STATE OF MAINE DISTRICT COURT Location Docket No. Plaintiff: individually and on behalf of: DEFENDANT'S MOTION TO on behalf of: DISSOLVE TEMPORARY ORDER FOR PROTECTION (with incorporated Affidavit) (19-A M.R.S.A. § 4006(7)) (5 M.R.S.A. § 4654(6)) v. Defendant: on behalf of: MOTION TO MODIFY/AMEND (with incorporated Affidavit) The Defendant _____________________________ states that the finding(s) in the (Temporary) Order are not justified and hereby requests, for the following facts and reasons, the (Temporary) Order for Protection dated be Dissolved Modified/Amended 1._____________________________________________________________ ___________ _______________________________________________________________ ___________ _______________________________________________________________ ___________ 2.____________________________________________________________________ ____ ____________________________________________________________ ______________ ____________________________________________________________________ ______ Wherefore, Defendant asks the court to ____________________________________________________________________ Dated: Defendant Personally appeared the above named Defendant and signed and made oath to the truth of the statements in the above Motion and Affidavit and any attachments, before me, Dated: Clerk / Notary Public / Attorney at Law NOTICE OF HEARING The parties are hereby notified that the hearing in this matter is set for at (am) (pm) at the District Court located at: ______ . (Deputy) Clerk PA-010, Rev. 08/09 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com RETURN OF SERVICE , ss. On , at a.m. / p.m., I made service of the Defendant's Motion to Dissolve/Amend/Modify Temporary Order upon the plaintiff by delivering a copy of the Motion and Notice of Hearing to the plaintiff in hand at: (location where served) Authorized Officer PA-010, Rev. 08/09 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com