephone #:__________________________________. (2) in person at (location):____________________________________________________,California. (3) e-mail to e-mail address:__________________________________________________________. (4) other (please describe):___________________________________________________________. 7b. A THIRD PARTY GAVE NOTICE to _______________________________________________ as described in the attached declaration signed by the third party. I HAVE NOT GIVEN NOTICE to ___________________________ for the following reason: 8a. Contained in my written declaration in support of the request for an emergency temporary order filed concurrently herewith. 8b. I made good-faith efforts to give notice to the opposing party, as described in the attached declaration, but was unable to do so. I understand that I must appear in person in Department 12, located on West Street between the main courthouse and Justice Center, at 1:15 p.m. on ___________________ (no sooner than the first business day after this document is received by the Court if notice is provided by 10:00 a.m. on the day before the hearing.) I declare under penalty of perjury under the laws of the State of California that this declaration is true and correct. Dated: (print name) (signature) (Please note: After the above hearing, the documents will be submitted for signature and processed. The moving party must pick the documents up in Room 319 (with photo identification) and have them personally served upon the other party in a timely manner.) ______________________________________________________________________________________ Form Approved for Optional Use Shasta County Superior Court LF-006 [rev April 11, 2011] FC §§3062-3064, §6326; Local Rule 14.03 DECLARATION OF NOTICE FOR EMERGENCY CRC Rule 3.1200-3.1207 TEMPORARY ORDER American LegalNet, Inc. Page 1 of 1 www.FormsWorkFlow.com