IN THE COURT OF COMMON PLEAS OF FRANKLIN COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS Case No. Plaintiff v. Judge Magistrate Defendant MOTION OF PLAINTIFF/DEFENDANT, Partys Name , FOR TEMPORARY ORDERS PURSUANT TO CIVIL RULE 75(N) Plaintiff/Defendant hereby requests the following temporary orders: temporary spousal support in the amount of $ per month; the allocation of parental rights, including designation as the temporary residential parent and legal custodian of the minor child(ren); temporary child support in the amount of $ per month ; an allocation of the indebtedness of the parties; reasonable expense money in the amount of $ ; and any other equitable temporary relief. Counsel for Plaintiff/Defendant Sup. Ct. No. Memorandum Plaintiff/Defendant has filed affidavits with this motion in support of the requests for relief. NOTICE OF HEARING AND STATUS CONFERENCE You are hereby given notice that this motion for temporary orders shall be heard upon affidavits only, and without oral testimony, before Magistrate , HearingRoom , at 8:30 a.m. on , 373 South HighStreet, Third Floor, Columbus, Ohio. Counter affidavits may be filed within fourteen days of when you are served with this motion and the supporting affidavits. Pursuant to Local Rule 3, a status conference shall also be conducted by the Magistrate at the time of the temporary orders hearing noted above. All parties and their counsel shall be present for the status conference and shall attempt to reach an amicable settlement of all issues in controversy, and in the event settlement is not possible, to expedite proceedings in the action. Your presence at the status conference may only be excused with advance permission of the Magistrate and notice to the opposing party/attorney. COC-DR-03A >>>> 2 IN THE COURT OF COMMON PLEAS OF FRANKLIN COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS ___________________ Plaintiff vs. Case No. __________________ ___________________ Defendant AFFIDAVIT OF PLAINTIFF/DEFENDANT STATE OF OHIO COUNTY OF FRANKLI N The plaintiff/defendant, being duly sworn, says that the following information is true and correct to the best of his/her knowledge and belief: Marriage Date_____________ Date Separated _________Ages: Wife_______ Husband________ No. of Children This Marriage: __________ Ages: ____________________________________ No. of Children Prior Marriage: Husband _______________ Wife ___________________ Birth Date: Husband ___________________ Wife ____________________ Social Security Number: Husband _______________________ Wife ______________________ Employment: Plaintiff Defendant Where Employed _____________________________ _____________________________ Employers Address ___________________________ ______________________________ Length of Employment _________________________ ___________________________ How Often Paid ______________________________ ______________________________ Gross Earnings Per Pay ________________________ ______________________________ Other Income ________________________________ ______________________________ Funds On Deposit _____________________________ ______________________________ Account Number with instructions, addresses, and indication of account type (joint or individual) to be included on a separate sheet attached hereto. Other Liquid Assets __________________________ _______________________________ If Unemployed: Date Last Employed: __________________________ ______________________________ Employer __________________________________ ______________________________ Unemployment Compensation: __________________ ______________________________ Workers Comp. Acct # ________________________ ______________________________ Monthly Expenses: Rent or Mortgage _____________________________ _____________________________ Food _______________________________________ ______________________________ Utilities ____________________________________ ______________________________ Auto _______________________________________ ______________________________ Child Care __________________________________ ______________________________ Other _______________________________________ _____________________________ Total: ______________________________________ _____________________________ Debtor Creditor Balance Monthly Purpose ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Affiant:_________________ Sworn to me and subscribed in my presence this _______day of ___________, 20 ___________ ________________________________ NOTARY PUBLIC