RCW 26.10.115, CR 65(b) Mandatory Form ( 06/2018 ) FL Non - Parent 421 Motion for Immediate Restraining Order Non - Parent Custody (Ex Parte) p. 1 of 8 Superior Court of Washington, County of In re custody of: Children : Petitioner/s (person/s who started this case) : Respondents ( parents and any guardian or custodian) : No. Motion for Immediate Restraining Order Non - parent Cust ody (Ex Parte) (MTSC) Motion for Immediate Restraining Order Non-Parent Custody (Ex Parte) Use this form in non-parent custody cases only. For marriage/domestic partnership cases, use form FL Divorce 221. For parentage cases, use form FL Parentage 321. To both parties: Deadline! State Court Rules if there is no local rule. Court Rules and forms are online at ww w.courts.wa.gov . If you want the court to consider your side, you must : File your original documents with the Superior Court Clerk; AND Have a copy of your papers served on all other parties or their lawyers; AND Go to the hearing. Bring proposed orders to the hearing. To the person filing this m otion: You must ask the court to sign the Immediate Restraining Order (Ex Parte) and Hearing Notice (FL Non - Parent office for the procedure in your county. You must have this Motion and the Immediate Restraining Order personally served (by someone else) on the restrained person/s. American LegalNet, Inc. www.FormsWorkFlow.com RCW 26.10.115, CR 65(b) Mandatory Form ( 06/2018 ) FL Non - Parent 421 Motion for Immediate Restraining Order Non - Parent Custody (Ex Parte) p. 2 of 8 To the person receiving this motion: If you do not agree with the requests in this motion, file a statement (us ing form FL All Family 135, Declaration ) explaining why the court should not approve those requests. You may file other written proof supporting your side, and propose your own Residential Schedule (FL Non - Parent 405) or Child Support Worksheets . If t he court grants an Immediate Restraining Order without notice to you, you can file a motion to change or terminate it before the hearing date. (Civil Rule 65(b).) There is no pattern form for that motion. 1. My name is: . I am asking the court for an Immediate Restraining Order against (name/s): . I want these children under 18 to be protected by the order: Age Age 1. 2. 3. 4. 5. 6. 2. I ask the court to approve an Immediate Restraining Order to protect me and/or the children involved in this case. Without this order, the children or I could be hurt or suffer damage or loss immediately. This harm could be irreparable. (Explain how you or the children could be harmed beyond repair): (If you need additional space use the Declaration form FL All Family 135.) 3. Notice (check one): I should not have to notify the other parties in advance that I am filing this Motion because the children or I could be harmed beyond repair if I gave any advance notice. (Explain why the harm could happen before a hearing could be held with notice to the other parties.) American LegalNet, Inc. www.FormsWorkFlow.com RCW 26.10.115, CR 65(b) Mandatory Form ( 06/2018 ) FL Non - Parent 421 Motion for Immediate Restraining Order Non - Parent Custody (Ex Parte) p. 3 of 8 I have notified the other parties that I am asking for an Immediate Restraining Order. (Describe anything done to give the other parties or their lawyers notice of this Motion): 4. Court hearing request I ask the court to approve an Immediate Restraining Order now, and hold a hearing within 14 days to consider all of my requests for temporary orders listed below. I will have the other parties served with notice of the hearing so the court can hear their sides. Other: 5. Adequate Cause The court found there was adequate cause to allow this case to move forward on (date): . The court has not yet decided whether there is adequate cause to allow this case to move forward. An adequate cause hearing is scheduled for (date): . No adequate cause hearing has been scheduled. 6. Indian Children (An Indian child is a child who is a member of an Indian tribe, or who is the biological child of an Indian tribe member and eligible for membership. You must try to find out if any child in this case is an Indian child. If so, the federal and state Indian Child Welfare Acts will apply to your case.) None of the children are Indian children. I ask the court to find that the federal and state Indian Child Welfare Acts do not apply to this case. The children are or may be Indian children. Jurisdiction The court has jurisdiction over the Indian children because they are: not domiciled or living on an Indian reservation, and are not wards of a tribal court. domiciled or living on an Indian reservation, and (check all that apply): ts exclusive jurisdiction (expressly declined). (RCW 13.38.060) Washington State should claim emergency jurisdiction for children temporarily located off the reservation to protect the children from immediate physical damage or harm. (RCW 13.38.140) Notice to tribes Petitioner (check one): provided or is providing did not provide the required Indian Child Welfare Act Notice (form FL Non-Parent 402) and a ribe/s, the parents and any Indian custodian. American LegalNet, Inc. www.FormsWorkFlow.com RCW 26.10.115, CR 65(b) Mandatory Form ( 06/2018 ) FL Non - Parent 421 Motion for Immediate Restraining Order Non - Parent Custody (Ex Parte) p. 4 of 8 7. Active duty military (The federal Servicemembers Civil Relief Act covers: Army, Navy, Air Force, Marine Corps, and Coast Guard members on active duty; National Guard or Reserve members under a call to active service for more than 30 days in a row; and commissioned corps of the Public Health Service and NOAA. The state stationed in or residents of Washington state, and their dependents, except for the commissioned corps of the Public Health Service and NOAA.) None of the other parties are covered by the state or federal Service Members Civil Relief Acts. (Name): is covered by the state federal Service Members Civil Relief Act. For persons covered only by the state act Military duty may keep the service member or dependent from responding or coming to the hearing on this motion. I ask the court to approve temporary orders even if the covered person asks for a temporary orders now because: I ask the Court to approve these orders immediately (check all that apply): 8. Do not disturb No request. Order (name/s): not to disturb my peace or the peace of any child listed in 1. 9. Stay away No request. Order (name/s): n ot to go onto the grounds of or enter my home, workplace, or school, and the daycare or school of any child listed in 1. Also, not knowingly to go or stay within feet of my home, workplace, or school, or the daycare or school of any child listed in 1. 10. Do not hurt or threaten No request. Order (name/s): not to: Assault, harass, stalk or molest me or any child listed in 1; or Use, try to use, or threaten to use physical force against me or the children that would reasonably be expected to cause bodily injury. American LegalNet, Inc. www.FormsWorkFlow.com RCW 26.10.115, CR 65(b) Mandatory Form ( 06/2018 ) FL Non - Parent 421 Motion for Immediate Restraining Order Non - Parent Custody (Ex Parte) p. 5 of 8 Warning! If the court extends this order after a full hearing, the court must consider if weapons restrictions are required by state law; f ederal law may also prohibit the Restrained Person from possessing firearms or ammunition. 11. Surrender weapons No request. Order (name/s): to surrender any firearms and other dangerous weapons that he/she possesses to (check one): the police chief or sheriff. h is/her lawyer. other person (name): . 12. Protect children No request. Order (name/s): not to take the children listed in 1 out of Washington State. Order that the children listed in 1 will live with me until the hearing. Other (specify): 13. Other immediate orders No request. (Specify): I ask the court to approve these temporary orders at the hearing (check all that apply): 14. Extend immediate orders Extend the immediate orders I asked for above to stay in effect until the case is done. 15. Prohibit weapons and order surrender No request. Order (name/s): : Not to possess or obtain any firear