IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN IN THE MATTER OF: ________________________________, Petitioner, vs. ________________________________, Respondent. Petitioner Respondent requests a hearing on: Temporary Ex Parte Custody Order (ORS 107.097(3)) [prior to a final judgment] [1 hr.] Temporary Ex Parte Custody Order (ORS 107.139) [after to a final judgment] [1 hr.] I object to the Temporary Ex Parte Custody Order on the ground that the child was not in immediate danger at the time the order was issued. Temporary Order of Protective Restraint (107.097) [30 mins.] I object to the Protective Order of Restraint because I disagree with the representation of the status quo in the following particulars: ) ) ) ) ) ) ) ) ) ) CASE NUMBER:______________________ REQUEST FOR HEARING ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ . Temporary Status Quo Hearing (on Modifications only) (107.138) [30 mins] Expedited Parenting Enforcement Proceeding (107.434) [1 hour] Other:_____________________________________________________________________ Estimated length of hearing: _________ hours. Note: if the time requested exceeds the presumptive hearing times above the requesting party must attach an affidavit with a list of witnesses and an explanation for why the hearing would have to exceed the usual time. Date:__________________________ ___________________________________________ Signature of Petitioner Respondent ___________________________________________ Print or Type Name of Petitioner / Respondent All parties must notify the court of any change of address promptly. All notices of hearings will be sent to the address on this form and this case will be dismissed if you do not appear at scheduled hearings. Page 1 of 2: Request for Hearing / Pro Se / General Form ­ (8/09) American LegalNet, Inc. www.FormsWorkFlow.com Submitted by: ________________________________________________________________ Print Name Attorney for Petitioner/Respondent: OSB Number:_________________ ________________________________________________________________ Contact Address ________________________________________________________________ City State Zip ________________________________________________________________ Contact telephone number(s) Certificate of Service by Mail or Delivery: I certify that I mailed a copy of this document by First Class US Mail with Postage Paid to the other party, or if they have an attorney, to their attorney, at the following address: ________________________________________________ ____________________________________________________________________________, on the following date: _________________________.[ I certify that I personally hand delivered this document to the address listed above on the following date: _________________.] ______________________________ Signature Petitioner Respondent _________________________________________ Print Name I certify this is a true copy: ______________________________ Signature Petitioner Respondent Page 2 of 2: Request for Hearing / Pro Se / General Form ­ (8/09) American LegalNet, Inc. www.FormsWorkFlow.com