4. REQUEST FOR APPROVAL OF RESTRAINING ORDER. (check all that apply): Do not disturb. No request. Order my spouse not to disturb my peace or the peace of any child listed in Section 1 above. Stay away. No request. Order my spouse not to go onto the grounds of or enter my home, workplace, or school and the daycare or school of any child listed in above. Section 1 Also, not knowingly to go or stay within ______ feet of my home, workplace, or school and the daycare or school of any child listed in above. Section 1 My spouse and I live together. do not live together. (check one): Do not hurt or threaten. No request. Order my spouse not to assault, harass, stalk, or molest me or any child listed in Section 1 above. Do not use, try to use, or threaten to use physical force that would reasonably be expected to cause bodily injury against me or any child listed in above. Section 1 Care of children. No request. Order my spouse not to take the children listed in above out of Washington Section 1 State. Order that the children listed in above will live with me until the hearing. Section 1 Other _________________________________________________________ (specify): Protect property. No request. Order my spouse not to move, take, hide, damage, borrow against, sell or try to sell, or dispose of any property. Order my spouse not to make changes to any medical, health, life, property, or auto insurance policy that covers me or any child named in above. Section 1 Order that ____________________________ shall receive the per-capita and (name): bonus funds for the children. Order that Enrollment hold the per-capita and bonus funds for the children. Other (specify): Other immediate orders. No request. (specify):
4. REQUEST FOR APPROVAL OF RESTRAINING ORDER. (check all that apply): Do not disturb. No request. Order my spouse not to disturb my peace or the peace of any child listed in Section 1 above. Stay away. No request. Order my spouse not to go onto the grounds of or enter my home, workplace, or school and the daycare or school of any child listed in Section 1 above. Also, not knowingly to go or stay within ______ feet of my home, workplace, or school and the daycare or school of any child listed in Section 1 above. My spouse and I (check one): live together. do not live together. Do not hurt or threaten. No request. Order my spouse not to assault, harass, stalk, or molest me or any child listed in Section 1 above. Do not use, try to use, or threaten to use physical force that would reasonably be expected to cause bodily injury against me or any child listed in Section 1 above. Care of children. No request. Order my spouse not to take the children listed in Section 1 above out of Washington State. Order that the children listed in Section 1 above will live with me until the hearing. Other (specify): Protect property. No request. Order my spouse not to move, take, hide, damage, borrow against, sell or try to sell, or dispose of any property. Order my spouse not to make changes to any medical, health, life, property, or auto insurance policy that covers me or any child named in Section 1 above. Order that (name): ____________________________ shall receive the per-capita and bonus funds for the children. Order that Enrollment hold the per-capita and bonus funds for the children. Other (specify): Other immediate orders. No request. (specify): _________________________________________________________
14.0%20Motion%20for%20Restraining%20Order.docx