RCW 26.26 A.470, .465 , CR 65(b)
(07 /2019 )
FL Parentage 321
Motion for Immediate
Restraining Order (Ex Parte)
p. 1 of 7
Superior Court of Washington, County of _______________
In re parentage / parenting and support:
Petitioner /s (person /s who started this case) :
And Respondent/s (other party/parties) :
No.
Motion for Immediate Restraining Order
(Ex Parte)
(MTSC )
Motion for Immediate Restraining Order (Ex Parte)
Use this form for unmarried parents (parentage) cases only. For other cases, use FL Divorce 221, FL Non -Parent
421, or FL Modify 621, depending on the type of case .
To both parties:
Deadline! Your paper s must be filed and served by the deadline in your county’s Local Court Rules, or by the
State 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
Give the Judge/Commissioner a copy of your papers (if required by your county’s Local Court Rules); AND
Have a copy of your papers served on all other parties or their lawyers; AND
Go to the hearing.
Read your county’s Local Court Rules, if any.
Bring proposed orders to the hearing.
To the person filing this motion:
You must ask the court to sign the Immediate Restraining Order (Ex Parte) and Hearing Notice (FL Parentage
322). This Order may be signed “ex parte” (without the other party there). Contact the Superior Court Clerk’s
office for the procedure in your county. You must have this Motion and the Immediate Restraining Order
personally served (by someone else) on the restrained person.
To the person receiving 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 propose your own Parenting Plan, Residential Schedule, or Child Support Worksheets .
If the court grants an Immediate Restraining Order without notice to you, you can file a motion to change or
termina te it before the hearing date. (Civil Rule 65(b).) There is no pattern form for that motion.
RCW 26.26 A.470, .465 , CR 65(b)
(07 /2019 )
FL Parentage 321
Motion for Immediate
Restraining Order (Ex Parte)
p. 2 of 7
1. My name is: . I am asking the court for an
Immediate Restraining Order against (name/s): .
[ ] I want these child ren under 18 to be protected by the order :
Child ’s name Age Child ’s name Age
1. 4.
2. 5.
3. 6.
2. I ask the court to approve an Immediate Restraining Order to protect me and/or any child
listed in 1. Without this Order, the children or I could be hurt or suffer damag e or loss
immediately. This harm could be irreparable. (Explain how you or the children could be
harmed beyond repair):
(If you need additional space use the Declaration form FL All Family 135.)
3. Notice (check one):
[ ] I should not have to notify the other parties in advance that I am filing this Motion
because any child listed in 1 or I could be harmed beyond repair if I gave any advance
notice. (Explain why you or the children could be harmed by providing advance notice ):
[ ] I have notified the other parties that I am asking for an Immediate Restraining Order .
(Describe any steps taken to give the other parties or their lawyer ’s notice of this
Motion):
RCW 26.26 A.470, .465 , CR 65(b)
(07 /2019 )
FL Parentage 321
Motion for Immediate
Restraining Order (Ex Parte)
p. 3 of 7
4. Court hearing request
I ask the court to approve an Immedia te Restraining Order now, and hold a hearing within
14 days to consider my requests for temporary orders listed below. I will have the other
parties served with notice of the hearing so the court can hear their sides.
[ ] Other:
5. Active duty milit ary
(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 Service Members’ Civil Relief Act covers those service members listed above who are either
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 o nly 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
stay or doesn’t respond. It would be very unfair (a manifest injustice) not to make
temporary orders now because:
I ask the Court to approve these orders immediately (check all that apply):
6. Do not disturb
[ ] No request.
[ ] Order (name/s): not to disturb
my peace or the peace of any child listed in 1.
7. Stay away
[ ] No request.
[ ] Order (name/s): not to go onto the
grounds of or enter my home, workplace, or school, and the daycare or school of any
child listed in 1.
[ ] Also, not knowingly to go or stay within feet of my home, workplace or
school, or the daycare or school of any child listed in 1.
8. Do not hurt or threaten
[ ] No request.
RCW 26.26 A.470, .465 , CR 65(b)
(07 /2019 )
FL Parentage 321
Motion for Immediate
Restraining Order (Ex Parte)
p. 4 of 7
[ ] Order (name/s): not to:
Assault, harass, stalk or molest me or any child listed in 1; or
Use, try to use, or threaten to use physical force against me or the children that
would reasonably be expected to cause bodily injury.
Warning! If the court extends this order after a full hearing and the parties are intimate partners, the
court must consider if weapons restrictions are required by state law; f ederal law may also prohibit the
Restrained Person from possessing firearms or ammunition.
[ ] Intimate Partner : The Restrained Person and the Protected Person are/were
intimate partners because they are ( check all that appl y):
[ ] current or former spouses 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 have never resided
together.
9. Surrender weapons
[ ] No request.
[ ] Order (name/s): to immediately surrender
any firearms and other dangerous weapons that he/she possesses t o (check one):
[ ] the police chief or she riff. [ ] his/her lawyer. [ ] other person :
(name): .
10. Care and safety of children until the hearing
[ ] No request.
[ ] Order (name/s): not to take the
children listed in 1 out of Washington State.
[ ] Order that the children listed in 1 will live with me until the hearing.
[ ] Other (specify):
11. Other immediate orders
[ ] No request.
[ ] (Specify):
I ask the court to approve these temporary orders at the hearing to stay in
effect until the case is done (check all that app ly) :
12. Extend immediate orders
[ ] Extend the immediate orders I asked for above to stay in effect until the case is done.
RCW 26.26 A.470, .465 , CR 65(b)
(07 /2019 )
FL Parentage 321
Motion for Immediate
Restraining Order (Ex Parte)
p. 5 of 7
13. Prohibit weapons and order surrender
[ ] No request.
[ ] Order (name/s): :
Not to access, possess , or obtain any firearms , other dangerous weapons, or
concealed pistol license s until the Order ends, and to
Immediately s urrender any firearms, other dangerous weapons, or concealed pistol
license s that he/she possesses or controls t o (check one): [ ] the police chief or
cou nty sheriff. [ ] his/her lawyer. [ ] other person (name): .
14. Care and safety of children (check all that apply)
[ ] No request.
[ ] Approve the Parenting Plan (form FL All Family 140) or Residential Schedule (form FL
Parentage 304) proposed by [ ] me [ ] (name): .
[ ] Order (name): not to take the children out of
Washington State.
[ ] Appoint a person to investigate and report to the court about what is in the children ’s
EHVWLQWHUHVWDQGRUGHUZKRZLOOSD\WKLVSHUVRQ¶VIHHV7KLV person should be a/n
(check one):
[ ] Guardian ad Litem (GAL) or Evaluator/Investigator as chosen by the court.
[ ] Guardian ad Litem (GAL).
[ ] Evaluator/Investigator.
[ ] (Name):
[ ] A Sexual Assault Allegation form has been filed saying t he child was conceived by a
sexual assault. The fact -finding hearing on this allegation has not happened yet :
[ ] No residential time or decision making should be ordered until after the fact -finding
hearing.
[ ] I have a bonded and dependent relation ship with the child that is parental in nature .
It is in the child ’s best interests to order residential time or decision making now.
[ ] Other:
15. Provide support
[ ] No request.
[ ] Order child support according to the Washington state child su pport schedule.
16. Pay fees and costs
[ ] No request.
[ ] Order (name): to:
[ ] Pay my lawyer’s fees for this case. Amount: $
Make payments to (name) :
RCW 26.26 A.470, .465 , CR 65(b)
(07 /2019 )
FL Parentage 321
Motion for Immediate
Restraining Order (Ex Parte)
p. 6 of 7
[ ] Pay other professional fees and costs for this case. Amount: $
to (name):
for (purpose):
[ ] Based on the Sexual Assault Allegation, award lawyer’s fees consistent with
RCW 26.09.140. RCW 26.26.760 (12) .
Order (name): to:
Pay my lawyer’s fees for this case. Amount: $
Make payments to (name) :
17. Other temporary orders
[ ] No request.
[ ] (Specify):
Reasons for my requests
18. 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 a parenting plan or residential schedule, also fill out the Information for
Temporary Parenting Plan , form FL All Family 139, and a proposed Parenting Plan , form
FL All Family 140, or Residential Schedule , form FL Parentage 304.
If you are asking for child support, also f ill out the Child Support Worksheets and Financial
Declaration , form FL All Family 131, and file the required financial records. If you or
anyone else has ever received public assistance for any child in this case , also fill out the
Public Assistance Decl aration , form FL All Family 132.
If you are asking to prohibit weapons or order surrender, give your reasons at the end of
this section.
If you are asking to change an earlier temporary order, give the date of the earlier order
and explain how circumstan ces have changed since then.
RCW 26.26 A.470, .465 , CR 65(b)
(07 /2019 )
FL Parentage 321
Motion for Immediate
Restraining Order (Ex Parte)
p. 7 of 7
[ ] Reasons for “Prohibit weapons and order surrender” request (check all that apply):
[ ] (Name): has used, displayed, or threatened to
use a firearm or other dangerous weapon in a felony. (Describ e):
[ ] (Name): previously committed an offense
making him or her ineligible to possess a firearm under RCW 9.41.040. (Describe):
[ ] (Name): ’s possession of firearm presents a
serious and imminent threat (harm that may happen immedi ately) to public health
or safety, or to the health or safety of any individual. (Describe):
Person asking for this order fills out below:
I declare under penalty of perjury under the laws of the state of Washington that the facts I have
provided on this form are true.
Signed at (city and state): Date:
Person asking for this order signs here Print name here
I agree to accept legal papers for this case at (check one):
[ ] my lawyer’s address, listed below.
[ ] the following address (thi s does not have to be your home address):
street address or PO box city state zip
Note: You and the other party/ies may agree to accept legal papers by email under Civil Rule 5 and local court
rules.
(If this address changes before the case ends, y ou must notify all parties and the court clerk in writing. You may
use the Notice of Address Change form (FL All Family 120). You must also update your Confidential Information
form (FL All Family 001 ) if this case involves parentage or child support.)
Lawyer (if any) fills out below:
Lawyer signs here Print name and WSBA No. Date
Lawyer’s street address or PO box city state zip
Email (if applicable):
Warning! Documents filed with the court are available for anyone to see unless they are se aled. Financial,
medical, and confidential reports, as described in General Rule 22, must be sealed so they can only be seen by
the court, the other party, and the lawyers in your case. Seal those documents by filing them separately, using a
Sealed cover sheet (form FL All Family 011, 012, or 013). You may ask for an order to seal other documents.
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