Person Filing: __________________________________________________ Address: __________________________________________________ City, State, Zip Code: __________________________________________________ Phone Number(s): __________________________________________________ ATLAS Number (if applicable):____________________________________________ Attorney Bar Number (if applicable): _______________________________________ Self (Without a Lawyer) OR Representing: Petitioner Respondent Attorney for: For Clerk's Use Only SUPERIOR COURT OF ARIZONA MOHAVE COUNTY ____________________________________ (Name of Petitioner) Case Number:_________________________ ____________________________________ (Name of Respondent) MOTION FOR PRE-DECREE TEMPORARY ORDER WITHOUT NOTICE FOR LEGAL DECISION MAKING I MAKE THE FOLLOWING STATEMENTS TO THE COURT UNDER OATH OR AFFIRMATION: 1. 2. MY NAME IS: ____________________________________________________________. (Name of Person asking for Emergency Order) 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 child(ren) that might occur without this Order (Use additional paper if necessary). __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Check here if continued on attached page(s). 3. PEOPLE INVOLVED. This Motion concerns the following people: Name of Mother: Name of Father: _______________________________________________________________ _______________________________________________________________ Name of Other Person: _______________________________________________________________ Name of Other Person: _______________________________________________________________ Name(s) of Children: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _________________________________________________________ Revised: 1/1/2013 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________________________ 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 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 ATTEMPTED TO GIVE NOTICE TO THE OTHER PARTY AS FOLLOWS: Explain when, how, and to whom you attempted to give notice. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 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 child(ren) would suffer if you gave the other party advance notice of this Motion. (Use additional paper if necessary). ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Check here if continued on attached pages(s) 5. MOTION FOR TEMPORARY ORDERS WITH NOTICE: I filed a "Motion for Temporary Orders with Notice" on (date)_______________________in the Superior Court of Arizona in Mohave County. I have attached a copy of it to the Judge's/Commissioner's copy and the other party's copy of this Motion. (You cannot file this "Motion for Temporary Orders Without Notice" unless you filed or are filing a "Motion for Temporary Orders with Notice.") DIVORCE OR OTHER PETITION: You cannot file this "Motion for Temporary Orders Without Notice" unless you or the other party has already filed or you are filing one of the following petitions: A. I or the other party filed in the Superior Court in Mohave County a (check one box) "Petition for Divorce, or Legal Separation, or Annulment" "Petition for Paternity, and Legal Decision Making" "Petition for Legal Decision Making/Parenting Time" (where paternity and/or support already established) B. 7. Date Petition was filed:______________________________. 6. INFORMATION ABOUT OTHER EMERGENCY CASES INVOLVING THE SAME PARTIES OR CHILDREN: Check the boxes that apply and write in the information requested. Current emergency cases: To the best of my knowledge, there are no pending proceedings or 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.) Revised: 1/1/2013 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________________________ 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, etc:_____________ Location of Court (city and state): ____________________________________________________ Explain type of case. (Juvenile, Criminal, Order of Protection, etc.)_________________________ ______________________________________________________________________________ Explain what Order or Judgment said, or basis for dismissal:______________________________ ______________________________________________________________________________ ______________________________________________________________________________ 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: __________________________