ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 939 W. Main Street El Centro, CA 92243 PETITIONER: RESPONDENT: DECLARATION REGARDING EX PARTE NOTICE CASE NUMBER: Other party (or attorney if represented): a. Name: ___________________________________________ b. Address: _________________________________________ c. Phone Number: ___________________________________ DECLARATION REGARDING NOTICE 1. The undersigned or another case. has has not made any prior applications on the same issue in this case 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 before 10:00 a.m. on the Court day before the hearing: By: Personal Delivery First Class Mail Fax with confirmation of receipt Telephone Other (explain):___________________________________________ Date and time I gave notice_____________________________________ (Date) (Time) Form Approved for Optional Use FL-06A (Adopted 01/01/10; Revised 01/01/11, 01/01/12, 01/01/13) DECLARATION REGARDING EX PARTE NOTICE Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER: RESPONDENT: CASE NUMBER: 5. The other party or their attorney details) has or has not confirmed receipt of the motion (state ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 6. I have given 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. I do not anticipate the 7. I anticipate the other party will oppose this application. opposing party will oppose this application. 8. The Domestic Violence Protection Act. I have not given notice to the other party or attorney for the following reasons: This is a DVP (The Domestic Violence Protection Act Other-Local Rule 5.1.1(e) Explain: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: _____________________ ______________________________ Signature of Declarant Form Approved for Optional Use FL-06A (Adopted 01/01/10; Revised 01/01/11, 01/01/12, 01/01/13) DECLARATION REGARDING EX PARTE NOTICE Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com