Mendocino — MMC-121

Source: https://www.mendocino.courts.ca.gov/system/files/forms-and-filings/mmc-121.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 MENDOCINO UKIAH Courthouse TEN MILE Branch Court 100 North State Street 700 South Franklin Street Ukiah, CA 95482 Fort Bragg, CA 95437 In re:

CASE NUMBER:

EX PARTE DATE:
DECLARATION re: NOTICE upon EX PARTE TIME:
APPLICATION for ORDERS LOCATION:

In most cases, you must notify all parties that you are requesting a court order. This is called “notice”. Regardless of how you notice the other side that you are requesting a court order, copies of the documents that you have filed with the court MUST be provided to the other party pursuant to local rules as soon as is reasonably practicable, but no later than 10 a.m. the court day prior to the ex parte review. I, the undersigned, declare:

1. I am the (choose one): self-represented Petitioner/Plaintiff self-represented Respondent/Defendant attorney for the Child(ren) attorney for the Petitioner/Plaintiff attorney for the Respondent/Defendant

2. Pursuant to CRC 3.1203 and 3.1204, I have informed of this ex parte request for (name of person you notified) and that s/he will have to (type of relief sought)

appear before the court on the above listed date and time if s/he objects to this ex parte request. 3. Notice was given by (check all that apply): Date Time Telephone Notification (no later than 10:00 a.m. the court day before ex parte appearance): at am/pm Personal Delivery (no later than 10:00 a.m. the court day before ex parte appearance): at am/pm First Class Mail (copy of ex parte application mailed at least 5 days before ex parte appearance): at am/pm at (address) Fax Text Email Other Social Media Delivery at am/pm at (Attach printed email or social media page, text (date) (time) (fax number) screen shot or proof showing fax was received).

If notice was provided later than 10:00 a.m. the court day before the ex parte appearance, explain why:

4. I received the following response to the above notice: See attached written response. Oral response received:
5. I have not given notice of this request for ex parte orders because (attach additional pages if necessary): Notice would frustrate the purpose of the orders sought (explain below). Great or irreparable injury will result to me before orders can be issued and/or I fear for my safety (explain below). A good faith effort was made to notify the opposing party, but notice was unable to be given (explain attempts below). The opposing party agrees to the orders requested. No significant burden or inconvenience to the opposing party will result from the orders requested (explain below). Other (explain): I declare under penalty of perjury that the foregoing is true and correct.

Date: Signed:

MMC-121 (rev 0126)