Imperial — Declaration Regarding Ex Parte Notice (FL-06A)

Source: https://www.imperial.courts.ca.gov/system/files/fl-06a.pdf

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL
939 W. Main Street
El Centro, CA 92243

PETITIONER:

RESPONDENT:

DECLARATION REGARDING EX PARTE NOTICE CASE NUMBER:

Other party (or attorney if represented):

a. Name: ___________________________________________

b. Address: _________________________________________

c. Phone Number: ___________________________________

DECLARATION REGARDING NOTICE

1. The undersigned has has not made any prior applications on the same issue in this case
or another case.

2. If there has been another case, fill in the County in which the case is pending:
County: __________________ Case number: _________________.

3. This order will will not result in a change of the status quo.

4. I have given notice to the other party/attorney that on ___________ at __________ in
Date Time
Department ____, I would make an ex parte application. Notice was given by the following
method before 10:00 a.m. on the Court day before the hearing:

Personal Delivery* Fax with confirmation of receipt*

First Class Mail* Telephone

Other (explain):___________________________________________

Date and time I gave notice_____________________________________
(Date) (Time)
*Attach copy of document delivered

Form Approved for Optional Use www.imperial.courts.ca.gov FL-06A (Adopted 01/01/10; Last Revised 01/01/20) DECLARATION REGARDING EX PARTE NOTICE Page 1 of 2

PETITIONER: CASE NUMBER:

RESPONDENT:

5. The other party or their attorney has or has not confirmed receipt of the motion (state

details)

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

6. I have given notice that I would present this application for these orders on___________
at __________ am/pm in Department _______________ of the Superior Court, 939 Main
Street, El Centro, CA.

7. I anticipate the other party will oppose this application. I do not anticipate the
opposing party will oppose this application.

8. The Domestic Violence Protection Act. I have not given notice to the other party or attorney
for the following reasons:

There is a risk of immediate harm to a child or a risk that a child will be removed from
California. Explain:
________________________________________________________________________
________________________________________________________________________

Other-Local Rule 5.1.1(e) Explain:
________________________________________________________________________
________________________________________________________________________

________________________________________________________________________

I declare under penalty of perjury under the laws of the State of California that the foregoing
is true and correct.

Dated: _____________________ ______________________________
Signature of Declarant

Form Approved for Optional Use www.imperial.courts.ca.gov FL-06A (Adopted 01/01/10; Last Revised 01/01/20) DECLARATION REGARDING EX PARTE NOTICE Page 2 of 2