(This document must be filed by noon on the day of the ex parte hearing) NAME, ADDRESS & TELEPHONE NUMBER FOR COURT USE ONLY TELEPHONE NO: ATTORNEY FOR (NAME): 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: REQUEST FOR WAIVER OF NOTICE WITH DECLARATION IN SUPPORT THEREOF (NON-DOMESTIC VIOLENCE) (Pursuant to Rules of Court 5.4, 5.151, 5.165 and 5.167) CASE NUMBER: I request that notice NOT be given by me. In support of this request I provide the following statements: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Form Adopted for Mandatory Use Yuba County Superior Court Effective 3/1/14 Revised 3/26/14 DECLARATION RE REQUEST FOR WAIVER OF NOTICE WITH DECLARATION IN SUPPORT THEREOF (NON-DOMESTIC VIOLENCE) (Pursuant to Rules of Court 5.4, 5.151, 5.165 and 5.167) FL14076 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com SHORT TITLE: CASE NUMBER: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ________________________________________ Printed Name _____________________________________________ Signature of Declarant ________________________________________________________________________________________ ORDER GOOD CAUSE APPEARING, THE COURT ORDERS that waiver of the notice of the of the ex parte hearing (non-domestic violence) is hereby: Granted Denied Date:______________ _________________________________ JUDGE OF THE SUPERIOR COURT Form Adopted for Mandatory Use Yuba County Superior Court Effective 3/1/14 Revised 3/26/14 DECLARATION RE REQUEST FOR WAIVER OF NOTICE WITH DECLARATION IN SUPPORT THEREOF (NON-DOMESTIC VIOLENCE) (Pursuant to Rules of Court 5.4, 5.151, 5.165 and 5.167) FL14076 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com