400 - 0030 3 Extreme Risk Motion to Renew/Terminate Protection Order (0 6 /2018) Page 1 of STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION Unit Docket No. Petitioner Respondent Date Of Birth State of Vermont V. MOTION TO TERMINATE/RENEW EXTREME RISK PROTECTION ORDER An Order for extreme protection was entered in the above case on: . The Pe titioner Respondent r equests that this Order of the Court be: Terminated Renewed until Affidavit in Support of Request In support of this request, subject to the penalties for perjury, I state the following facts to be true to the best of my knowledge and belief. ( Specifically describe the facts that support your request. ) Dated Signature Print Name Signed and sworn to before me: NOTICE This affidavit will be served on opposing party with a copy of the M otion to T erminate/ R enew the E xtreme R isk P rotection O rder. WARNING MAKING A FALSE STATEMENT IN THIS AFFIDAVIT IS A CRIME SUBJECT TO A TERM OF IMPRISONMENT OR A FINE, OR BOTH, AS PROVIDED BY 13 V.S.A. 247 4058 Date Signature of Notary Public Expiration Date American LegalNet, Inc. www.FormsWorkFlow.com