ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 939 Main Street El Centro, CA 92243 PETITIONER: RESPONDENT: DECLARATION REGARDING EX PARTE NOTICE CASE NUMBER: Opposing party (or attorney if represented): a. Name: ___________________________________________ b. Address: _________________________________________ c. Phone Number: ___________________________________ DECLARATION REGARDING NOTICE 1. The undersigned has case or another case. has not made any prior applications on the same issue in this 2. If there has been another case, fill in the County in which the case is pending: County: __________________ Case number: _________________. 3. This order will will not result in a change of the status quo. 4. I have given notice of the ex parte application to the other party/attorney by the following method at least by 10:00 a.m. the previous day set for the hearing: By: Personal Delivery Fax with confirmation of receipt First Class Mail Telephone Other (explain):___________________________________________ Date and time I gave notice_____________________________________ (Date) (Time) 5. The other party or their attorney has or has not confirmed receipt of the motion (state details) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Form Approved for Optional Use FL-06 (A) (01/01/10; Revised 01/01/11) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com DECLARATION REGARDING EX PARTE NOTICE PETITIONER: CASE NUMBER: RESPONDENT: 6. I gave notice that I would present this application for these orders on___________ at __________ am/pm in Department _______________ of the Superior Court, 939 Main Street, El Centro, CA. 7. I anticipate the other party will oppose this application. other party will oppose this application. I do not anticipate the 8. If this is not an application under the Domestic Violence Protection Act, I have not given notice to the other party or attorney for the following reasons (See Local Rule 5.1(e)): ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: _____________________ Form Approved for Optional Use FL-06 (A) (01/01/10; Revised 01/01/11) ______________________________ Signature of Declarant Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com