Form 458A (Rev. 7/07) The Family Court of the State of Delaware In and For New Castle Kent Sussex County AFFIDAVIT FOR WRIT OF INJUNCTION/SEQUESTRATION Petitioner v. Respondent Name Name File Number(s) CPI Number(s) Section I I, the undersigned affiant, being duly sworn according to law, do hereby attest to the truth of the allegations made in the attached Petition. I hereby request that a Writ of Sequestration issue without notice to the Respondent. In support thereof I attest to the following: 1. 2. 3. Respondent has used or threatened to use a firearm(s) against me or I fear that the respondent will use a firearm(s) against me. Respondent is in possession of the following firearm(s): (List and describe in detail what firearm(s) the Respondent possesses.) Furthermore, I hereby attest the above listed firearm(s) can be found at the following locations(s): (Describe in detail exactly where the firearm(s) are located, including the address, and where specifically at that address they may be found. If not the Respondent’s address, describe in detail whose address it is) Section II I further swear and attest that unless the Writ of Sequestration issues before a final hearing on the underlying Petition for Protection from Abuse, I will suffer immediate and irreparable injury or bodily harm as follows: (Describe in detail specific threats made or actions taken by the Respondent towards you regarding the firearm(s)). ______________________________ Signature SWORN TO AND SUBSCRIBED before me this date ____________________________ ______________________________ Notary Public American LegalNet, Inc. www.FormsWorkflow.com