NAME, STATE BAR NO., ADDRESS & TELEPHONE NO. OF ATTORNEY OR UNREPRESENTED PARTY FOR COURT USE ONLY Attorney for: PLACER COUNTY SUPERIOR COURT 10820 Justice Center Drive P. O. Box 619072 Roseville, CA 95661-9072 PETITIONER: RESPONDENT: Notice of Ex Parte Hearing (Family Law) 1. I am counsel for Petitioner Respondent in this action. CASE NO: 2. I request that an ex parte hearing be set for the following date: ________________ in Dept. 41 at __________ am/pm. (Date and time must be Mon-Fri. between 8:30am and 1:30pm at least 24 hours after this notice has been sent to the court and 24 hours after the other party has been notified.) 3. Pursuant to Placer County Superior Court Standing Order 09-001 (You must give 24 hour notice to the other side.), I am able to inform the opposing party ________________________________________________ (name) of this ex parte request by: telephone call in person Other (describe)___________________________________________or I have not given notice of this application for ex parte hearing because: Giving notice would frustrate the purpose of the order (explain in detail):_______________________________ ___________________________________________________________________________________________ I will suffer immediate and irreparable injury if notice is given (explain in detail):_________________________ ____________________________________________________________________________________________ Basis for request for ex parte orders: 1. Describe the issue(s) that must be considered at the ex parte hearing. ______________________________________________________________________________________________ ______________________________________________________________________________________________ 2. Describe in detail the emergency for the court to consider. ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 3. Can any of the issues described above be deferred to a later hearing? ______________________________________________________________________________________________ ______________________________________________________________________________________________ Dated: ______________ ______________________________ TYPE OR PRINT NAME _________________________________ SIGNATURE OF DECLARANT Fax this form to the Court at (916) 408-6285, or bring to the Family Law filing window at 10820 Justice Center Drive, Roseville, CA . American LegalNet, Inc. www.FormsWorkFlow.com