Superior Court of Washington County of [ ] In re the Marriage of: [ ] In re the Domestic Partnership of: No. Petitioner, and Motion and Declaration for Temporary Order (MTAF) Respondent. I. Motion Based on the declaration below, the undersigned moves the court for a temporary order which: [] [] [] [] [] [] [] [] orders temporary maintenance. orders child support as determined pursuant to the Washington State child support statutes. approves the parenting plan which is proposed by the [ ] petitioner [ ] respondent. restrains or enjoins the [ ] petitioner [ ] respondent from transferring, removing, encumbering, concealing or in any way disposing of any property except in the usual course of business or for the necessities of life and requiring each party to notify the other of any extraordinary expenditures made after the order is issued. restrains or enjoins the [ ] petitioner [ ] respondent from disturbing the peace of the other party or of any child. restrains or enjoins the [ ] petitioner [ ] respondent from going onto the grounds of or entering the home, work place or school of the other party or the day care or school of the following named children: . restrains or enjoins the [ ] petitioner [ ] respondent from knowingly coming within or knowingly remaining within (distance) ____________________ of the home, work place or school of the other party or the day care or school of the following children: _____________________________________________________________________________. restrains or enjoins (name) __________________________ from molesting, assaulting, harassing, or stalking (name) ______________________________. (If the court orders this relief and the parties are intimate partners as defined under federal law, the restrained person will be prohibited from possessing a firearm or ammunition under federal law for the duration of the Mtn/Decl for Temp Ord (MTAF) - Page 1 of 3 WPF DR 04.0100 Mandatory (6/2008) - RCW 26.09.060; .110; .120; .194 American LegalNet, Inc. www.FormsWorkflow.com [] [] [] [] [] [] [] [] [] [] [] order. An exception exists for law enforcement officers and military personnel when carrying department/government-issued firearms. 18 U.S.C. § 925(a)(1).) restrains or enjoins the [ ] petitioner [ ] respondent from removing any of the children from the state of Washington. restrains or enjoins the [ ] petitioner [ ] respondent from assigning, transferring, borrowing, lapsing, surrendering or changing entitlement of any insurance policies of either or both parties whether medical, health, life or auto insurance. (If this box is checked clear and convincing reasons for this request must be presented in the declaration below.) requires the [ ] petitioner [ ] respondent to surrender any deadly weapon in his or her immediate possession or control or subject to his or her immediate possession or control to the sheriff of the county having jurisdiction of this proceeding, to his or her lawyer or to a person designated by the court. makes each party immediately responsible for their own future debts whether incurred by credit card or loan, security interest or mortgage. divides responsibility for the debts of the parties. authorizes the family home to be occupied by the [ ] petitioner [ ] respondent. orders the use of property. requires the [ ] petitioner [ ] respondent to vacate the family home. requires the [ ] petitioner [ ] respondent to pay temporary attorney fees, other professional fees and costs in the amount of $_______________ to: appoints a guardian ad litem on behalf of the minor children. other: Dated: Signature of Requesting Party or Lawyer/WSBA No. Print or Type Name II. Declaration Temporary relief is required because: Mtn/Decl for Temp Ord (MTAF) - Page 2 of 3 WPF DR 04.0100 Mandatory (6/2008) - RCW 26.09.060; .110; .120; .194 American LegalNet, Inc. www.FormsWorkflow.com If the surrender of deadly weapons is requested, list reasons: [] If the other party is not present and: a) is on active duty and is a National Guard member or Reservist residing in Washington, or b) is a dependent of a National Guard member or Reservist residing in Washington on active duty, list the reasons why this temporary order should be granted despite the absence of the other party: I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Signed at (city) ___________________, (state) ___________________ on (date) ____________________. Signature of Requesting Party Print or Type Name Do not attach financial records, personal health care records or confidential reports to this declaration. Such records should be served on the other party and filed with the court using one of these cover sheets: 1) Sealed Financial Source Documents (WPF DRPSCU 09.0220) for financial records 2) Sealed Personal Health Care Records (WPF DRPSCU 09.0260) for health records 3) Sealed Confidential Report (WPF DRPSCU 09.270) for confidential reports If filed separately using a cover sheet, the records will be sealed to protect your privacy (although they will be available to all parties in the case, their attorneys, court personnel and certain state agencies and boards.) See GR 22(C)(2). Mtn/Decl for Temp Ord (MTAF) - Page 3 of 3 WPF DR 04.0100 Mandatory (6/2008) - RCW 26.09.060; .110; .120; .194 American LegalNet, Inc. www.FormsWorkflow.com