_____________________________________,
Petitioner,
v.
_____________________________________,
Respondent.
(check and complete applicable alternatives)
[ ] modify paragraph ____ of the temporary domestic order as follows:
______________________________________________________________
______________________________________________________________.
[ ] terminate the temporary domestic order because:
______________________________________________________________
______________________________________________________________.
[ ] terminate or modify the temporary child support because:
_______________________________________________________________
_______________________________________________________________.
[ ] modify the temporary division of income and debts of the parties because2:
_______________________________________________________________
_______________________________________________________________.
[ ] dismiss the temporary restraining order because3:
________________________________________________________________
________________________________________________________________.
[ ] terminate or modify the temporary wage withholding order because:
________________________________________________________________
________________________________________________________________.
__________________________________
Signature
__________________________________
Name (printed)
__________________________________
(Address
__________________________________
Telephone number
I hereby certify that on this ____ day of _____________, _______ this motion
was
[mailed by United States mail, postage prepaid, and addressed to:
Name: ________________________________
Address: ________________________________
City, state and zip code: ________________________________]
[faxed by ________________________ (name of person who faxed) to
_________________ (defendant or defendant's attorney). The transmission
was reported as complete and without error. The time and date of the
transmission was _____ (a.m) (p.m) on _______________ (date).]
[e-mailed by ________________________ (name of person who transmitted) to
______________________ at _________________ (electronic address of
recipient) who agreed to service in this manner. The transmission was
successful. The time and date of the transmission was _________ (a.m)
(p.m.) on _____________________ (date).]
________________________________
Signature of attorney
________________________________
Date of signature
If this notice was served by a person other than an
attorney, the following must also be completed and filed
with the court:
I declare under penalty of perjury that a copy of this motion was served by
[mail] [fax] [electronic transmission] as described above on this ____ day of
__________________, ________.
__________________________________________
Signature of person who made service
Subscribed and sworn to before me
this ___ day of _____________, _____.
______________________________
Judge, notary or other officer
authorized to administer oaths
______________________________
Official title
_______________________________
Signature
_______________________________
Date of signature
2. If a court order of temporary division of income and debts is being challenged, you must complete an "interim income and expense" form and file it with the court at
the time you file this response.
3. If you believe that your spouse may injure you or cause
some other harm to you, your children or other
household member, you may file a petition for a
temporary restraining order or you may file a "Petition
for Order for Protection from Domestic Abuse".
[Approved, effective November 1, 2000 until November 1, 2001; approved, effective
November 1, 2001.]