For Clerk's Use Only Name of Person Filing: _________________________________ Mailing Address: _________________________________ City, State, Zip Code: _________________________________ Phone Number(s): _________________________________ ATLAS Number (if applicable): _________________________________ Attorney Bar Number (if applicable): _________________________________ Self Without a Lawyer OR Representing: Petitioner OR Respondent Attorney for: SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case Number:_________________________ Name of Petitioner PETITION FOR EMERGENCY TEMPORARY ORDER AND __________________________________ Name of Respondent For Legal Decision Making To Stop or Change Parenting Time (formerly known as "Visitation") Other WITHOUT NOTICE, or WITH NOTICE I, (Name of Person Asking for Emergency Order) MAKE THE FOLLOWING STATEMENTS TO THE COURT UNDER OATH pursuant to Rule 65(d) A.R.Civ.P. 1. REASONS WHY I NEED THIS ORDER. Explain in detail the emergency facts which now exist, what injury you fear could occur, why you need this Order immediately, and why an emergency order is the only way to solve the problem: (Use additional paper if necessary): ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 2. NOTICE TO THE OTHER PARTY. Answer one of the following about notice to the other party: This is how I gave notice to the other party or his or her attorney: Whom I gave notice to: When I gave notice: How I gave notice: This is how I tried to give notice to the other party or his or her attorney: Who I tried to give notice to: When: How: Revised: 1/1/2013 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.______________________________ I did not try to give advanced notice: (Explain what injury, loss or damage you would suffer if you gave the other party advance notice of this Petition.) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 3. PEOPLE INVOLVED. This Petition concerns the following people: Name of Mother: Name of Father: Names of Other People: ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ Name of minor child(ren) and their ages: 4. PETITION FOR TEMPORARY ORDERS: I filed a "Petition for Temporary Orders" 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 Petition. (You cannot file this emergency petition unless you filed or are filing a "Petition for Temporary Orders.") DIVORCE OR OTHER PETITION: You cannot file this emergency petition 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 Legal Decision Making/Parenting Time" (first court order for paternity and/or support has been established) "Petition for Parenting time" (first court order for paternity and/or support has been established) B. Date Petition was filed ___________________. 5. 6. INFORMATION ABOUT OTHER EMERGENCY CASES INVOLVING THE PARTIES OR THE CHILD(REN): Check the boxes that apply and then write in the information requested. Current emergency cases: To the best of my knowledge, there are no pending proceedings for emergency orders about the minor child(ren) in any other court. (If this is not a true statement, see a lawyer for help.) Past emergency cases: Either or both parties have filed for emergency court orders in the past. (If so, you most complete the following information. Use additional paper if necessary): Revised: 1/1/2013 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Case No.___________________________ Name of Parties: __________________________________________________________________ Date of order, judgment, dismissal, etc.: ________________________________________________ Explain what order or judgment said, or basis for dismissal: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Court Case Number: ___________________; Location of court (city and state):_________________ ________________________________________________________________________________ 7. 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) Name of Parties: __________________________________________________________________ Court Case Number: ___________________; Location of court (city and state):_________________ ________________________________________________________________________________ What order or judgment said:_________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Explain type of case: (Criminal, Order of Protection, Injunction against Harassment, divorce, Paternity, etc.)_____________________________________________________________________________ Status of case now: Final Order entere