FOR CLERK’S USE ONLY Name of Person Filing: _____________________________________________ Mailing Address: _____________________________________________ City, State, Zip Code: _____________________________________________ Day/Evening Phone Number: __________________________________________ SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case Number:__________________________ ______________________________________________ Name of Petitioner EMERGENCY TEMPORARY ORDER REGARDING: AND ______________________________________________ Name of Respondent Child Custody Child Visitation Other: ____________________________ ______________________________________________ THIS IS AN IMPORTANT COURT ORDER THAT AFFECTS YOUR RIGHTS. READ CAREFULLY. IF YOU DO NOT UNDERSTAND THIS ORDER, CONTACT AN ATTORNEY FOR LEGAL ADVICE. THE COURT FINDS: 1. INFORMATION ABOUT PETITIONS. A Petition for: Dissolution of Marriage Legal Separation Custody/Visitation Was filed by: rebmeceD Petitioner/ Respondent on this _______________ day of _______________, 20 _______. A “Petition for Temporary Orders” was filed by: rebmeceD Petitioner/ Respondent on this _______________ day of _______________, 20 _______. The court read the Petition, took testimony if relevant, considered all matters and issues an emergency temporary order. 2. EMERGENCY SITUATION. The court has found that an emergency exists and this order must be entered immediately to avoid irreparable harm because: Someone is about to cause serious bodily harm to another person immediately, OR 9/23/2010 Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________________________________ The health, safety, and welfare of a person is otherwise in serious and immediate jeopardy as follows (describe): _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 3. NO ADVANCE NOTICE. Applicable only if this is an Emergency Order Without Advance Notice: Advance notice of this order was not required to be given to the other party or his or her attorney or others entitled to prior notice because: The petitioning party tried with due diligence to give advanced notice to all parties but was unable; OR Advanced notice is not required because to do so would result in immediate and irreparable injury, loss, or damage to the petitioning party before the other party can be heard. 4. BEST INTEREST OF THE CHILD(REN) This Order is made in the best interest of the child(ren) whose names and dates of birth(month/day/year) are listed below. Name ____________________________________________ Date of Birth _________________________ Name ____________________________________________ Date of Birth _________________________ Name ____________________________________________ Date of Birth _________________________ Name ____________________________________________ Date of Birth _________________________ Name ____________________________________________ Date of Birth _________________________ THE COURT ORDERS: 1. EMERGENCY TEMPORARY CHILD CUSTODY is awarded to: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 2. EMERGENCY TEMPORARY VISITATION shall be as follows: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 3. OTHER EMERGENCY TEMPORARY ORDERS: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 9/23/2010 Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case No._____________________________________ 4. 5. THIS ORDER SHALL CONTINUE UNTIL: _________________________(date), OR for Emergency Orders Without Notice until (date) _____________________unless extended by the court, or by agreement between the parties in writing and filed with this court. SERVICE AND NOTICE TO THE OTHER PARTY: NO NOTICE GIVEN PRIOR TO FILING THE PETITION FOR EMERGENCY TEMPORARY ORDERS. The person who requested this Order shall personally serve or give actual notice to the other party by serving the following documents: a. b. c. d. e. f. g. “Petition for Dissolution, or Legal Separation, or Annulment, or Custody/Visitation” AND “Petition for Temporary Order” AND “Petition for Emergency Temporary Order” AND A copy of the Order, AND A copy of the “Order to Appear” AND A copy of all other documents filed in support of all Petitions, AND A blank copy of the “Affidavit of Financial Information” and the “Parents Child Support Worksheet” (if child support requested) NOTICE GIVEN PRIOR TO FILING THE PETITION FOR EMERGENCY TEMPORARY ORDERS BUT THE OTHER PARTY FAILS TO “APPEAR OR RESPOND.” The person who requested this Order shall personally serve or give actual notice to the other party by serving the following documents: a. A copy of this “Emergency Temporary Order” AND b. A copy of the “Order to Appear” (if signed by the judge) 6. BOND in the amount of $ ________________ shall be posted with the Clerk of the Court no later than this date: ___________________and this time: ___________________as security for the payment of costs and damages that may be incurred or suffered by any party as a result of this Order should it be determined the basis of this Order was false or without merit. Bond shall be posted by (Name(s)): _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 7. IMPORTANT NOTICE TO THE PARTIES. An “Order to Appear” has also been entered for the judge to hear the testimony of both sides to this dispute, and to decide whether to extend, change, or cancel this Order. The person who asked for this “Emergency Temporary Order” is required to serve upon the other party a copy of that “Order to Appear.” Be sure you know when the hearing is scheduled and come to the hearing. Failure to come could result in a civil arrest warrant being issued against you. DONE IN OPEN COURT: _____________________ (date) 9/23/2010 ________________________________________ JUDGE/COMMISSIONER Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com