SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE RULES (FL.010) Page 1 of 2 (A.D. 1-1-1) Mandatory DECLARATION RE: NOTICE OF EX PARTE APPLICATION FOR ORDERS ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) : TELEPHONE: FAX NO. (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE Butte County Courthouse North Butte County Courthouse One Court Street, Oroville, CA 95965 1775 Concord Avenue, Chico, CA 95928 (530) 532 - 7002 (530) 532 - 7002 P ETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER: DECLARATION RE: NOTICE OF EX PARTE APPLICATION FOR TEMPORARY ORDERS CASE NUMBER: I, , do declare that I am: Petitioner/Plaintiff Respondent/Defendant Other I declare as follows: Pursuant to Rule 16.5(b) of the Butte County Local Rules of Court and CRC, Rule 3.1204(b)(1) on at am/pm, I advised by: Telephone call In person Other (describe): , that I would be seeking ex parte orders affecting CUSTODY and VISITATION of our (child)ren other (describe): and, if (s)he wishes to oppose the request for temporary orders (s)he will have to appear at Butte County Superior Court, One Court Street, Oroville, CA 95965 North County Superior Court, 1775 Concord Avenue, Chico, CA 95928 at 3:00 pm on (date). 1.His/Her response to this notice was: 2.I asked if (s)he would be appearing in court to respond to this request and his/her response was: Pursuant to CRC, Rule 3.1204(b)(2) and (3), I have not given notice of this application for ex parte orders because giving notice would frustrate the purpose of the order because: American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE RULES (FL.010) Page 2 of 2 (A.D. 1-1-1) Mandatory DECLARATION RE: NOTICE OF EX PARTE APPLICATION FOR ORDERS OR: I will suffer immediate and irreparable injury if notice is given because: OR: I made a good faith attempt to inform the opposing party but was unable to do so because: If notice was given later than 10:00 am the court day prior to the hearing, notice was provided later than 10:00 am the day before the 3:00 pm ex parte appearance because: An Order Shortening Time for service and/or hearing date will not be sufficient to address the problem because: I have read and am aware of the requirements for ex parte orders regarding custody and visitation of children set forth in Butte County Local Rules, Rule 16.5(e). I understand that I have an absolute duty to inform the Court about any existing orders for child custody and visitation, and to tell the Court how existing orders for child custody and visitation will be affected if the Court grants my ex-parte request for orders. Existing orders for child custody and visitation are: These orders will be affected, if the Court grants my request for ex parte orders, as follows: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. (DATE) (PRINT NAME) (SIGNATURE) American LegalNet, Inc. www.FormsWorkFlow.com