Attorney or Party Without An Attorney (Name, State Bar No. & Address) For Court Use Only Telephone No. Attorney for: Superior Court of California, County of San Bernardino Petitioner: Respondent: DECLARATION REGARDING EX PARTE NOTICE TO OPPOSING PARTY -BLACK INK ONLY ­ CASE NUMBER The undersigned hereby declares that I gave notice to the opposing party about where and when the application for the emergency order would be made as follows: Name of Party Notified/Served: _________________________________________________________ Date of Notice: ___________________ Time Notice Was Given: __________ A.M. P.M. Form of Notice: Oral Written Other: _______________________ Information Given: That at ______ A.M. P.M., on _______________________ (court date), the moving party would appear at the Superior Court, located at: _______________________________________________________________________________ California, in Department _______ to ask for immediate temporary orders regarding: Custody Visitation Temporary Guardianship Restraining Order Residence Exclusion Property Control Other: _______________________________________________________________________ I have received the following response to this notice: ________________________________________________________________________________________________ _________________________________________________________________________________________________ CONTINUED ON BACK SIDE See Rules of Court, Rule 5.165 for notice requirements -- no later than 10:00 am on the court day before the matter is to be considered by the court or provide written explanation of exceptional circumstances. SB-19447 Revised 3.11.13 American LegalNet, Inc. www.FormsWorkFlow.com Is opposition expected from the other party? Yes No Unknown For All Cases Except Domestic Violence Restraining Order I have served the other party with a copy of the paperwork. I have not yet had a reasonable opportunity to serve the other party with the paperwork. My notice to the other party was later than 10:00am on the court day before the hearing. See the attached declaration explaining the exceptional circumstances about why there was shorter notice. ALL CASES: You may ask the court to excuse you from giving notice to the other party for good cause. If you did not give notice to the other party, you must write down your explanation here. Below you will find a list of reasons from California Rules of Court Rule 5.165 why no notice may be acceptable. _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: _________________________ Signed by: ___________________________________________ Street Address: _____________________________________ City/State/Zip: ______________________________________ California Rules of Court, Rule 5.165 The party made reasonable and good faith efforts to give notice to the other party, and further efforts to give notice would probably be futile or unduly burdensome; Giving notice would frustrate the purpose of the order; Giving notice would result in immediate and irreparable harm to the applicant or the children who may be affected by the order sought; Giving notice would result in immediate and irreparable damage to or loss of property subject to disposition in the case; or The parties agreed in advance that notice will not be necessary with respect to the matter that is the subject of the request for emergency orders. See Rules of Court, Rule 5.165 for notice requirements -- no later than 10:00 am on the court day before the matter is to be considered by the court or provide written explanation of exceptional circumstances. SB-19447 Revised 3.11.13 American LegalNet, Inc. www.FormsWorkFlow.com