SUPERIOR COURT OF CALIFORNIA, COUNTY OF MENDOCINO ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number, Address, Phone No.) FOR COURT USE ONLY Attorney for: UKIAH BRANCH, 100 NORTH STATE STREET, UKIAH, CA 95482 TEN MILE BRANCH, 700 SOUTH FRANKLIN STREET, FORT BRAGG, CA 95437 Case Number PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: DECLARATION re: NOTICE upon EX PARTE APPLICATION for ORDERS Hearing Date: Time: Dep't.: In most cases, you must notify all parties that you are requesting a court order. This is called "notice". Regardless of how you notice the other side that you are requesting a court order, copies of the documents that you have filed with the court, excluding those for a restraining order, MUST be served on the other party as soon as is reasonably practicable, but in no event later than the time of the hearing set. (Local Rules 8.5; 13.15; 14.4; 15.5.b.4) I, the undersigned, declare: 1) I am the (choose one): attorney for the Petitioner/Plaintiff self-represented Petitioner/Plaintiff attorney for the Respondent/Defendant self-represented Respondent/Defendant (name of person you notified) attorney for the Child(ren) of this ex parte request for and that s/he will 2) Pursuant to CRC 3.1203 and 3.1204, I have informed (type of relief sought) have to appear before the court on the above listed date and time if s/he objects to this ex parte request. 3) Notice was given by (check all that apply): Telephone Notification (no later than 10:00 a.m. the court day before the ex parte appearance): (date) at (time) a.m. / p.m. a.m. / p.m. Personal Delivery (no later than 10:00 a.m. the court day before the ex parte appearance): (date) at (time) First Class Mail (copy of ex parte application mailed at least 5 days before the ex parte appearance): (date) (address) at (time) a.m. / p.m. at _________________________________________________________________________________________________ Fax Delivery (copy of ex parte application faxed no later than 10:00 a.m. the court day before the ex parte appearance): at a.m. / p.m. at (attach proof showing fax was received). (date) (time) (fax number) If notice was provided later than 10:00 a.m. the court day before the ex parte appearance, explain why: 4) I received the following response to the above notice: See attached written response. Oral response received: 5) I have not given notice of this request for ex parte orders because: Notice would frustrate the purpose of the orders sought (explain below or in an attachment). Great or irreparable injury will result to me before orders can be issued and/or I fear for my safety (explain below or in an attachment). A good faith effort was made to notify the opposing party but notice was unable to be given (explain notice attempts below). The opposing party agrees to the orders requested. No significant burden or inconvenience to the opposing party will result from the orders requested (explain below or in an attachment). Other (explain): I declare under penalty of perjury that the foregoing is true and correct. Date: MMC-121 (rev 060116) Signed: American LegalNet, Inc. www.FormsWorkFlow.com