Madera Superior Court Form Adopted for Optional Use MAD-0005 (Rev. 3/06/19) EX - PAR TE DECLARATION Page 1 of 1 I am, (specify): attorney for plaintiff/petitioner defendant/respondent not a party in the case (name): 1. I did did not give notice. (if you gave notice, complete number 2 and 3 if no notice is given complete number 4a, 4b, or 4c) 2. PURSUANT TO RULE 2.4.6 OF THE LOCAL RULE OF COURT I HAVE INFORMED (name) , OF THIS EX-PARTE APPLICATION REQUESTED BY (name) .[Complete A, B OR C below] A. TELEPHONE ON (Date): at (Time): A.M./P.M. B. IN PERSON ON (Date): at (Time): A.M./P.M. C. OTHER 3. I TOLD (name): THAT (name): WOULD BE BRINGING AN EX- PARTE REQUEST ON AT 8:15 A.M. IN DEPARTMENT OF THE MADERA SUPERIOR COURT. THAT HE/SHE WILL HAVE TO COME TO COURT AT THAT TIME IF HE/SHE OBJECTS TO THIS EX PARTE REQUEST. 4. I HAVE NOT GIVEN NOTICE OF THIS APPLICATION FOR EX PARTE ORDER FOR THE FOLLOWING REASON (S): a. GIVING NOTICE WOULD FRUSTRATE THE PURPOSE OF THE ORDER (explain in detail as to why notice is not given): b. I WILL SUFFER IMMEDIATE AND IRREPARABLE INJURY IF NOTICE IS GIVEN (explain in detail as to why you fear giving notice): c. OTHER (explain in detail): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (Type or Print Name) (Signature of Applicant) ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address) TELEPHONE NO.: FAX NO.: ATTORNEY FOR (Name): FOR COURT USE ONLY SUPER I OR COURT OF CALIFORNI A, COUNT Y OF MADERA 200 South G Street Madera, California 93637 PLAINTIFF/PETITIONER: CASE NUMBER: D EFENDAN T/RESPONDENT: HEARING DATE : HEARING TIME : EX - PARTE DECLARA TION D EPARTMENT : American LegalNet, Inc. www.FormsWorkFlow.com