Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Lawyer's Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR For Clerk's Use Only Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case Number: Name of Petitioner/Parent A MOTION FOR PRE-DECREE TEMPORARY ORDER WITHOUT NOTICE FOR LEGAL DECISION MAKING AND PHYSICAL CUSTODY Other: _________________________ Name of Respondent/Parent B I MAKE THE FOLLOWING STATEMENTS TO THE COURT UNDER OATH OR AFFIRMATION: 1. MY NAME IS: (Name of Person asking for Emergency Order) 2. REASONS WHY I NEED THIS ORDER. Explain in detail the emergency facts which now exist, and what irreparable injury (serious or life-threatening injury or damage that cannot be prevented or undone) to you or the minor child(ren) that might occur without this Order (Use additional paper if necessary). Check here if continued on attached page(s). © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PTO Page 1 of 5 DRTE11f - 062916 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: _____________ 3. PEOPLE INVOLVED. This Motion concerns the following people: Name of Parent A: Name of Parent B: Name of Other Person: Name of Other Person: Name(s) of Children: 4. REQUIRED INFORMATION: NOTICE OR REASONS WHY NOTICE NOT ATTEMPTED. Actual Notice regarding a request that affects another party's rights concerning his or her minor children is normally required. Check the box to indicate whether you gave or attempted to give notice to any other parties or their attorneys. I GAVE or ATTEMPTED TO GIVE NOTICE TO THE OTHER PARTY AS FOLLOWS: Explain when, how, and to whom you attempted to give notice. Check here if continued on attached page(s). OR, I DID NOT ATTEMPT TO GIVE NOTICE BECAUSE: If you checked this box you MUST explain what injury, loss or damage you or the minor child(ren) would suffer if you gave the other party advance notice of this Motion. Check here if continued on attached page(s). 5. TEMPORARY ORDERS WITH NOTICE. I filed or I will file a "Motion for Pre-Decree Temporary Orders with Notice" in the Superior Court of Arizona in Maricopa County on this date: ________________ , and I have attached a copy to the Judicial Officer's copy and to the other party's copy of this Motion. OR, I have NOT filed a "Motion for Temporary Orders with Notice" and I understand that: temporary orders without notice expire in a matter of days, and if no temporary orders with notice have been issued by the Court before these orders expire, no court order will be in effect. Note: You cannot file this "Motion for Temporary Orders Without Notice" unless you or the other party has already filed one of the following petitions: © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PTO Page 2 of 5 DRTE11f - 062916 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: _____________ 6. DIVORCE, LEGAL SEPARATION, ANNULMENT, LEGAL DECISION MAKING (CUSTODY) OR OTHER PETITION: A. I or the other party filed in the Superior Court in Maricopa County a (check one box) "Petition for Divorce, or Legal Separation, or Annulment" "Petition for Paternity, and Legal Decision Making (Custody)" "Petition for Legal Decision Making (Custody)/Parenting Time/Child Support" (where paternity and/or support already established) B. Date Petition was filed: . 7. INFORMATION ABOUT OTHER EMERGENCY CASES INVOLVING THE SAME PARTIES OR CHILDREN: Check the boxes that apply and write in the information requested (next page). Current emergency cases: To the best of my knowledge, there are no pending proceedings for emergency orders about these children in any other court. (If this is not a true statement, this Court may not be able to enter an Order and you may want to consult a lawyer for advice.) Past emergency cases: Either or both parties have filed for emergency court orders in the past. (If so, complete the following information. Use additional paper if necessary.) Names of Parties: Date of Order, Judgment, Dismissal: Location of court (city and state): Case No. Explain Type of Case: (Juvenile, Criminal, Order of Protection, etc.) Explain what order or judgment said, or basis for dismissal: © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PTO Page 3 of 5 DRTE11f - 062916 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: _____________ 8. ALL OTHER COURT CASES INVOLVING EITHER OR BOTH OF THE PARTIES: Describe all other court cases that involve either or both of the parties, whether pending or not, including criminal cases. Complete all the information for each court order (use extra paper if necessary). Names of Parties: Date of Order, Judgment, Dismissal: Case No. Location of court (city and state): Type of Case: (Juvenile, Criminal, Order of Protection, etc.) Explain what order or judgment said, or basis for dismissal: Status of Case Now: Final Order Entered; Case is Over. Date Order/Judgment signed: ___________________ Hearing Date Set On (date): Location/address: Other (explain in detail): at (time): 9. ANY OTHER GOVERNMENT AGENCY INVOLVEMENT WITH EITHER OR BOTH THESE PARTIES, OR THESE CHILDREN: State whether there have been or are any complaints with or investigations by any government agency, including Child Protective Services, involving the parties or the minor child(ren). If so, explain the agency, date, type of case, and status of case. Check here if continued on attached page(s). © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED PTO Page 4 of 5 DRTE11f - 062916 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: _____________ 10. CRIMES OF ANY PARTY: Explain here if any party involved with this case has been charged with committing a dangerous crime including child molestation or domestic violence: Check here if continued on attached page(s). I MAKE THE FOLLOWING REQUESTS TO THE COURT: 1. For a "Temporary Order Without Notice" as follows: Check the boxes that apply: Awarding me Temporary Legal Decision Making and Physical Custody of the minor child(ren) until a full court hearing. Other (explain): 2. For a court hearing when the parties can testify about the facts related to this "Motion for a Temporary Order Without Notice" and any "Motion for Temporary Orders," so that the judge can decide whether to continue or modify the terms of the Emergency Order. 3. For any other order that is in the best interests of the minor children named above. UND