Superior Court of Washington County of In re Parentage: No. Petitioner, and Respondent and Motion/Declaration for Ex Parte Restraining Order and Order to Show Cause (MTSC) Respondent. I. Motion Based upon the declaration below, the undersigned moves the court for a temporary order and order to show cause. 1.1 Ex Parte Restraining Order A temporary restraining order should be granted without written or oral notice to the other party or the other party's lawyer because immediate and irreparable injury, loss, or damage will result before other party or the other party's lawyer can be heard in opposition. This order should restrain or enjoin: [] (Name) _______________________________________ from disturbing the peace of the other party or of any child. [] (Name) _______________________________________ from entering the residence of (name) ________________________________________. The protected person (name) _____________________________, waives confidentiality of the address which is (address)__________________________________________________________. [] (Name) _______________________________________ 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: _____________________________________________________________________. (Name) _______________________________________ from knowingly coming within or knowingly remaining within (distance) _______________________ of the home, work [] Mtn/Decl for Ex Parte Restraining Ord (MTSC) - Page 1 of 5 WPF PS 04.0150 Mandatory (6/2008) - CR 56(b); RCW 26.26.590 American LegalNet, Inc. www.FormsWorkflow.com [] [] [] place or school of (name) ____________________________ or the day care or school of these children: ___________________________________________________________. Other: __________________________________________________________________. (Name) ______________________________________ from molesting, assaulting, harassing, or stalking (name) _______________________________. (If the court orders this relief, the restrained person will be prohibited from possessing a firearm or ammunition under federal law for the duration of the order. An exception exists for law enforcement officers and military personnel when carrying department/governmentissued firearms. 18 U.S.C. § 925(a)(1).) (Name) ______________________________________ from removing any of the children from the state of Washington. Other: The other party should be required to appear and show cause why these restraints should not be continued in full force and effect pending final determination of this action. 1.2 Other Ex Parte Relief [] [] 1.3 Surrender of Deadly Weapons [] [] 1.4 Order that (name) ______________________________ shall be the person with whom the children reside until the hearing. Other: Does not apply. (If this box is checked, clear and convincing reasons for this request must be presented in paragraph 2.3.) The court should require (name) ____________________________ 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. Other Temporary Relief [] [] Does not apply. (Name) ______________________________should also be required to appear and show cause why the court should not enter a temporary order which: [] [] orders child support as determined pursuant to the Washington State Child Support Schedule. approves the parenting plan which is proposed by (name) __________________. [] requires (name) ______________________________ 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. Mtn/Decl for Ex Parte Restraining Ord (MTSC) - Page 2 of 5 WPF PS 04.0150 Mandatory (6/2008) - CR 56(b); RCW 26.26.590 American LegalNet, Inc. www.FormsWorkflow.com [] 1.5 other: Other Dated: Signature of Requesting Party or Lawyer/WSBA No. Print or Type Name II. Declaration 2.1 Injury to be Prevented The ex parte restraining order requested in paragraph 1.1 and 1.2 above is to prevent the following injury (define the injury): 2.2 Reasons why the Injury may be Irreparable This injury may be irreparable because: Mtn/Decl for Ex Parte Restraining Ord (MTSC) - Page 3 of 5 WPF PS 04.0150 Mandatory (6/2008) - CR 56(b); RCW 26.26.590 American LegalNet, Inc. www.FormsWorkflow.com 2.3 Clear and Convincing Reasons why Weapons Should be Surrendered [] [] 2.4 Reasons for a Temporary Order [] [] 2.5 Does not apply. (Name) _______________________________ should be required to surrender any deadly weapons as requested in paragraph 1.3 above because of following clear and convincing reasons: Does not apply. It is necessary that the court issue a temporary order with the relief requested in paragraph 1.4 above for the reason set forth below. Service Member or Dependent of Service Member Mtn/Decl for Ex Parte Restraining Ord (MTSC) - Page 4 of 5 WPF PS 04.0150 Mandatory (6/2008) - CR 56(b); RCW 26.26.590 American LegalNet, Inc. www.FormsWorkflow.com [] 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).) III. Efforts to Give Other Party Notice The following efforts have been made to give the other party or other party's lawyer notice and the following reasons exist why notice should not be required: Dated: Signature of Requesting Party or Lawyer/WSBA No. Print or Type Name Mtn/Decl for Ex Parte Restraining Ord (MTSC) - Page 5 of 5 WPF PS 04.0150 Mandatory (6/2008) - CR 56(b); RCW 26.26.590 American LegalNet, Inc. www.FormsWorkflow.com