STATEOFVERMONTSUPERIORCOURTFAMILYDIVISION UnitDocketNo.v. MOTION FOR EMERGENCY RELIEF I have filed a motion for with the court. In addition to what I have requested in my motion, I am also requesting that the Court take the following emergency action: I am asking the court to schedule a hearing as soon as possible on my motion. I am asking the Court to immediately issue the following emergency order for the protection of myself or my children until the court holds a hearing on my motion: I am asking the Court to immediately issue the following emergency order for the protection of my property until the court holds a hearing on my motion: SUPPLEMENTAL AFFIDAVIT IN SUPPORT OF EMERGENCY REQUEST Under penalty of perjury I hereby swear that the facts I have written below are true to the best of my knowledge and belief. 1. There is an immediate threat of personal injury to myself or my child? yes no If yes, please describe why you believe this is true. American LegalNet, Inc. www.FormsWorkFlow.com . 2. There is an immediate threat of damage or injury to my financial interests or property. yes no If yes, please describe why you believe this is true. . 3. Please state any other fact or circumstance which causes you to believe this court needs to issue an emergency order or schedule an emergency hearing. . DateSignatureName(PleasePrint) Subscribed to and sworn before me on , 20. Notary Public 10/10 SML American LegalNet, Inc. www.FormsWorkFlow.com