Fill and Sign the Form 652

Form 652Rev 03/12 1 of 4 The Family Court of the State of Delaware In and For New Castle Kent Sussex County MOTION AND AFFIDAVIT FOR INTERIM RELIEF Petitioner v. Respondent Temporary Custody of: The following temporary financial relief: In support thereof, the Movant alleges the following (State the specific facts that support a request for entry of an order until the full hearing can be held): Movant Sworn to subscribed before me this ______ day of ______________________, _________ Clerk of Court/Notary PublicDate NameName File Number Street Address (including Apt)Street Address (including Apt) P.O. Box NumberP.O. Box Number Petition Number City/State/Zip CodeCity/State/Zip Code Attorney Name Attorney Interpreter needed? Yes No Interpreter needed? Yes NoLanguage Language A Proceeding involving having been filed heretofore in this Court, Movant hereby moves the Court for: Form 652Rev 03/12 2 of 4 AFFIDAVIT OF MAILING I, the Movant, affirm that a true and correct copy of this Motion was placed in the U.S. Mail on the day of and sent to the other party or attorney at the address listed on the petition, first class postage pre-paid. Movant Sworn to subscribed before me this ______ day of ______________________, _________ Clerk of Court/Notary Public Form 192 Rev 12/13 3 of 4 The Family Court of the State of Delaware In and For New Castle Kent Sussex County , Petitioner File No.: v. Petition No.: , Respondent ))))))))) NOTICE OF MOTION TO: PLEASE TAKE NOTICE that the attached Motion is herewith presented to the Court for consideration. If you are opposed to this motion, you must file a written response with the Court within ten (10) days of the service of this motion. If no response is timely filed, the motion may be decided without further opportunity for you to be heard on the matter. Family Court Rules, Rule 7(b)(2). Movant/Attorney Name and address of Movant/Attorney Street Address (including Apt) P.O. Box Number City/State/Zip Code Date Form 192 Rev 12/13 4 of 4 The Family Court of the State of Delaware In and For New Castle Kent Sussex County ) , ) Petitioner ) File No.: v. )) Petition No.: , ) Respondent ) In Re: )) ORDER Having considered the request of the movant, ,IT IS SO ORDERED, this date: That Judge/Commissioner CC: Petitioner Respondent Petitioner Attorney Respondent Attorney DAG PD Other DCSE