06/27/05 At Part ____of the Supreme Court of the State of New York held in and for the County of ______________________ on leave blank ______________________, 200__. leave date blank P R E S E N T: HON. J.S.C. Name of Justice if matter assigned ---------------------------------------------------------------x Index No. ______________ insert court index no. : Plaintiff, ORDER TO SHOW CAUSE :FOR TEMPORARY -against- RELIEF : : Defendant. : ----------------------------------------------------------------x Upon reading and filing the annexed affidavit of ___________________, th e (Plaintiff/ your name (movant) cross out Defendant) in this action, sworn to on ____________________, together with the Statement inapplicable date of affidavit of Net Worth, sworn to on _______________________, and all other papers attached to this date of Statement of Net Worth Order to Show Cause, and a Summons with Notice (or Summons and Complaint)* LET _________________________, (Plaintiff/Defendant), show cause before t his Court opposing partys name cross out inapplicable at Part_____ Room_____ thereof to be held at the Courthouse located at leave blank _________________________________________________ , New York on ________ _______, address of Courthouse leave blank at 9:30 a.m. or as soon thereafter as the parties can be heard, * If action is being commenced simultaneously with service of Order to Show Cause 1 American LegalNet, Inc. www.USCourtForms.com>>>> 2WHY an Order should not be made and entered (check the applicable boxes): Granting to movant an Order of Protection; Granting to movant and movants child(ren) an Order of Protection; Granting to movant temporary custody of the child(ren); Granting to movant temporary child support pursuant to the guidelines set forth in the Child Support Standards Act; Granting to movant visitation of the children during the pendency of this action; Granting to movant temporary maintenance; Ordering the opposing party during the pendency of this action to provid e medical insurance coverage for movant and the child(ren), and ordering the opposing party to pay a pro rata share of unreimbursed medical expenses for the child(ren); Ordering the non-custodial parent to purchase and maintain in full force and effect a life insurance policy in an amount sufficient to secure support obligations and naming the movant as irrevocable beneficiary during the pendency of this action; Granting exclusive possession of the marital residence to the movant; Ordering the opposing party, his or her agents, or anyone else acting on his or her behalf, except as otherwise directed by the court and during the pendency of this action, from selling, canceling, dissipating, transferring, encumbering, borrowing from or against, or otherwise disposing of or destroying any property acquired by the parties during the marriage, whether such property is owned by the parties jointly or indivi dually or with any third party or parties, including but not limited to: personal and real property, 2 American LegalNet, Inc. www.USCourtForms.com>>>> 3 pensions, savings plans, bank accounts, certificates of deposit, insuran ce payments, tax refund payments, stocks, bonds, and other assets in safe deposit boxes or other depositories; Granting such other and further relief as the Court may deem just and proper. SUFFICIENT REASON APPEARING THEREFOR, ORDERED , that a Temporary Order of Protection shall issue this date in favor of _____________________________against ________________________________. Terms/conditions your name spouses name of such Order are set forth on the attached Temporary Order of Protection. ORDERED , that pending the hearing of the instant application and the further Or der of this Court, ________________________, his or her agents, or anyone else acting on his or her behalf, spouses name except as otherwise directed by the Court and during the pendency of this action, refrain from selling, canceling, dissipating, transferring, encumbering, borrowing from or against, or otherwise disposing of or destroying any property acquired by the parties during the marriage, whether such property is owned by the parties jointly or individually or with any third party or parties, including but not limited to: personal and real property, pensions, savings plans, bank accounts, certificates of deposit, insurance payments, tax refund payments, stocks, bonds, and other assets in safe deposit boxes or other dep ositories; his or her agents, or anyone else acting on his or her behalf, except for everyday living expenses, and/or in the ordinary course of business.* ORDERED , that service of a copy of this Order to Show Cause, the papers upon wh ich it is granted and the Temporary Order of Protection, if any, (together with a Summons with Notice or Summons and Complaint).** be made by personal delivery upon _____________________ spouses name and spouses __________________________at________________________________________on o r before attorneys name address of spouse and spouses attorney * alleges that spouses business is marital property ** if action is being commenced simultaneously 3 American LegalNet, Inc. www.USCourtForms.com>>>> 4__________________________, be deemed good and sufficient service. leave date blank E N T E R, _____________________________ Justice of the Supreme Court 4 American LegalNet, Inc. www.USCourtForms.com