Form 652 (Rev. 03/12) The Family Court of the State of Delaware In and For New Castle Kent Sussex County MOTION AND AFFIDAVIT FOR INTERIM RELIEF Petitioner Name Street Address (including apartment) P.O. Box Number City/State/Zip Code Attorney Name v. Respondent Name Street Address (including apartment) P.O. Box Number City/State/Zip Code Attorney File Number Petition Number Interpreter needed? Language Yes No Interpreter needed? Language Yes No A Proceeding involving Court, Movant hereby moves the Court for: Temporary Custody of: The following temporary financial relief: having been filed heretofore in this In support thereof, the Movant alleges the following (State the specific facts that support a request for entry of an order until the full hearing can be held): Movant Sworn to subscribed before me this ______ day of ______________________, _________ Mediator/Notary Public 1 of 4 Date American LegalNet, Inc. www.FormsWorkFlow.com Form 652 (Rev. 03/12) AFFIDAVIT OF MAILING I, the Movant, affirm that a true and correct copy of this Motion was placed in the U.S. Mail on the day of and sent to the other party or attorney at the address listed on the petition, first class postage pre-paid. Movant Sworn to subscribed before me this ______ day of ______________________, _________ Mediator/Notary Public 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Form 192 (Rev. 10/10) The Family Court of the State of Delaware In and For New Castle , Petitioner Kent Sussex County v. , Respondent ) ) ) ) ) ) ) ) ) File No.: Petition No.: NOTICE OF MOTION TO: PLEASE TAKE NOTICE that the attached Motion is herewith presented to the Court for consideration. If you are opposed to this motion, you must file a written response with the Court within ten (10) days of the service of this motion. If no response is timely filed, the motion may be decided without further opportunity for you to be heard on the matter. Family Court Rules, Rule 7(b)(2). Date Movant/Attorney Name and address of Movant/Attorney Street Address P.O. Box Number City/State/Zip Code 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Form 192 (Rev. 10/10) The Family Court of the State of Delaware In and For New Castle Kent Sussex County ) ) ) ) ) ) ) ) ) , Petitioner File No.: Petition No.: In Re: v. , Respondent ORDER Having considered the request of the movant, IT IS SO ORDERED, this date: , That Judge/Commissioner cc: 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com