Form 656 (Rev 08/16) WARNING! This form may only be used in Protection from Abuse cases. American LegalNet, Inc. www.FormsWorkFlow.com Form 656 (Rev 08/16) The Family Court of the State of Delaware In and For New Castle Kent Sussex County AFFIDAVIT FOR EMERGENCY EXPEDITED HEARING Protection From Abuse Petitioner Name: Respondent Name: File Number Petition Number 1.) I, the undersigned affiant, being duly sworn according to law, do hereby attest to the truth of the allegations made in the underlying petition. I request an emergency expedited hearing be scheduled on this matter within fifteen (15) days pursuant to 10 Delaware Code §1043(c). 2.) I understand that if an expedited hearing is scheduled, the Respondent will be served with a copy of my Petition for Protection From Abuse, a copy of this Affidavit for Emergency Expedited Hearing and notice of the hearing date. 3.) I further attest that unless relief is granted on an expedited basis, the following immediate and irreparable harm will result: 4.) I understand that I have the option of filing for an emergency ex parte order and that, if I chose to do so, I would have a hearing today. Affiant/Petitioner Sworn to and subscribed before me this day of , Clerk of Court/ Notary Public Date The Court has reviewed the Petitioner's application and, if necessary, has questioned the Petitioner under oath. Petitioner's application is hereby: Approved. Return to case processing for notification to the parties of a hearing before at on Disapproved. The file shall be returned to civil case processing to follow normal scheduling So Ordered this Date: Commissioner/Judge American LegalNet, Inc. www.FormsWorkFlow.com