Legal Application and Order Form

LEGAL APPLICATION AND ORDER FORM

This Legal Application and Order Form is submitted by Applicant Name: against Respondent Name: in Court/Tribunal: Case Number: .

RECITALS

WHEREAS, Applicant asserts that grounds exist for relief as described herein and has filed supporting documents with the Court on ; and

WHEREAS, Respondent has been served or will be served in accordance with the methods set forth below and is entitled to notice and an opportunity to be heard except as otherwise provided for emergency or ex parte relief; and

WHEREAS, the parties seek an order setting forth the relief requested, findings of fact, and the method of enforcement of such relief.

NOW THEREFORE, in consideration of the mutual covenants and statements contained herein, and subject to the Court's determination, the parties hereby submit this application and proposed order.

1. APPLICATION AND RELIEF REQUESTED

1.1 Applicant applies for the following relief (describe specifically the injunctive, monetary, administrative or declaratory relief sought):

1.2 Legal grounds and statutory or equitable basis for relief (cite statutes, rules, or legal theories relied upon):

1.3 Supporting documents submitted with this application (check all that apply and identify each):

Affidavit(s) or declaration(s)    Exhibits    Motion or memorandum    Other:

1.4 Emergency or ex parte relief requested: Yes No

If emergency or ex parte relief is requested, state the specific immediate harm and why notice should be excused:

2. SERVICE, NOTICE, AND HEARING

2.1 Applicant certifies that notice to Respondent will be provided as follows (select method(s) and supply details):

Personal service    U.S. Mail    Email    Other:

2.2 Proposed hearing date and time (if requested): at .

3. FINDINGS AND PROPOSED ORDER

3.1 Proposed findings of fact in support of the relief requested (set forth factual predicates with specificity):

3.2 Proposed order language (check each box to indicate requested relief and provide specifics where indicated):

Grant temporary injunctive relief as follows:

Enter judgment for monetary relief in the amount of: $

Other relief (specify):

4. EFFECTIVE DATE, DURATION, AND ENFORCEMENT

4.1 Proposed effective date of order: . If no date is specified, the order is proposed to take effect upon entry by the Court.

4.2 Duration of the order: .

4.3 Enforcement provisions (contempt, sanctions, bond requirements, or other remedies requested):

5. FEES, COSTS, AND BOND

5.1 Filing fees and costs requested to be awarded: $

5.2 Bond requested as condition for injunctive relief: $ (state reasons if bond is sought or waived)

6. CERTIFICATION, VERIFICATION, AND AUTHORITY

6.1 Certification. The undersigned certifies under penalty of perjury under the laws of the state applicable to this action that the factual statements made in this Application and any appended affidavits are true and correct to the best of the undersigned's knowledge, information and belief, and that the legal contentions are made in good faith.

6.2 Authority. The person signing below represents that they have authority to submit this Application on behalf of the Applicant and to bind Applicant to the representations contained herein.

7. NOTICES

Notices required under this Application shall be given in writing and shall be effective upon receipt at the addresses provided above unless an alternative method of service is specifically ordered by the Court.

8. MISCELLANEOUS PROVISIONS

Governing Law. This Application and any Order entered hereunder shall be governed by and construed in accordance with the laws of the state governing the underlying action, without regard to its conflict of law principles.

Entire Agreement. This Application, together with any attachments and orders entered by the Court, constitutes the entire agreement between the parties with respect to the matters addressed herein and supersedes any prior oral or written communications on the same subjects.

Severability. If any provision of this Application or any Order entered pursuant to it is held invalid or unenforceable, such provision shall be severed and the remaining provisions shall continue in full force and effect.

Amendments; Waiver. Any amendment to this Application or any Order must be in writing and signed by the Party seeking amendment and, where required, approved by the Court. The failure to enforce any provision shall not be deemed a waiver of future enforcement of that or any other provision.

Counterparts. This Application may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument.

9. SIGNATURES AND VERIFICATION

The undersigned certify that they are authorized to submit this Application on behalf of the respective parties and verify the truth of the statements made herein under penalty of perjury.

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