RCW 26. 10.110, .115 Mandatory Form ( 06/2018 ) FL Non - Parent 423 Motion for Temporary Non - Parent Custody Order p. 1 of 7 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 Temporary Non - Parent Custody Order and Restraining Order (MTNPO) Motion for Temporary Non-Parent Custody Order and Restraining Order Use this form in non-parent custody cases only. For divorce cases, use form FL Divorce 223. For parentage cases, use form FL Parentage 323. To both parties: Deadline! Court Rules if there is no local rule. Court Rules and forms are online at www.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 filin g this motion: You must schedule a hearing on this motion. You may use the Notice of Hearing (form FL All Family 185) unless To the person receivin g this motion: If you do not agree with the requests in this motion, file a statement (using 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 prop ose your own Residential Schedule or Child Support Worksheets . American LegalNet, Inc. www.FormsWorkFlow.com RCW 26. 10.110, .115 Mandatory Form ( 06/2018 ) FL Non - Parent 423 Motion for Temporary Non - Parent Custody Order p. 2 of 7 1. My name is: . I ask the court for temporary orders approving the requests listed below. 2. Children Age Age 1. 4. 2. 5. 3. 6. 3. 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. 4. 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): 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 American LegalNet, Inc. www.FormsWorkFlow.com RCW 26. 10.110, .115 Mandatory Form ( 06/2018 ) FL Non - Parent 423 Motion for Temporary Non - Parent Custody Order p. 3 of 7 5. 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: 6. Care of children No request. Give me custody of the children. Approve my proposed Residential Schedule (form FL Non-Parent 405). Order (name/s): not to take the children out of Washington State. bes(check one): Guardian ad Litem (GAL) or Evaluator/Investigator as chosen by the court. Guardian ad Litem (GAL). Evaluator/Investigator. (Name): Other: 7. Support, insurance and taxes No request. Order child support according to the Washington state child support schedule. American LegalNet, Inc. www.FormsWorkFlow.com RCW 26. 10.110, .115 Mandatory Form ( 06/2018 ) FL Non - Parent 423 Motion for Temporary Non - Parent Custody Order p. 4 of 7 Order (name/s): to provide and keep health insurance for the children. Order (name/s): uninsured medical, day care, or other necessary expenses (check one): as listed on the proposed Child Support Order. as follows (specify): Order that (name/s): may claim the children as dependents on tax forms. Other: 8. Fees and costs No request. Order (name/s): to: Amount: $ Make payments to (name): Pay other professional fees and costs for this case. Amount: $ to (name): for (purpose): 9. Restraining Order No request. The Court already signed a Restraining Order on (date): in this case. I am not asking the court to make any changes to this Restraining Order. I ask the Court to remove (terminate) this Restraining Order. I ask the Court to change this Restraining Order as follows (specify): I ask the Court for a Restraining Order (form FL All Family 150) that orders (name/s): to obey the restraints and orders checked below. (Check all that apply; also check the Do not disturb Do not disturb my peace or the peace of any child listed in 2. Stay away Do not go onto the grounds of or enter my home, workplace, or school, and the daycare or school of any child listed in 2. Also, do not knowingly go or stay within feet of my home, workplace, or school, or the daycare or school of any child listed in 2. American LegalNet, Inc. www.FormsWorkFlow.com RCW 26. 10.110, .115 Mandatory Form ( 06/2018 ) FL Non - Parent 423 Motion for Temporary Non - Parent Custody Order p. 5 of 7 Do not hurt or threaten Do not assault, harass, stalk or molest me or any child listed in 2; and Do not use, try to use, or threaten to use physical force against me or children that would reasonably be expected to cause bodily injury. Warning! If the court makes this order, the court must consider if weapons restrictions are required by state law; federal law may also prohibit the Restrained Person from possessing firearms or ammunition. Prohibit weapons and order surrender Do not possess or obtain any firearms, other dangerous weapons, or concealed pistol license until the Order ends, and Surrender any firearms, other dangerous weapons, and any concealed pistol license that he/she possesses to (check one): the police chief or sheriff. his/her lawyer. other person (name): . Other: 10. Other temporary orders No request. (Specify): Reasons for my requests 11. Why are you asking the court for the orders you checked above? (Explain): If you need additional space use the Declaration form FL All Family 135. If you are asking for child support, also fill out the Child Support Worksheets. If you have received public assistance for any child in this case, also fill out the Public Assistance Declaration, form FL All Family 132. Child support is based upon the income of both parents, not the income of the non-parent custodian. For parents If you are asking for any order involving money (including child support), also fill out the Financial Declaration, form FL All Family 131, and file the required financial records. For non-parents If you are asking for any order involving money (other than child support), also fill out the Financial Declaration, form FL All Family 131. If you are asking to prohibit weapons or order surrender, give your reasons at the end of this section. If you are asking to