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IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff vs. ____________________, Defendant Case No. _______________

MOTION TO EXTEND FINAL PROTECTION FROM ABUSE ORDER The undersigned party in the above captioned matter moves the court to set a hearing to extend the protection from abuse order entered on ___________________, ______. In support of the motion, I request extension of the order because:

The name, current address and telephone number of the other party where the order for hearing may be served is:

WHEREFORE, I request that the court extend its final order and ask for any other relief the court deems just and equitable. I also request that the court set this matter for hearing. ____________________________________ Movant Date of hearing: Time: Place: ____________________ ____________________ ____________________ ____________________ ____________________ ____________________________________ ____________________________________ Movant's address ____________________________________ Movant's phone number

NOTE:

DO NOT DISCLOSE THE MOVANT'S ADDRESS IF SUCH LOCATION MUST REMAIN CONFIDENTIAL FOR THE PROTECTION OF THE PLAINTIFF, PLAINTIFF' CHILD(REN) OR THE MINOR CHILD(REN) RESIDING WITH S THE PLAINTIFF!

07/10/04

CERTIFICATE OF MAILING I hereby certify that I served a copy of the foregoing motion to extend a final protection from abuse order by mailing it on the _____ day of _____________, _____, as certified mail return receipt requested to the following name and address: ______________________________________________ ______________________________________________ ______________________________________________ _______________________________________ Movant

07/10/04