Form 654 (Rev 05/19) WARNING! This form may only be used in Protection from Abuse cases. American LegalNet, Inc. www.FormsWorkFlow.com Form 654 (Rev 05/19) The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County AFFIDAVIT FOR EMERGENCY EX PARTE ORDER Protection from Abuse I, the undersigned movant, being duly sworn according to law, do hereby attest to the truth of the allegations made in the underlying petition. I request that an Emergency Ex Parte Order be issued without notice to the Respondent. 1. Notice to the Respondent: a. I have made the following efforts to give notice to the respondent: OR b. Notice should not be required because: 2. I request the following specific relief: 3. I further attest that unless relief is granted on an ex parte basis, the following immediate and present danger of domestic violence exists: Petitioner222s Signature Sworn to subscribed before me this day of , Clerk of Court / Notary Public Date File Number Petition Number Movant Respondent Name: Name: American LegalNet, Inc. www.FormsWorkFlow.com Form 654 (Rev 05/19) File No.: Case No.: The Court has reviewed the Petitioner222s Application and has questioned the Petitioner under oath. Petitioner222s Application is hereby: Disapproved. Return to case processing for: Normal Scheduling of a hearing before at on Expedited Scheduling of a hearing before at on Approved. Ex Parte Order attached. Emergency Ex Parte Request and Petition for Protection from Abuse are Dismissed . Reason for dismissal: So Ordered this Date: Commissioner/Judge American LegalNet, Inc. www.FormsWorkFlow.com