Fill and Sign the Use This Form in Marriagedomestic Partnership Cases Only

RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 1 of 9 Superior Court of Washington, County of _______________ In re the marriage / domestic partnership of: Petitioner (person who started this case) : And Respondent (other spouse / partner) : No. Motion for Immediate Restraining Order (Ex Parte) (MTSC) Motion for Immediate Restraining Order (Ex Parte) Use this form in marriage/domestic partnership cases only. For other cases, use FL Parentage 321, FL Non -Parent 421, or FL Modify 621, depending on the type of case . To both parties: Deadline! Your papers 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 c onsider 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 t heir lawyers; AND  Go to the hearing. The court may not allow you to testify at the motion 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 Divorce 222). 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 th e Immediate Restraining Order personally served (by someone else) on the other party. 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 or Child Support Worksheets . If the court grants an Immediate Restraining Order without notice to you, you can fil e a motion to change or terminate it before the hearing date. (Civil Rule 65(b).) There is no pattern form for that motion. RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 2 of 9 1. I am the (check one): [ ] Petitioner. [ ] Respondent. I am asking for an Immediate Restraining Order against my spous e/domestic partner. [ ] I want my children 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 my children. W ithout this Order, my children or I could be hurt or suffer damage or loss immediately. This harm could be irreparable. (Explain how you or your children could be harmed beyond repair): (If you need additional space use the Declaratio n form FL All Family 135.) 3. Notice (check one): [ ] I should not have to notify the other side in advance that I am filing this Motion because my children 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 side that I am asking for an Immediate Restraining Order . (Describe any steps taken to give your spouse/domestic partner or their lawyer notice of this Motion): RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 3 of 9 4. Court hearing request I ask the court to approve an Immediate Restraining Order now, and hold a hearing within 14 days to consider all of my requests for temporary orders listed below. I will have my spouse/domestic partner served with notice of the hea ring so the court can hear his/her side. [ ] Other: 5. Active duty military (The federal Service member s Civil Relief Act covers:  Army, Navy, Air Force, Marine Corps, and Coast Guard members on active duty ;  National Guard or Reserve members under a c all 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.) [ ] My spouse/domestic partner is not covered by the state or federal Service Members ’ Civil Relief Acts. [ ] My spouse/domestic partner is covered by the [ ] state [ ] federal Service Members ’ Civil Relief Act. [ ] For persons covered only 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 appr ove 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 my spouse/domestic partner not to disturb my peace or the peace of any child listed in 1. 7. Stay away [ ] No request. [ ] Order my spouse/domestic partner n ot to go onto the grounds of or enter my home, wor kplace, 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. My spouse/domestic partner and I (check one): [ ] live together. [ ] do not live together. RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 4 of 9 8. Do not hurt or threaten [ ] No request. [ ] Order my spouse/domestic partner not to:  Assault, harass, stalk , or molest me or any child listed in 1; or  Use, try to use, or threaten to use physical fo rce 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, the court must consider if weapons restrictions are required by state law; f ederal law may also prohi bit the Restrained Person from possessing firearms or ammunition. 9. Surrender weapons [ ] No request. [ ] Order my spouse/domestic partner to immediately surrender any firearms and other dangerous weapons that he/she possesses t o (check one): [ ] the police chief or sheriff. [ ] his/her lawyer. [ ] other person (name): . 10. Care and safety of children until the hearing [ ] No request. [ ] Order my spouse/domestic partner not to take the children listed in 1 out of Washington State. [ ] Order that the children listed in 1 will live with (check one): [ ] me [ ] my spouse/ domestic partner until the hearing. [ ] Other (specify): 11. Protect property [ ] No request. [ ] Order (check one ): [ ] my spouse/domestic partner [ ] both parties not to move, take, hide, damage, borrow against, sell or try to sell, or get rid of any property, unless it is a usual business practice or to pay for basic necessities. (If the court makes this order, both spouses/domestic partners must notify each other about any expenses that are out of the ordinary.) 12. Do not change insurance [ ] No request. [ ] Order (check one ): [ ] my spouse/domestic partner [ ] both parties not to make changes to any medical, health, life, or auto insura nce policy that covers either spouse/domestic partner or any child listed in 1. That means s/he must not transfer, cancel, borrow against, let expire, or change the beneficiary of any policy. RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 5 of 9 13. 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 apply) : 14. Extend immediate orders Extend the immediate orders I asked for above to stay in effect until the case is done. 15. Proh ibit weapons and order surrender [ ] No request. [ ] Order my spouse/domestic partner:  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 county sheriff. [ ] his/her lawyer. [ ] other person (name): . 16. Care and safety of children (check all that apply) [ ] No request. [ ] Approve the parenting plan proposed by [ ] me [ ] my spouse/domestic partner. [ ] Order my spouse/domestic partner not to take the children listed in 1 out of Washington State. [ ] Appoint a person to investigate and report t o the court about what is in the children’s EHVWLQWHUHVWDQGRUGHUZKRZLOOSD\WKLVSHUVRQ¶VIHHV7KLVSHUVRQVKRXOGEHDQ (check one): [ ] Guardian ad Litem (GAL) or Evaluator/Investigator as chosen by the court. [ ] Guardian ad Litem (GAL). [ ] Evaluator/Investigator. [ ] (Name): [ ] Other : 17. Provide support [ ] No request. [ ] Order child support according to the Washington state child support schedule. RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 6 of 9 [ ] Order (check one): [ ] me [ ] my spouse/domestic partner to pay spousal support (maintenance/alimony) in the amount of: $ every month until (date or event): . 18. Family home [ ] No request. [ ] Stay in the home [ ] I want continue living in the family home. [ ] My spouse/domestic partner may continue living in t he family home. [ ] Move out Order my spouse/domestic partner to move out of the family home by (date) : . 19. Use of property [ ] No request. [ ] Order that I can possess and use (specify): [ ] property in my possession now . [ ] vehicle(s): [ ] other: [ ] Order that my spouse/domestic partner can possess and use (specify): [ ] property in his/her possession now . [ ] vehicle(s): [ ] other : 20. Household expenses [ ] No request. [ ] Order household expenses to be paid as follows : Expense Who should pay [ ] First Mortgage [ ] Petitioner [ ] Respondent [ ] Second Mortgage/Line of Credit [ ] Petitioner [ ] Respondent [ ] Rent or lease payment [ ] Petitioner [ ] Respondent [ ] Utilities [ ] Petitioner [ ] Respondent [ ] Homeowner’s Insurance [ ] Petitioner [ ] Respondent [ ] Property Taxes [ ] Petitioner [ ] Respondent [ ] Vehicle (specify): [ ] Petitioner [ ] Respondent [ ] Vehicle (specify): [ ] Petitioner [ ] Responde nt RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 7 of 9 Expense Who should pay [ ] Child Care [ ] Petitioner [ ] Respondent [ ] Other: [ ] Petitioner [ ] Respondent 21. Divide debts [ ] No request. [ ] Order my spouse/domestic partner and me to: [ ] Each be responsible for his/her own future debts, including deb t from credit cards, loans, security interest, and mortgages. [ ] Divide our debts as follows (list debts and who will pay each one): Debt (describe) Who should pay 1. [ ] Petitioner [ ] Respondent 2. [ ] Petitioner [ ] Respondent 3. [ ] Petitione r [ ] Respondent 4. [ ] Petitioner [ ] Respondent 5. [ ] Petitioner [ ] Respondent 6. [ ] Petitioner [ ] Respondent 22. Pay for insurance [ ] No request. [ ] Pay insurance premiums as follows (list policies and who should pay each one): Policy (describe) Who should pay 1. [ ] Petitioner [ ] Respondent 2. [ ] Petitioner [ ] Respondent 3. [ ] Petitioner [ ] Respondent 23. Pay fees and costs [ ] No request. [ ] Order my spouse/domestic partner to: [ ] Pay my lawyer’s fe es for this case. Amount: $ Make payments to (name) : [ ] Pay other professional fees and costs for this case. Amount: $ to (name): for (purpose): RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 8 of 9 24. Other temporary orders [ ] No request. [ ] (Specify):  Reasons for my requests : 25. 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, also fill out the Information for Temporary Parenting Plan , form FL All Family 139, and a proposed Parenting Plan , form FL All Family 140.  If you are asking for child support, also fill out the Child Support Worksheets . If you have received public assistance for any child in this case, also fill out the Public Assistanc e Declaration , form FL All Family 132.  If you are asking for any order involving money (including child support), also fill out the Financial Declaration , form FL All Family 131, and file the required financial records.  If you are asking to prohibit weap ons 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 circumstances have changed since then. [ ] 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. (Describe): RCW 26.09.060, CR 65(b) Mandatory Form (07/2019 ) FL Divorce 221 Motion for Immediate Restraining Order (Ex Parte) p. 9 of 9 [ ] (Name): previously committed an offens e 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 immediately) 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 (this does not have to be your home address): street addres s 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, you must notify all parties and the court clerk in writing. Yo u 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 Prin t 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 sealed. Financial, medical, and confidential reports, as descr ibed 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 separat ely, using a Sealed cover sheet (form FL All Family 011, 012, or 013). You may ask fo r an order to seal other documents.