OFP401 State ENG Rev 7/15www.mncourts.gov/formsPage 1 of 2State Of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: Domestic Abuse Petitioner (first, middle, last) Respondent (first, middle, last)vs.In the Matter of:Affidavit and Motion to Modify Order for Protection (Minn. Stat. 247 518B.01, subd. 11) I, , state that:1. I am the Petitioner Respondent in this action.2. A domestic abuse Order for Protection was issued on . I request that it beamended as follows: 3. Describe in detail why the Court should issue an amended Order for Protection: 4. An emergency exists because of an immediate danger of physical harm tome or my child(ren).5. Because of the danger of physical harm, I am requesting that the court grant my request for a change in the Order for Protection immediately and until the date of the hearing for modification.Notice To the Above Named Petitioner/Respondent: Please take Notice that on at .m. at (Date) (Time) (Address) before, I will ask the Court to change the Order for (Judge)Protection as requested in my affidavit above.I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. American LegalNet, Inc. www.FormsWorkFlow.com OFP401 State ENG Rev 7/15www.mncourts.gov/formsPage 2 of 2 Dated: Signature County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address: Distribution Certified copy or original-Return to Court Administrator with Affidavit of Personal Service attached Copy for Petitioner(s) Copy for Respondent(s) Copy for file until original returned Copy for local police department Copy for Sheriff Other: Dissolution File American LegalNet, Inc. www.FormsWorkFlow.com