ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME, ADDRESS, PHONE) FOR COURT USE ONLY Attorney for: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STANISLAUS Street Address: 800 11th Street, Modesto, CA 95354 Civil Clerk's Office: 1100 I Street, P.O. Box 1098, Modesto, CA 95353 Petitioner/Plaintiff: Respondent/Defendant: DECLARATION RE: NOTICE UPON EX PARTE APPLICATION FOR ORDERS I, the undersigned, declare: 1. I am: ( 1 ) counsel for petitioner/plaintiff respondent/defendant ( 2 ) unrepresented petitioner/plaintiff unrepresented respondent/defendant ( 3 ) other (explain): _______________________________________________________________ 2. The opposing party is represented by counsel: YES NO Unknown. address, and telephone number: 3. The parties in this have not been involved in another Family, Domestic Violence (family or criminal), Probate, or Juvenile Court case. The parties have been involved in another Family, Domestic Violence (family or criminal), Was a Restraining Order Issued? Type of Case: Names of Parties in case: Probate or Juvenile case as listed below: Case No. /County where filed: If you checked yes, fill in attorney's name, Case Number: 4. I have given 24 hour notice of this ex parte application yes no (skip #5, 6 and complete #7 below). Pursuant to Local Rule 7.14, a copy of these pleadings were given to: _________________________________ By: personal delivery overnight mail or other overnight carrier fax transmission 5. 6. 7. other (explain): ______________________________ Date and time of notice: ____________________, 20___, at __________ a.m./p.m. A written response is attached, or I have received the following oral response: ___________________________ ________________________________________________________________________________________ Unless a written response is attached, I understand the Court will not consider my request until the Expiration of the 24 hour period. I have not given notice of the present application for ex parte orders because: A. Notice would frustrate the purpose of the orders sought. B. Applicant would suffer immediate and irreparable harm before the court orders could issue. C. No significant burden or inconvenience to the responding party will result. D. The orders requested are those permitted without notice by Local Rule 7.15. E. I made reasonable, good faith efforts to give notice, as follows: ______________________ F. Other: _________________________________________________________________ You must explain why you checked 7a, b, c, d, or e: _______________________________________ ________________________________________________________________________________ I declare under penalty of perjury under the laws of the State of California the foregoing is true and correct, at _______________, California, this _______ day of ____________, 20____, at __________a.m./p.m. Signature of Declarant: FL004 (Mandatory Form) DECLARATION RE: NOTICE UPON EX PARTE APPLICATION FOR ORDERS Rev 6/11 American LegalNet, Inc. www.FormsWorkFlow.com