Fill and Sign the And Hearing Notice Form

RCW 26. 09.260 , 26.50; CR 65(b) Mandatory Form (07/2019 ) FL Modify 622 Immediate Restraining Order (Ex Parte) and Hearing Notice p. 1 of 4 Superior Court of Washington, County of _______________ In re: Petitioner/s (as listed on the Petition ): And Respondent/s (as listed on the Petition ): No. Immediate Restraining Order (Ex Parte) and Hearing Notice (TPROTSC / ORTSC) [x] Clerk’s ac tion required : 2, 13 [ ] Interpreter required Immediate Restraining Order (Ex Parte) and Hearing Notice Use this form only for cases about changing a parenting/custody order. For other cases, use FL Divorce 22 2, FL Parentage 32 2, or FL Non -Parent 42 2, depending on the type of case . 1. This Order starts immediately and ends after the hearing listed below. 2. Hearing Notice – The court will consider extending this order and the other requests made by the protected person at a court hearing: on: at: [ ] a.m. [ ] p.m. date time at: , court’s address room or department docket / calendar or judge / commissioner’s name Warning! If you do not go to the hearing, the court may make orders against you without hearing your side. 3. This Order restrains (name): . Warning! You must obey this order or you may be jailed.  Violation [of sections 6-8] of this order with actual notice of its terms is a criminal offense under chapter 26.50 RCW and will subject a violator to arrest.  Violation of any part of this order may result in financial penalties or contempt of court.  This order is enforceable in all 50 U.S. states, the District of Columbia, and U.S. territories and tribal lands (18 U.S.C. § 2265). RCW 26. 09.260 , 26.50; CR 65(b) Mandatory Form (07/2019 ) FL Modify 622 Immediate Restraining Order (Ex Parte) and Hearing Notice p. 2 of 4 4. This Order protects (name/s): and these children under 18 (if any) : Child’s name Age Child’s name Age 1. 4. 2. 5. 3. 6. 5. Findings The court has reviewed the Motion for Immediate Restraining Order , supporting documents, and any other evidence considered on the recor d, including . The court finds there would be irreparable harm as described in the Motion if this order is not granted. [ ] If hearing date is more than 14 days away – There is good cause to keep this order in effect until the hearing date (which is between 14 and 28 days after this order is issued) because (describe the good cause): [ ] Intimate Partner : The Restrained Person and the Protected Person are/were intimate partners because they are ( check all that apply): [ ] current or former s pouses or d omestic partners , or parents of a child -in-common . [ ] age 16 or older and are/were in a dating relationship , and are currently residing together or resided together in the past. [ ] age 16 or older and are/were in a dating relationship , but h ave never resided together. [ ] Other findings:  Court Orders to the Restrained Person listed in 3: 6. Do not disturb [ ] No request made. [ ] Request denied. [ ] The Restrained Person must not disturb the peace of the Protected Person or of any child listed in 4. 7. Stay away [ ] No request made . RCW 26. 09.260 , 26.50; CR 65(b) Mandatory Form (07/2019 ) FL Modify 622 Immediate Restraining Order (Ex Parte) and Hearing Notice p. 3 of 4 [ ] Request denied. [ ] The Restrained Person must not go onto the grounds of or enter the Protected Person’s home, workplace , or school, and the daycare or school of any child listed in 4. [ ] Also, t he Restrained Person must not knowingly go or stay within feet of the Protected Person’s home, workplace or school, or the daycare or school of any child listed in 4. 8. Do not hurt or threaten [ ] No request made . [ ] Request denied. [ ] The Restrained Person must not:  Assault, harass, stalk or molest the Protected Person or any child listed in 4; or  Use, try to use, or threaten to use physical force against the Protected Person or children that would reasonably be expected to cause bodily in jury. 9. Surrender weapons [ ] Does not apply. No order entered in section 8 and no request made. [ ] Request denied and surrender of weapons not required . [ ] The Restrained Person must follow the Order to Surrender Weapons Issued Without Notice (form All Cases 2 -030) signed by the court and filed separately. Findings – The court finds irreparable injury could result if this order is not issued until the time for response has elapsed. 10. Care and safety of children until the hearing [ ] No req uest made. [ ] Request denied. [ ] (Name/s): must not take the children listed in 4 out of Washington state. [ ] Until the hearing, t he children listed in 4 will live with (name): [ ] Other: 11. Bond [ ] No bond or security is required. [ ] (Name): must file a bond or post security. Amount: $ . 12. Other immediate orders [ ] Does not apply. RCW 26. 09.260 , 26.50; CR 65(b) Mandatory Form (07/2019 ) FL Modify 622 Immediate Restraining Order (Ex Parte) and Hearing Notice p. 4 of 4 [ ] 13. To the Clerk: Provide a copy of this order and the Law Enforcement Information Sheet to the agency listed below within one c ourt day. The law enforcement agency must enter this order into the state’s database. Name of law enforcement agency where the protected person lives: Ordered. Date Time Judge or Commissioner Presented by: Sign here Print name (if lawy er, also list WSBA #) Date To the Protected Person: Warning! You must have this order served on the Restrained Person before it can be enforced. You have a right to have law enforcement serve this order free of charge if restraints are ordered in secti ons 6, 7, 8, or 9 above . 1. Fill out a Law Enforcement Information Sheet (form All Cases 01.0400) and give it to the clerk. 2. You must have this Order, and the paperwork you filed with the court to get this Order, personally served on the Restrained Person by someone 18 or older who is not a party to this case. (Do not serve the Law Enforcement Information Sheet on the Restrained person – it is only for law enforcement.) 3. After serving, the server fills out a Proof of Personal Service (FL All Family 101) and gi ves it to you. Then:  File the original Proof of Personal Service with the court clerk.  Give a copy of the Proof of Personal Service to the law enforcement agency listed above.  Go to the hearing.  Bring proposed orders to the hearing.