(This form can be submitted at the hearing) NAME, ADDRESS & TELEPHONE NUMBER TELEPHONE NO: ATTORNEY FOR (NAME): FOR COURT USE ONLY FAX NO: SUPERIOR COURT OF CALIFORNIA COUNTY OF YUBA 215 FIFTH STREET, SUITE 200 MARYSVILLE, CA 95901-5737 (530) 749-7600 PLAINTIFF/PETITIONER: vs. DEFENDANT/RESPONDENT: CASE NUMBER: DECLARATION RE NOTICE OF EX PARTE APPLICATION FOR TEMPORARY EMERGENCY COURT ORDERS Pursuant to California Rules of Court, Rule 3.1203 a party seeking an ex parte order must notify all parties no later than 10:00 a.m. the court day before the ex parte appearance, absent a showing of exceptional circumstances that justify a shorter time for notice. 1. NOTICE GIVEN BY: Name (cannot be a party): Telephone #:_______________ a. I gave notice to ______________________________ (name) on __________________ (date) at ___________ (time) by: telephone _________________________ (number) left message on voicemail facsimile __________________________ (number) text message ______________________ (number) e-mail ____________________________ (address) that an ex parte hearing has been set in the above case at the time and date given by the clerk regarding paperwork submitted to the Court. I informed the party that they could contact the clerk to verify the hearing. b. I have made a reasonable and good faith effort to notify the other party. Briefly describe what efforts were made to notify the other party: ____________________________________________ ______________________________________________________________________________ 2. NO NOTICE GIVEN (can be completed by a party) a. I did not give notice to the other party because notice could cause the other party to respond with violence that would result in physical or emotional injury, damage to property of declarant or other person(s) or could make the situation worse. b. I did not give notice to the other party because notice could result in the other party fleeing with the minor child(ren). c. Notice was not given to the other party as I was unable to locate/contact same. Briefly describe what efforts were made to contact the other party:_______________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ________________________________________ Printed Name Form Adopted for Mandatory Use Yuba County Superior Court Effective 07/01/11; Rev. 07/01/12 _____________________________________________ Signature of Declarant DECLARATION RE NOTICE OF EX PARTE APPLICATION FOR TEMPORARY EMERGENCY COURT ORDERS FL03003b American LegalNet, Inc. www.FormsWorkFlow.com