Free Motion for Temporary Relief - West Virginia

IN THE FAMILY CO URT OF ________________ COUNTY, WEST VIRGINIA. In Re: The Marriage / Children of: _________________________, Petitioner _________________________ _________________________
Add ress

Civil Action No. ____________ and _________________________. Respondent _________________________ _________________________
Add ress

________________
Daytime phone

________________
Daytime phone

MOTION FOR TEMPORARY RELIEF This Motion is being made by: ______________________________________. (Print your name .) NOTICE OF MOTION TO: ______________________________________
(Print the nam e of the o ppo sing party.)

TAKE NOTICE that ____________________________, will come before the Family
(Print your name.)

Court of _________________ County, and make a MOTION for the Court to ORDER certain Temporary Relief. This Motion for Temporary Relief will be made at ____ a.m./p.m. on the ____ day of ___________________, _____. MOTION I, ____________________________, request the Court to Order the following Temporary Relief. (Place an "X " in the blank in fro nt of the relief you wa nt.) 1. ___ 2. ___ Allocate custodial responsibility and time spent with the children . Order a reasonable amount of money for support of the children.

3. ___ Order a reasonable amount of money for spousal support. 4. ___ Order a reasonable amount of money for medical and health care support.

5. ___ Issue a Restraining Order.

SCA -FC-11 2 (12/01)

Motion for Temporary Relief

Page 1 of 2

7. ___ 8. ___

Adopt my Individual Proposed Parenting Plan, a copy of which I have attached to this Motion. Other relief requested: _____________________________________________________

______________________________________________________________________________ _____________________________________________________________________________.

_____________________________________________
(Sign your name before a Notary or Dep uty Circuit Clerk.)

Sworn to before me on the ____ day of __________________, ______.

______________________________
Notary Public / Other Official Commission expires:______________________.

CERTIFICATE OF SERVICE State of West Virginia County of _______________________________ I, ____________________________, the person making this Motion for Temporary Relief, mailed the Motion and Notice, together with any and all attached documents, by first class United States Mail, postage paid, to _________________________, at the address of _______________________________________________, on the ____ day of __________________, _____.

___________________________ Signature

____________ Date

SCA -FC-11 2 (12/01)

Motion for Temporary Relief

Page 2 of 2